Breaking Every Chain Counseling, LLC
NOTICE OF PRIVACY PRACTICES
Breaking Every Chain Counseling, LLC d.b.a. BECC
Mental Health Counseling Services
Effective Date: January 1, 2026
1. INTRODUCTION
This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
This Notice is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections for your protected health information (PHI). This Notice also complies with Indiana state laws regarding the confidentiality of mental health records under IC 16-39 and IC 25-23.6.
2. UNDERSTANDING YOUR HEALTH RECORD/INFORMATION
Each time you visit our practice, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your Protected Health Information (PHI), serves as a:
Basis for planning your care and treatment
Means of communication among the many health professionals who contribute to your care
Legal document describing the care you received
Means by which you or a third-party payer can verify that services billed were actually provided
Tool in educating health professionals
Source of data for medical research
Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve
3. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding the health information we maintain about you:
3.1 Right to Inspect and Copy
You have the right to inspect and copy your health information, including medical and billing records used to make decisions about your care. To inspect and copy your health information, you must submit your request in writing to Privacy Officer, Breaking Every Chain Counseling, LLC d.b.a. BECC. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request, in accordance with Indiana Code 16-39-5.
We may deny your request to inspect and copy in certain limited circumstances. If you are denied access to health information, in most cases you may request that the denial be reviewed. A licensed healthcare professional chosen by the practice will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
3.2 Right to Amend
If you believe that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the practice. To request an amendment, your request must be made in writing and submitted to Privacy Officer, Breaking Every Chain Counseling, LLC d.b.a. BECC. You must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
Was not created by us, unless the person or entity that created the information is no longer available to make the amendment
Is not part of the health information kept by or for the practice
Is not part of the information which you would be permitted to inspect and copy
Is accurate and complete
3.3 Right to an Accounting of Disclosures
You have the right to request an accounting of certain disclosures of your health information made by us during the six years prior to your request. This accounting will not include disclosures of information:
For treatment, payment, and health care operations
Made to you
Made pursuant to your authorization
Made for national security or intelligence purposes
Made to correctional institutions or law enforcement officials
That occurred prior to April 14, 2003
To request this accounting of disclosures, you must submit your request in writing to Privacy Officer, Breaking Every Chain Counseling, LLC d.b.a. BECC. Your request must state a time period which may not be longer than six years. The first accounting you request within a 12-month period will be free. For additional requests within that same 12-month period, we may charge you for the reasonable costs of providing the accounting.
3.4 Right to Request Restrictions
You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend.
We are not required to agree to your request except in one situation: if you ask us not to disclose information to your health plan for payment or health care operations purposes, and the information pertains solely to a health care item or service for which you, or someone on your behalf, has paid us in full out-of-pocket, we must honor that request.
To request restrictions, you must make your request in writing to Privacy Officer, Breaking Every Chain Counseling, LLC d.b.a. BECC. In your request, you must tell us what information you want to limit, whether you want to limit our use or disclosure or both, and to whom you want the limits to apply.
3.5 Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to Privacy Officer, Breaking Every Chain Counseling, LLC d.b.a. BECC. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
3.6 Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy.
To obtain a paper copy of this Notice, contact Privacy Officer, Breaking Every Chain Counseling, LLC d.b.a. BECC.
3.7 Right to be Notified of a Breach
You have the right to be notified in the event that we (or a Business Associate) discover a breach of unsecured protected health information involving your information.
4. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
The following categories describe different ways that we use and disclose health information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
4.1 For Treatment
We may use health information about you to provide you with mental health treatment or services. We may disclose health information about you to doctors, nurses, technicians, office staff, or other personnel who are involved in taking care of you and your health. For example, we might disclose information to a psychiatrist for medication management, or to another therapist if we refer you for specialized treatment. Different departments or staff within our practice may also share information about you in order to coordinate your care, such as prescriptions, lab work, or clinical assessments.
4.2 For Payment
We may use and disclose health information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about counseling services you received so your health plan will pay us or reimburse you for the services. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
4.3 For Health Care Operations
We may use and disclose health information about you for health care operations. These uses and disclosures are necessary to run the practice and ensure that all of our patients receive quality care. For example, we may use health information to:
Review the quality and effectiveness of our services
Evaluate the performance of our staff in caring for you
Train students and staff
Conduct compliance reviews and business planning
Contact you to remind you of appointments
4.4 Appointment Reminders
We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or medical care at the practice.
4.5 Treatment Alternatives
We may use and disclose health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
4.6 Individuals Involved in Your Care or Payment for Your Care
We may release health information about you to a friend or family member who is involved in your medical care or helps pay for your care. We may also give information to someone who helps pay for your care. Additionally, we may disclose health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location. You have the right to agree or object to these disclosures, or to request restrictions.
4.7 As Required by Law
We will disclose health information about you when required to do so by federal, state, or local law, including Indiana state statutes.
4.8 To Avert a Serious Threat to Health or Safety
We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. However, any disclosure would only be to someone able to help prevent the threat. This is consistent with Indiana law regarding the duty to warn identifiable third parties of imminent danger.
5. SPECIAL SITUATIONS
5.1 Military and Veterans
If you are a member of the armed forces, we may release health information about you as required by military command authorities. We may also release health information about foreign military personnel to the appropriate foreign military authority.
5.2 Workers' Compensation
We may release health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness, in accordance with Indiana Workers' Compensation laws.
5.3 Public Health Risks
We may disclose health information about you for public health activities. These activities generally include the following:
To prevent or control disease, injury, or disability
To report births and deaths
To report child abuse or neglect, as required by Indiana Code 31-33-5
To report adult abuse, neglect, or exploitation, as required by Indiana Code 12-10-3
To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence
To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
5.4 Health Oversight Activities
We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, licensure actions, and disciplinary actions by the Indiana Professional Licensing Agency or other governmental entities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
5.5 Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested, in accordance with Indiana Trial Rules.
5.6 Law Enforcement
We may release health information if asked to do so by a law enforcement official:
In response to a court order, subpoena, warrant, summons, or similar process
To identify or locate a suspect, fugitive, material witness, or missing person
About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement
About a death we believe may be the result of criminal conduct
About criminal conduct at the practice
In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime
5.7 Coroners, Medical Examiners, and Funeral Directors
We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary to carry out their duties.
5.8 Research
Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process that evaluates a proposed research project and its use of health information, trying to balance the research needs with patients' need for privacy. Before we use or disclose health information for research, the project will have been approved through this research approval process.
6. INDIANA-SPECIFIC PRIVACY PROTECTIONS
6.1 Mental Health Records Under Indiana Law
Indiana law (IC 16-39-2-8 and IC 25-23.6-6-1) provides additional protections for mental health and substance abuse treatment records. These records may not be disclosed without your written authorization except:
To practitioners, providers, or facilities providing treatment
When required by court order
For reporting child abuse or neglect
To avert imminent danger to the patient or others
As otherwise authorized by Indiana law
6.2 Minors' Rights Under Indiana Law
Under Indiana Code 16-36-1, minors may consent to mental health treatment without parental consent in certain circumstances. When a minor has consented to treatment independently, we will not disclose information to parents or guardians without the minor's authorization, except as required by law or in emergency situations where there is a serious threat to the minor's health or safety.
6.3 Duty to Warn
Indiana law imposes a duty to warn identifiable third parties when a patient presents a serious and imminent threat of harm. We may disclose protected health information to the extent necessary to warn the intended victim and law enforcement authorities when we determine that a patient poses such a threat.
7. OTHER USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
8. PSYCHOTHERAPY NOTES
Psychotherapy notes are notes recorded by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session. These notes are kept separate from the rest of your medical record. We will not use or disclose your psychotherapy notes without your written authorization, except for the following purposes: your treatment, to train our staff, to defend ourselves in legal proceedings brought by you, where required by law, to avert a serious and imminent threat to public health or safety, to a health oversight agency for lawful oversight of the originator of the psychotherapy notes, or for the lawful activities of a coroner or medical examiner.
9. OUR RESPONSIBILITIES
We are required by law to maintain the privacy of your health information and to provide you with this Notice of our legal duties and privacy practices with respect to your health information.
We are required to abide by the terms of this Notice currently in effect.
We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all health information that we maintain. If we make material changes to our privacy practices, we will provide you with a revised Notice either by mail or electronically, and will post the revised Notice in our office and on our website (if applicable).
10. CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in our office. The Notice will contain the effective date on the first page.
11. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact:
Privacy Officer Breaking Every Chain Counseling, LLC d.b.a. BECC 1617 Montcalm Street, Indianapolis, IN 46202 (317) 419-3443 frontoffice@beccindy.com
To file a complaint with the Department of Health and Human Services:
Office for Civil Rights U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 1-877-696-6775 www.hhs.gov/ocr/privacy/hipaa/complaints/
You will not be penalized or retaliated against for filing a complaint.
12. CONTACT INFORMATION
If you have any questions about this Notice or would like further information concerning your privacy rights, please contact:
Privacy Officer Breaking Every Chain Counseling, LLC d.b.a. BECC 1617 Montcalm Street, Indianapolis, IN 46202 (317) 419-3443 frontoffice@beccindy.com