THERAPY WITH AKILAH, LLC

NOTICE OF PRIVACY PRACTICES

Effective Date: January 1, 2025

This Notice describes how medical and mental health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

OUR COMMITMENT TO YOUR PRIVACY

Therapy with Akilah, LLC is committed to protecting the privacy of your health information. We are required by law to:

  • Maintain the privacy of your protected health information (PHI)

  • Provide you with this Notice of our legal duties and privacy practices

  • Follow the terms of the Notice currently in effect

  • Notify you if we are unable to agree to a requested restriction

  • Accommodate reasonable requests to communicate health information by alternative means or locations

This Notice applies to all records of your care maintained by Therapy with Akilah, LLC, whether created by our practice or your previous healthcare providers.

WHAT IS PROTECTED HEALTH INFORMATION (PHI)?

Protected Health Information (PHI) includes any information about your:

  • Past, present, or future physical or mental health condition

  • Healthcare services you receive

  • Payment for healthcare services

Examples include: diagnosis, treatment notes, appointment records, billing information, and any identifying information (name, address, phone number, email, etc.) combined with health information.

HOW WE MAY USE AND DISCLOSE YOUR PHI

1. FOR TREATMENT

We may use and disclose your PHI to provide, coordinate, or manage your mental health care and related services.

Examples:

  • Maintaining clinical notes about your therapy sessions

  • Coordinating care with other healthcare providers (with your authorization)

  • Consulting with other mental health professionals about your treatment

  • Using telehealth platforms (SimplePractice, Doxy.me) to conduct therapy sessions

2. FOR PAYMENT

We may use and disclose your PHI to obtain payment for services provided.

Examples:

  • Billing you or your insurance company for therapy services

  • Submitting claims to your insurance company

  • Verifying insurance coverage and benefits

  • Processing payments through our client portal (SimplePractice)

3. FOR HEALTHCARE OPERATIONS

We may use and disclose your PHI for healthcare operations necessary to run our practice.

Examples:

  • Quality assessment and improvement activities

  • Business planning and management

  • Training and supervision activities

  • Compliance and auditing activities

USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION

For uses and disclosures beyond treatment, payment, and healthcare operations, we will obtain your written authorization. You may revoke your authorization at any time by submitting a written request.

We will not use or disclose your PHI without your authorization for:

  • Marketing purposes

  • Sale of your information

  • Psychotherapy notes (beyond what's needed for treatment, payment, or operations)

  • Most uses and disclosures for purposes other than treatment, payment, or operations

USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

We are permitted or required by law to use or disclose your PHI without your authorization in the following circumstances:

1. When Required by Law

When federal, state, or local law requires disclosure.

2. For Public Health Activities

To report abuse, neglect, or domestic violence as required by law.

3. To Avert a Serious Threat to Health or Safety

When necessary to prevent or lessen a serious and imminent threat to your health and safety or the health and safety of another person or the public.

4. For Law Enforcement Purposes

When required by court order, subpoena, or other legal process.

5. For Legal Proceedings

In response to a court order, administrative order, subpoena, or other lawful process.

6. To Coroners, Medical Examiners, and Funeral Directors

For identification purposes, determination of cause of death, or other duties as authorized by law.

7. For Workers' Compensation

When necessary to comply with workers' compensation laws.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding your protected health information:

1. RIGHT TO INSPECT AND COPY

You have the right to inspect and obtain a copy of your PHI contained in your clinical record. To request copies of your records, submit a written request to:

Akilah J. Pierre, LMFT
Therapy with Akilah, LLC
5049 Copley Road
Philadelphia, PA 19144
Email: akilah@therapywithakilah.com

We may charge a reasonable fee for copying and mailing your records as permitted by law.

Exceptions: We may deny your request in certain limited circumstances as permitted by law. If denied, you have the right to request a review of the denial.

2. RIGHT TO AMEND

If you believe that information in your record is incorrect or incomplete, you may request that we amend it. Your request must be in writing and must provide a reason for the amendment.

We may deny your request if:

  • The information was not created by us

  • The information is not part of the records we maintain

  • The information is accurate and complete

If we deny your request, you have the right to submit a statement of disagreement.

3. RIGHT TO AN ACCOUNTING OF DISCLOSURES

You have the right to request an "accounting of disclosures" – a list of certain disclosures we have made of your PHI. This does not include disclosures for treatment, payment, healthcare operations, or disclosures made directly to you or with your authorization.

Your request must be in writing and must state the time period for which you want an accounting (not to exceed six years).

4. RIGHT TO REQUEST RESTRICTIONS

You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. You also have the right to request limits on disclosures to persons involved in your care.

We are required to agree to your request if:

  • The disclosure is to a health plan for payment or operations (not treatment)

  • The information pertains to services you paid for out-of-pocket in full

We are not required to agree to other requested restrictions. If we do agree, we will comply with your request unless the information is needed to provide emergency treatment.

5. RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS

You have the right to request that we communicate with you about your PHI by alternative means or at alternative locations.

Example: You may request that we contact you only at your work phone number or via email instead of your home phone.

Your request must be in writing and must specify how or where you wish to be contacted. We will accommodate reasonable requests.

6. RIGHT TO A PAPER COPY OF THIS NOTICE

You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically. You may request a copy by contacting us at the information below.

7. RIGHT TO BE NOTIFIED OF A BREACH

You have the right to be notified if we discover a breach of your unsecured PHI.

SPECIAL PROTECTIONS FOR CERTAIN TYPES OF INFORMATION

Psychotherapy Notes

Psychotherapy notes (personal notes kept separate from your medical record) have special protections. We will not use or disclose these notes without your written authorization except for:

  • Your treatment by our practice

  • Training programs for mental health professionals

  • Defending ourselves in legal proceedings brought by you

  • Situations required by law

Substance Abuse Treatment Records

If you receive substance abuse treatment services, federal law (42 CFR Part 2) provides additional privacy protections for those records.

HIV/AIDS Information

Information about HIV/AIDS status receives special protection under state and federal law and generally requires your specific written authorization for disclosure.

TELEHEALTH SERVICES

Therapy with Akilah, LLC provides services exclusively via telehealth (online therapy). We use HIPAA-compliant platforms for video sessions:

  • SimplePractice (primary platform for client portal, scheduling, and video sessions)

  • Doxy.me (alternative HIPAA-compliant video platform)

Security measures:

  • All platforms are HIPAA-compliant and use encryption

  • Video sessions are not recorded unless you provide written consent

  • We use secure, encrypted email (Gmail with encryption) for limited communications

Your responsibilities:

  • Use a private location for telehealth sessions

  • Use a secure internet connection (not public Wi-Fi)

  • Protect your login credentials for the client portal

Limitations:

  • Technology can fail; we have backup procedures in place

  • Unauthorized access is possible if you do not secure your devices

  • We are not responsible for security breaches on your end

EMAIL AND TEXT MESSAGE COMMUNICATIONS

Email: We use email (Gmail) for administrative communications such as appointment confirmations and general information. Email is not completely secure. We will not discuss clinical information via unencrypted email unless you specifically request it and acknowledge the risks.

Text Messages: We may send appointment reminders via text message through SimplePractice. These messages do not contain clinical information.

Your consent: By providing your email address and phone number, you consent to receive administrative communications via these methods. You may withdraw consent at any time.

CLIENT PORTAL

We use SimplePractice as our secure client portal. Through the portal, you can:

  • Schedule and manage appointments

  • Complete intake forms and assessments

  • View and pay invoices

  • Access session notes (if provided)

  • Communicate securely with your therapist

The portal is password-protected and HIPAA-compliant. You are responsible for maintaining the confidentiality of your login credentials.

MINORS AND PERSONAL REPRESENTATIVES

If you are a minor (under 18 in most states), your parent or legal guardian generally has the right to access your health information. However, in certain circumstances, we may provide services to minors without parental consent as permitted by state law, and in those cases, we may not disclose information to parents without the minor's consent.

If you have a personal representative (such as a legal guardian or someone with power of attorney), that person may exercise your rights regarding your PHI.

STATE-SPECIFIC PRIVACY RIGHTS

If you are a minor (under 18 in most states), your parent or legal guardian generally has the right to access your health information. You may have additional privacy rights under the laws of Pennsylvania, New Jersey, or Washington, D.C. (the states where we are licensed to practice).

Pennsylvania: Additional protections exist for mental health records under PA law.
New Jersey: Additional protections exist for mental health and substance abuse records.
Washington, D.C.: Additional protections exist for mental health records.

If you have questions about your state-specific rights, please contact us., in certain circumstances, we may provide services to minors without parental consent as permitted by state law, and in those cases, we may not disclose information to parents without the minor's consent.

If you have a personal representative (such as a legal guardian or someone with power of attorney), that person may exercise your rights regarding your PHI.

OUR RESPONSIBILITIES

We are required by law to:

  • Maintain the privacy and security of your PHI

  • Notify you promptly if a breach occurs that may have compromised your information

  • Follow the duties and privacy practices described in this Notice

  • Not use or share your information other than as described here unless you give us written permission

We will not:

  • Use or share your information for marketing or advertising purposes

  • Sell your information to third parties

  • Share your information with your employer (unless you work for an employee assistance program that referred you)

CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time. Any changes will apply to all PHI we maintain. When we make significant changes, we will:

  • Post the new Notice on our website (www.therapywithakilah.com)

  • Make copies available upon request

  • Notify clients at their next session or via email

The effective date of the Notice is listed at the top of this document.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

Therapy with Akilah, LLC:
Akilah J. Pierre, LMFT
5049 Copley Road
Philadelphia, PA 19144
Email: akilah@therapywithakilah.com
Phone: 610-227-5071

OR

U.S. Department of Health and Human Services:
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints

You will not be penalized or retaliated against for filing a complaint.

CONTACT INFORMATION

If you have questions about this Notice or about our privacy practices, please contact:

Akilah J. Pierre, LMFT
Therapy with Akilah, LLC
5049 Copley Road
Philadelphia, PA 19144
Email: akilah@therapywithakilah.com
Phone: 610-227-5071
Website: www.therapywithakilah.com