Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.

Since I am my own compliance officer, please direct all questions about this notice to me.

EFFECTIVE DATE OF THIS NOTICE: This notice went into effect on November 1, 2022.

I. MY PLEDGE REGARDING HEALTH INFORMATION.

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. I will only release information in accordance with state and federal laws and the ethics of the counseling profession. This notice applies to all of the records of your care generated by me. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

a. Make sure that Protected Health Information (“PHI”) that identifies you is kept private. This includes mental health and billing records.

b. Give you this notice of my legal duties and privacy practices with respect to health information.

c. Follow the terms of the Notice that is currently in effect.

I can change the terms of this Notice at anytime, and such changes will apply to all information I have about you. The new Notice will be available upon request.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.

Providing treatment services, collecting payment and conducting healthcare operations are necessary activities for quality care. State and federal laws allow us to use and disclose your health information for these purposes. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories below:

a. For Treatment Payment or Health Care Operations: Federal privacy rules (regulations) allow me as your health care provider to use or disclose your personal health information without your written authorization for purposes of running my practice, improving your care, carrying out my treatment of you, and contacting you when necessary.

b. I may also disclose your protected health information for the treatment activities of any health care provider without your written authorization. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between myself and other health care providers in the context of a crisis or emergency (ex. the crisis line counselor you called reached out to me) and referrals of a patient for health care from one health care provider to another. For example, a health care provider treating you consults with another health care provider about your overall condition, the treating health care provider would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist in the diagnosis and treatment of your condition.

c. Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order.

d. Other uses and disclosures in health care

Business associates. I may hire other businesses to do some jobs for me. Under the law, they are called my “business associates.” Examples may include a copy service to make copies of your health records, a practice management software that tracks client information, and a billing service to figure out, print, and mail my bills. These business associates need to receive some of your PHI to do their jobs properly. To protect your privacy, they have agreed in their contracts with me to safeguard your information just as I do.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION.

Session Notes: I do keep “Session notes” and any use or disclosure of such notes requires your Authorization EXCEPT when the use or disclosure is:

a. For my use in treating you.

b. For purposes of training, consultation or supervision to help me improve my clinical skills in providing care and treatment.

c. For my use in defending myself in legal proceedings instituted by you.

d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.

e. Required by law and the use or disclosure is limited to the requirements of such law.

f. Required by law for certain health oversight activities pertaining to the originator of the session notes.

g. Required by a coroner who is performing duties authorized by law.

h. Required to help avert a serious threat to the health and safety of others.

Marketing Purposes. As a health care provider, I will not use or disclose your PHI for marketing purposes.

Sale of PHI. As a health care provider, I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION.

Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

a. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

b. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

c. For health oversight activities, including audits and investigations.

d. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

e. For law enforcement purposes, including reporting crimes occurring in the premises.

f. To coroners or medical examiners, when such individuals are performing duties authorized by law.

g. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.

h. For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.

i. Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.

V. FOR CERTAIN HEALTH INFORMATION, YOU HAVE THE OPPORTUNITY TO SHARE YOUR CHOICES.

Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOUR RIGHTS.

You have the following rights with respect to your PHI:

a. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

b. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

c. The Right to See and Get Copies of Your PHI. You have the right to get an electronic (flat fee of $6.50 per request) or paper copy (fee for such a copy is $0.30 a page) of your sessions notes and other information on your chart that I have about you. I will provide you with a copy of your record, or a treatment summary of it, if you agree to receive a summary, within 30 days of receiving your written request. I generally do not recommend that you get a copy of your records, because the copy might be viewed inadvertently by others. I will be happy to review the records with you or provide a summary to you.

d. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, consultations, supervision, training, treatment alternatives, payment, health care operations, or for which you provided me with an Authorization (release of information). I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last 2 years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you $6.50 for each additional request.

e. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

f. The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.

g. The Right to Receive Changes in policy. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. You will be provided with a paper copy promptly.

h. The Right to File a Complaint. If you have a problem with how your PHI has been handled, or if you believe your privacy rights have been violated, please contact me. I will do my best to resolve your concerns and do as you ask. You have the right to file a complaint with me, the state regulatory board or with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, DC 20201, or by calling 202-619-0257.

I will not limit your care or take any actions against you if you complain or request changes.

If you have any questions, please contact me at 503.744.2980 | karenn@concinnitytherapy.com