Privacy is a very important concern for all those who come to this office. It is also complicated because of the many federal and state laws and our professional ethics. Because the rules are so complicated some parts of this Notice are very detailed and you may have to read them several times to understand them. If you have any questions, our Privacy Officer will be happy to help you understand our procedures and your rights. Our Privacy Officer can be contacted through our office.

About Your Privacy…

This notice will tell you how we handle your health care information for yourself and your family. It tells how we use this information here in this office, how we share it with other professionals and organizations, and how you can see it. We want you to know all of this so that you can make the best decisions for you and your family. Because the laws of this state and the laws of federal government are very complicated and we don’t want to make you read a lot that may not apply to you, we have removed a few small parts. If you have any questions or want to know more about anything in this Notice, please ask our Privacy Officer for more explanations or more details.

What we mean by “your medical information…”

Each time you visit us or any doctor’s office, hospital, clinic or any other healthcare providers, information is collected about you and your physical and behavioral (psychological) health. It may be information about your past, present or future health or conditions, or the tests and treatment you got from us or from others, or about payment for healthcare. The information we collect from you is called Protected Health Information (PHI). This information goes into your medical or health care records.

The following list is just to give you some examples of PHI and there may also be other kinds of information that go into your health care record here. PHI is likely to include these kinds of information:

  • Your history: As a child, in school and at work, marriage and personal history.
  • Reasons you came for treatment: Your problems, complaints, symptoms, or needs.
  • Any diagnoses given: “Diagnoses” are the medical terms for your problems or symptoms.
  • A treatment plan: A list of the treatments and any other services that we think will best help you.
  • Progress notes: Each time you come in we write down some things about how you are doing, what we notice about you and what you tell us.
  • Records we get from others who treated you or evaluated you.
  • Psychological test scores, school records, and other reports.
  • Information about medications you took or are taking.
  • Legal matters or billing and insurance information.

We use this information for many purposes. For example, it can be used:

  • To plan your care and treatment or decide how well our treatments are working for you.
  • When we talk with other healthcare professionals who are also treating you, such as your family doctor or the professional who referred you to us.
  • To show that you actually received the services from us that we billed to you or the insurance company.
  • For teaching and training other healthcare professionals or for medical or psychological research.
  • For public health officials trying to improve health care in this area of the country.
  • To improve the way we do our job by measuring the results of our work.

When you understand what is in your record and what it is used for you can make better decisions about who, when, and why others should have this information. Although your health record is the physical property of the healthcare practitioner or facility that collected it, the information belongs to you. You can read it and if you want a copy we can make one for you (but may charge you for the costs of copying and mailing, if you want it mailed to you). In some very rare situations you cannot see all of what is in you records. If you find anything in your records that you think is incorrect or believe that something important is missing you can ask us to amend (add information to) your record, although in some rare situations we don’t have to agree to do that. If you want, our Privacy Officer can explain more about this.

Privacy and the law

We are also required to tell you about privacy because of the privacy regulations of a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HIPAA law requires us to keep your Personal Healthcare Information (PHI) private and to give you this notice of our legal duties and our privacy practices which is called the Notice of Privacy Practices (NPP) when and if you start treatment with us. We will obey the rules of this notice as long as it is in effect but if we change it the rules of the new NPP will apply to all the PHI we keep. If we change the NPP we will post the new Notice in our office where everyone can see. You or anyone else can also get a copy from our Privacy Officer at any time and it may also be posted on our website.

How your protected health information can be used and shared

When your information is read by doctors or others in our (or any other) medical office, it is used by us to make decisions about your care and that is called, in the law, “use.” If the information is shared with or sent to others outside this office, that is called, in the law, “disclosure.” Except in some special circumstances, when we use your PHI here or disclose it to others, we share only the minimum necessary PHI needed for those other people to do their jobs. The law gives you rights to know about your PHI, how it is used and to have a say in how it is disclosed (shared) and so we will tell you more about what we do with your information.

HIPAA permits the use and disclosure of PHI for several reasons. Mainly, we will use and disclose it for routine purposes and we will explain more about these below. For other uses we must tell you about them and have a written Authorization from you unless the law lets or requires us to make the disclosures without your authorization. However, the law also says that there are some uses and disclosures that don’t need your consent or authorization. Not every disclosure or use of your PHI requires your consent.

Uses and disclosures of PHI in healthcare with your consent

After you have read this Notice you will be asked to sign a separate Consent form to allow us to use and share your PHI. In almost all cases we intend to use your PHI here or share you PHI with other people or organizations to provide Treatment to you, arrange for Payment for our services, or some other business functions called Health Care Operations. Together these routine purposes are called “TPO” and the Consent from allows us to use and disclose your PHI for “TPO”. Take a minute to re-read that last sentence until it is clear because it is very important. Next we will tell you more about “TPO.” “TPO” stands for Treatment, Payment or health care Operations

When you come to see us, several people in our office may collect information about you and all of it may go into your health care records here. Generally, we may use or disclose your PHI for three main purposes: treatment, obtaining payment, and what are called health care operations. For example:

For Treatment: We need information about you and your condition to provide care to you. You have to agree to let us collect the information and to use it and share it to care for you properly. Therefore, you must sign the Consent form before we begin to treat you because if you do not agree and consent we cannot treat you. We use your medical information to provide you with psychological treatments or services. These might include individual, family, or group therapy, psychological, educational, or vocational testing, treatment planning, or measuring the benefits or our services. We may share or disclose your PHI to others who provide treatment to you. We may share your information with your personal physician.

If you are being treated by a team of health care professionals, we can share some of your PHI with them so that the services you receive can all work together. The other professionals treating you will also enter their findings, the actions they took, and their plans into your medical record and so we may all see what treatments work best for you and make up a Treatment Plan. We may refer you to other professionals or consultants for services we cannot provide. When we do this we need to tell them some things about you and your conditions. We will get back their findings and opinions and those will go into your records here. If you receive treatment in the future from other professionals we can also share your PHI with them.

For Payment: We may use your information to bill you, your insurance company, or others so we can be paid for the treatments we provide to you. We may contact your insurance company to check on exactly what your insurance covers. We may have to tell them about your diagnoses, what treatments you have received, and the changes we expect in your conditions. We will need to tell them about when we met, your progress, and other similar things.

For Health Care Operations: For example, we may use your PHI to see where we can make improvements in the care and services we provide. We may be required to supply some information to some government health agencies so they can study disorders and treatments and make plans for services that are needed. If we do, your name and personal information will be removed form what we send. There are also other uses for Health Care Operations, such as:

Appointment Reminders: We may use and disclose medical information to reschedule or remind you of appointments for treatment or other care. If you want us to call or write to you only at your home or your work or prefer some other way to reach you, we usually can arrange that. Just tell us.

Treatment Alternatives: We may use and disclose your PHI to tell you about or recommend possible treatments or alternatives that may be of help to you.

Other Benefits and Services: We may use and disclose your PHI to tell you about health-related benefits or services that may be of interest to you.

Research: We may use or share your information to do research to improve treatments. For example, comparing two treatments for the same disorder to see which works better or faster or costs less. In all cases your name, address and other personal information will be removed from the information given to researchers. If they need to know who you are we will discuss the research project with you and you will have to sign a special Authorization form before any information is shared.

Business Associates: There are some jobs we hire other businesses to do for us. In the law, they are called our Business Associates. Examples of this may include a copy service we may use to make copies of your health records and/or a billing service that figures out, prints, and mails our bills or a typing service who prepares reports. These business associates need to receive some of your PHI to do their jobs properly. These businesses have agreed in their contract with us to safeguard your PHI.

Uses and disclosures of PHI where you have an opportunity to object

We can share some information about you with your family or close others. We will only share information with those involved in your care and anyone else you choose such as close friends or clergy. We will ask you about who you want us to tell what information about your condition or treatment. You can tell us what you want and we will honor your wishes as long as it not against the law.

If it is an emergency and we cannot ask in advance if you disagree, we can share information if we believe that it is what you would have wanted and if we believe it will help you if we do share it. If we do share information in an emergency, we will tell you as soon as we can. If you don’t approve we will stop, as long as it is not against the law.

Uses and disclosures that require your Consent or Authorization

If we want to use your information for any purpose besides TPO or those we described above, we need your permission on an Authorization form. We don’t expect to need this very often.

If you do authorize us to use or disclose your PHI, you can revoke (cancel) that permission, in writing, at any time. After that time, we will not use or disclose your information for the purposes that we agreed to. Of course, we cannot take back any information we had already disclosed with your permission or that we had used in our office.

Uses and disclosures that don’t require your Consent or Authorization

The law lets us use and disclose some of your PHI without your consent or authorization in some cases. Here are examples of when we might have to share your information.

When required by law: There are some federal, state, or local laws which require us to disclose PHI:

  • We have to report suspected child abuse.
  • We have to report suspicions that you may be going to hurt yourself or others.
  • If you are involved in a lawsuit or legal proceeding and we receive a subpoena, discovery request, or other lawful process, we may have to release some of your PHI. We will only do so after trying to tell you about the request, consulting your lawyer, or trying to get a court order to protect the information they requested.
  • We have to disclose some information to the government agencies that check on us to see that we are obeying the privacy laws.

For Law Enforcement Purposes and for Public Health Activities: We may release some medical information if asked to do so by a law enforcement official to investigate a crime or criminal or to agencies that investigate diseases or injuries.

Relating to decedents: We might disclose PHI to coroners, medical examiners or funeral directors, and to organizations relating to organ, eye, or tissue donations or transplants.

For specific government functions: We may disclose PHI of military personnel and veterans to government benefit programs relating to eligibility and enrollment. We may disclose your PHI to Workers Compensation and Disability programs, to correctional facilities if you are an inmate and for national security reasons.

To Prevent a Serious Threat to Health or Safety: If we come to believe that there is a serious threat to your health or safety or that of another person or the public we can disclose some of your PHI. We will only do this to persons who can prevent the danger.

Your rights regarding your health information

  1. You can ask us to communicate with you about your health and related issues in a particular way or at a certain place that is more private for you. For example, you can ask us to call you at home, and not at work to schedule or cancel an appointment. We will try our best to do as you ask.
  2. You have the right to ask us to limit what we tell people involved in your care or the payment for your care, such as family members and friends. While we don’t have to agree to your request, if we do agree, we will keep our agreement except if it is against the law, or in an emergency, or when the information is necessary to treat you.
  3. You have the right to look at the health information we have about you, such as your medical and billing records. You can even get a copy of these records but we may charge you. Contact our Privacy Officer to arrange how to see your records.
  4. If you believe the information in your records is incorrect or missing important information, you can ask us to make some kinds of changes to (“amending”) your health information. You have to make this request in writing and send it to our Privacy Officer. You must tell us the reasons you want to make the changes.
  5. You have the right to a copy of this notice. If we change this NPP we will post the new version in our office and on our website and you can always get a copy of the NPP from the Privacy Officer.
  6. You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with our Privacy Officer and with the Secretary of the Department of Health and Human Services. All complaints must be in writing. Filing a complaint will not change the health care we provide to you in any way.
  7. You may also have other rights that are granted to you by the laws of our state and these may be the same or different from the rights described above. Please ask if you have and questions about this. We will be happy to discuss these situations with you now or as they arise.

An accounting of disclosures

When we disclose you PHI we may keep some records of to whom we sent it, when we sent it and what we sent. You can get an accounting (a list) of many of these disclosures.

If you have questions or problems

If you need more information or have questions about the privacy practices described above please speak to the Privacy Officer whose name and telephone number are available at our office. If you have a problem with how your PHI has been handled or if you believe your privacy rights have been violated, contact the Privacy Officer.