NOTICE OF PRIVACY PRACTICES

Effective Date: 10/31/2024

This Notice describes how your health information may be used, disclosed, and how you can access it. Please review it carefully.

I. Our Commitment to Your Privacy

Your health information is personal and sensitive. We are committed to protecting it and maintaining its confidentiality. We create records of your care to provide quality services and comply with legal requirements. This Notice applies to all records of your care within this mental health practice and describes your rights to your health information and our legal responsibilities to keep it private.

We are required by law to:

  • Maintain the privacy of your Protected Health Information (PHI).

  • Provide this Notice outlining our legal duties and privacy practices.

  • Abide by the terms of this Notice.

We may update this Notice, and any changes will apply to all information we hold about you. The updated Notice will be available upon request and on our website.

II. How We Use and Disclose Health Information

Here are some of the ways we may use and disclose health information without your authorization:

1. Treatment, Payment, and Health Care Operations: We may use and disclose PHI to provide and coordinate your treatment and healthcare. This includes sharing information with other healthcare providers for consultation or referral purposes to ensure comprehensive care. Additionally, we may disclose PHI for billing and operations purposes to improve the quality of our services.

2. Legal Proceedings: If you are involved in a legal case, we may disclose PHI in response to a court or administrative order, or in response to a subpoena, but we will notify you about the request unless prohibited by law.

III. Uses and Disclosures Requiring Your Authorization

Certain uses and disclosures of your PHI require your explicit permission:

1. Psychotherapy Notes: Psychotherapy notes are records of your conversations during therapy sessions. These are highly protected and require your written authorization for disclosure unless used:

  • For your treatment.

  • In supervised training programs.

  • For legal defense, if you bring legal action against us.

  • As part of certain government compliance investigations.

2. Marketing Purposes and Sale of PHI: We will not use your PHI for marketing or sell your PHI in our business operations.

IV. Uses and Disclosures Not Requiring Authorization

Under specific circumstances, we may use or disclose PHI without your authorization:

1. Required by Law: We may disclose PHI as required by federal or state law.

2. Public Health and Safety: This includes situations where we need to report suspected abuse or to prevent a threat to anyone’s health or safety.

3. Health Oversight, Judicial, and Law Enforcement: PHI may be disclosed for audits, investigations, or to comply with legal orders and law enforcement.

4. Research Purposes: PHI may be used for research to improve mental health treatment approaches. Participation in research will always be subject to strict ethical standards.

5. Workers’ Compensation: We may use or disclose PHI to comply with workers’ compensation laws.

6. Appointment Reminders: We may contact you with reminders about upcoming appointments and to inform you of treatment alternatives or other health benefits that may interest you.

V. Right to Object to Certain Uses

You have the opportunity to object to disclosures to family, friends, or others involved in your care. If you object to any disclosures of this nature, please inform us.

VI. Your Rights Regarding Your PHI

You have the following rights related to your health information:

  1. Request Limits on Uses and Disclosures: You can request restrictions on certain uses and disclosures of PHI for treatment, payment, or health care operations. While we are not required to agree, we will consider all reasonable requests.

  2. Request Restrictions for Out-of-Pocket Expenses: If you pay out-of-pocket in full, you can request we not share that information with your health plan.

  3. Specify Contact Preferences: You can request alternative methods for us to communicate with you about your health.

  4. Access and Obtain Copies of Your PHI: You may review or request copies of your health information, with some exceptions. There may be a fee for copies provided.

  5. Request a Record of Disclosures: You can request a list of instances where your PHI was disclosed for non-treatment, non-payment, or health care operations purposes.

  6. Request Corrections to Your PHI: You may ask to correct or update your health information if you believe it is incorrect or incomplete.

  7. Receive a Copy of this Notice: You may request a paper or electronic copy of this Notice at any time.

Acknowledgment of Receipt of Privacy Notice

In compliance with HIPAA regulations, by checking the box below, you acknowledge that you have received a copy of this HIPAA Notice of Privacy Practices.