THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
My practice is dedicated to maintaining the privacy of your personal information. We are required also by law to keep your information private. These laws are complicated, but we must give you this important information. We can't cover all possible situations so please talk with me about any questions or problems.
If I want to use or disclose your information for any other purposes I will discuss this with you and ask you to sign a specific authorization for the release of your personal health information. I will never disclose your personal health information for marketing purposes or for any sale of such information.
There are some instances when personal information must be divulged: 1) If I suspect that you may do harm to yourself or others, I will share information with a person or organization who is able to help prevent or reduce the threat; 2) If you tell me, or suspect, abuse or molestation to a child, elderly or disabled person; 3) If you choose to waive your right to privacy by written or verbal authorization; 4) an order by the court; 5) If law enforcement official requires me to do so; 6) Some lawsuits and legal or court proceedings.
Your Rights Regarding Your Health Information
1. You can ask me to communicate with you about your mental health related issues in a particular way or at a certain place which is more private for you. For example, you call ask us to call you at home and not at work to schedule or cancel an appointment. We will try our best to do what you ask.
2. You have the right to ask about information that we have about you in your file. We do not shore your records electronically at this time. Access to your session notes will only be disclosed at our discretion. In some cases, a summary letter of your treatment may be more acceptable. If you request a copy of these records, we may charge you. Your notes may be released to the appropriate licensing board in response to a complaint that has been filed against the practice. You have a right to have a copy of your billing record.
3. You have the right to ask us to limit what we tell people involved in your care or the payment for your care. 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.
4. If you believe the information in your record is incorrect or incomplete, you can ask me to make some kinds of change (called amending) to your mental health information. You have to make this request in writing. You must tell me the reasons you want to make the changes. Changes are make at the professionals discretion.
5. The practice currently bills insurances electronically. We use the government required standards for PCI compliance at all times. You do have the right to restrict certain information to your health care plans where you have paid out of pocket. We will not release this information unless you specifically tell us to do so.
6. At this time, we do not correspond with clients through email. In the event that we would agree to accept emails, it would be for informational purposes only. In most cases this email may not be encrypted. As a result, the information contained in the email could be at risk. The office does accept fax transmissions.
7. You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with me or with the Secretary of the Dept. 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.
8. In the event that any of your personal health information has been compromised, you will be notified of such risk and to what degree, burglary, hacking, etc. We take great precaution to protect all personal health information.
9. You have the right to a copy of this notice. If we change this NPP we will post the new version in practice waiting room and on line.
if you have any questions regarding this notice or my privacy policies, please contact me at (304) 267-1012.