This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” or “PHI” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
Uses and Disclosures
How do we typically use or share your health information? We typically use or share your health information in the following ways.
- To treat you-we can use your health information and share it with other professionals who are treating you within our practice, including supervisors. We also share information with your other providers, such as your PCP, to coordinate care when applicable and with separate written consent.
- To run our practice-we can use and share your health information to run our practice, improve your care, and contact you when necessary.
- To bill for your services-we can use and share your health information to bill and get payment from health plans or other entities.
- To coordinate with select people you have identified-we can share certain PHI with those individuals that you have written separate authorizations to release and obtain information for that you deem integral to your care.
What other instances would we disclose PHI? In some situations, we are obligated and mandated to release select PHI. These situations include:
- When the client expresses suicidal, homicidal, or self harming ideation or there is reasonable evidence to support the concern that the client is a threat or harm to themselves or others.
- As legally mandated reporters, we are required to report any disclosures or reasonable suspicions of abuse or neglect of minor children, dependent adults, or elderly persons (60 or older).
- When a court order or subpoena is received directing the disclosure of information, we are legally mandated to comply.
- When therapy is court-ordered, some PHI related to treatment may be mandated to be released to specific parties.
Your Rights to Confidentiality and Privacy
- The right to privacy, security, and confidentiality of your identity, diagnosis, prognosis, and treatment.
- The right to have the entire staff keep your identity, diagnosis, prognosis, and treatment confidential.
- The right to be treated respectfully regarding your privacy.
- The right to understand how your Protected Health Information (PHI) is disclosed for purposes of treatment, payment, and healthcare options.
- The right to the confidentiality of your medical records and source of payment for services.
- The right to require my consent for the use of tape recordings, videotapes, and/or photographs of you, and to be informed of their purpose and how they will be used.
- The right to provide or refuse authorization for family members or others to participate in your treatment or for the release of confidential information to family members or others.
- The right to access your medical records in compliance with applicable state and federal laws in sufficient time to make decisions regarding my care.
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
Questions or Complaints
You may contact us at any time regarding questions about your PHI and privacy. If you have a complaint, you may contact our HIPAA Privacy Officer, Jeremiah Kraus, at firstname.lastname@example.org.