Notice of Privacy Practices
This Notice of Privacy Practices and HIPAA Regulations ("Notice") describes how medical information about you may be used and disclosed, and how you can get access to this information. Please read it carefully.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal law that requires that all medical records and other individually identifiable health information used or disclosed by my practice in any form—whether electronically, on paper, or orally—are kept properly confidential. HIPAA gives you, the patient, the right to understand and control how your personal health information (PHI) is used. HIPAA provides penalties for Covered Entities that misuse PHI.
As required by HIPAA, I have prepared this explanation of how I will maintain the privacy of your health information and how I may disclose your personal information when needed.
I may use and disclose your medical records only for the following purposes: treatment, payment, and healthcare operations.
- Treatment
- Providing, coordinating, or managing healthcare and related services are all considered a part of treatment. For example, if I refer you to another consulting physician, I may discuss your case with them as a part of coordinating your care.
- Payment
- Payment includes such activities as obtaining reimbursement for services, confirming coverage/eligibility for services, billing or collections activities, and utilization review. For example, sending your insurance company—another Covered Entity—a bill may include disclosure of what services were provided, such as psychotherapy.
- Healthcare Operations
- Healthcare operations largely includes running the business aspects of the practice, such as conducting quality assessments, auditing functions, or cost management analysis. An example of this would include patient survey cards.
I may also be required or permitted to disclose your PHI for the purposes of law enforcement or other legitimate judicial reasons. In all situations, I will do my best to ensure continued confidentiality to the greatest extent possible.
If in my clinical judgement, I determine that disclosure of PHI may be necessary to reduce imminent harm, such as that threatened by acts of suicide, violence, negligence, abuse, or other such potential harms, I may be entitled to disclose only such information as would be needed to mitigate that risk. For example, if I am concerned that you may be at risk of attempting suicide and am unable to reach you, I may reach out to your emergency contact in order to notify them of this possible risk.
I may contact you by phone or in writing to provide appointment reminders or information about treatment alternativies or other health-related benefits and services that may be of interest to you.
Psychotherapy notes—notes separate from the medical record regarding the process and content of psychotherapy, which are traditionally exempted from HIPAA—will only be disclosed with your explicit written authorization. Note that the typical content of the medical record, such as a review of symptoms, or a mental status exam, is not generally considered to constitute a "psychotherapy note," even if the main service rendered at the visit was psychotherapy.
You may provide written authorization to release your medical records or PHI at your request with non-Covered Entities, such as friends, family members, or spouses, which can be helpful in certain situations. You may revoke this authorization at any time.
You have the following rights with respect to your PHI:
- The right to request restrictions on certain uses and disclosures of PHI, including those related to disclosures to family members, other relatives, friends, or any other such person. Note that I am not required to honor all such restrictions, but will do my best to abide by them wherever I am able.
- The right to reasonable requests to receive confidential communications of PHI by alternative means or at alternative locations.
- The right to inspect and copy or amend your PHI. Note that requests for amendment may be denied if they are felt to be clinically inappropriate upon review.
- The right to receive an accounting of disclosures of your PHI.
- The right to obtain a paper copy of this notice upon request.
- The right to be advisesd if your unprotected PHI is intentionally or unintentionally disclosed.
If you have paid for services "out of pocket," in full and in advance, and you request that I not disclose PHI related solely to those services to a health plan, I will accommodate your request, except where I am required by law to make a disclosure.
I am required by law to maintain the privacy of your PHI and to provide you the notice of my legal duties and my privacy practices with regard to PHI.
This notice is effective as of August 31, 2020, and it is my intention to abide by the terms of the Notice currently in effect. I reserve the right to change the terms of the Notice and make the new notice effective for all PHI I may maintain.
You have recourse if you feel that your protections have been violated. You have the right to file a formal, written complaint with my office, and with the Department of Health and Human Services's Office of Civil Rights, without worry of retaliation.
Please feel free to contact me with any questions regarding this privacy notice.