Notice of Privacy Practices

Notice of Privacy Practices

Effective March 29, 2017

This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review this Notice carefully.

Your medical record may contain personal information about your health. This information may identify you and relate to your past, present or future physical or mental health condition and related health care services and is called Protected Health Information (PHI). This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable law. It also describes your rights regarding how you may gain access to and control your PHI. We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices by posting a copy on our website, sending a copy to you in the mail upon request or in-person.

How we may use and disclose PHI about you:

For care or treatment: Your PHI may be used and disclosed to those involved in your care for the purpose of providing, coordinating, or managing your services. This includes consultation with clinical supervisors or other team members. Your authorization is required to disclose PHI to any other care provider not currently involved in your care. Example: If another provider referred you to us, we may contact that provider to discuss your care or they may contact us.

For payment: Your PHI may be used and disclosed to parties involved in payment for care or treatment. If you pay for your care or treatment completely out of pocket with no use of any insurance, you have the right to restrict the disclosure your PHI to your health plan for purposes of payment, and we will honor that request as required by law. Example: Your payer may require copies of your PHI during a medical record request, chart audit, or review.

For business operations: We may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assessment, employee review, licensing, and conducting or arranging for other business activities. We may also disclose PHI while providing you appointment reminders or leaving messages on your phone or at your home about questions you asked or test results. Example: We may share your PHI with third parties that perform various business activities (e.g., Council on Accreditation or other regulatory or licensing bodies) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI.

Required by law: Under the law, we must make disclosures of your PHI available to you upon request. In addition, we must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule, if so required.

Without authorization: Applicable law and ethical standards permit us to disclose information about you without your authorization only in a limited number of other situations. Examples of some of the types of uses and disclosures that may be made without your authorization are those that are:

Required by law, such as the mandatory reporting of abuse/neglect or mandatory government agency audits or investigations (such as the health department)
Required by court order or subpoena
Necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.
If information is disclosed to prevent or lessen the threat, including the target of the threat.

Verbal permission: We may use or disclose your information to family members that are directly involved in your receipt of services with your verbal permission.

With authorization: All other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke your authorization in writing at any time. We will obtain your explicit written authorization before using or disclosing psychotherapy notes (except as permitted by law), for marketing purposes, or for the sale of PHI.

Your rights regarding your PHI: You have the following rights regarding PHI we maintain about you. To exercise any of these rights, please submit your request in writing to our Privacy Officer.

Right to access and inspect and copy. You have the right, which may be restricted only in exceptional circumstances or with documents released to us, to inspect and copy PHI that may be used to make decisions about services provided.

Right to amend. If you believe the PHI we maintain about you is incorrect or incomplete, you may request an amendment. We may deny your request in certain circumstances but will provide a written explanation.

Right to accounting of disclosures. You have the right to request an accounting of the disclosures we make of your PHI. We may charge you a reasonable fee if you request more than one accounting in any 12-month period.

Right to request restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for services, payment, or business operations. We are not required to agree to your request.

Right to request confidential communication. You have the right to request that we communicate with you about PHI matters in a specific manner (e.g., telephone, email, postal mail, etc.)

Right to a copy of this Notice. You have the right to a copy of this Notice.

Website Privacy: Any personal information you provide us with via our website (e.g., email address) will never be sold or rented to a third party without your expressed permission. If you provide us with any personal or contact information to receive anything from us, we may collect and store that personal data. We do not automatically collect your personal email address for visiting our site. In some instances, we may partner with a third party to provide services such as newsletters, surveys to improve services, health or company updates, and in such case, we may need to provide your contact information to said third parties. This information, however, will only be provided to these third party partners specifically for these communications, and the third party will not use your information for any other reason. While we may track the volume of visitors and download information from specific pages of our website, these numbers are only used in aggregate and without any personal information. This demographic information may be shared with our partners, but it is not linked to any personal information that can identify you or any visitor on our site.

Our site may contain links to outside websites. We do not take responsibility for the privacy policies or practices of these sites and encourage you to verify the privacy practices of all internet sites you use. While we make every effort to ensure that all the information provided on our website is correct and accurate, we make no warranty, expressed or implied, as to the accuracy, completeness or timeliness, of the information available on our site. We are not liable to anyone for any loss, claim or damages caused in whole or in part, by any of the information provided by our site. By using our website, you consent to the collection and use of personal information as detailed herein. Any changes to the Privacy Policy will be made public on this site regarding the collection and use of such information.

Breaches: In the event of a breach of unsecured PHI, you will be notified without unreasonable delay and no later than 60 days after discovery of the breach, as required by law.

Complaints: If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services Office for Civil Rights.

You will not be retaliated against for filing a complaint.

Complaints to HHS may be filed at:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201