Notice of Privacy Practices
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.
Privacy is a very important concern for all those who come to this office and who work here. It is also complicated, because of the many federal and state laws and our professional ethics. If you have any questions, please contact Meg McSherry (540-645-1655) who will be happy to help you understand our procedures and your rights.
Contents of this notice of privacy practices
- Introduction: To our clients
- What we mean by your medical information
- Privacy and the laws about privacy
- How your protected health information (PHI) can be used and shared
- Uses and disclosures with your consent
- The basic uses and disclosures: For treatment and payment
- Other uses and disclosures in health care
- Uses and disclosures that require your consent and authorization
- Uses and disclosures that don’t require your consent or authorization
- When required by law
- For law enforcement purposes
- For public health activities
- For matters relating to deceased persons
- For specific government functions
- To prevent a serious threat to health or safety
- Uses and disclosures where you have an opportunity to object
- An accounting of disclosures we have made
- Your rights about your protected health information
- If you have questions or problems
A. Introduction: To our clients
This notice will tell you how we handle your medical information. It tells how we use this information here in this office, how we disclose/share it with other health care professionals and organizations, and how you can see it. We want you to know all of this so that you can make the best decisions for yourself and your family. If you have any questions or want to know more about anything in this notice, please ask our owner, Meg McSherry, for answers or explanations.
B. What we mean by your medical information
Each time you visit us or any doctor’s office, hospital, clinic, or other health care provider, information is collected about you and your physical and mental health. It may be information about your past, present, or future health or conditions, or the tests or treatment you got from us or from others, or about payment for health care. All this information is called “PHI,” which stands for “protected health information” which means its privacy must be protected. This information goes into your medical or health care records in our office.
In this office, your PHI is likely to include these kinds of information:
- Your history: Things that happened to you as a child; your school and work experiences; your marriage, relationships, and other personal history.
- Your medical history of problems and treatments.
- Reasons you came for treatment: Your problems, complaints, symptoms, or needs.
- Diagnoses: These are the medical terms for your problems or symptoms.
- A treatment plan: This is a list of the treatments and other services that we think will best help you.
- Progress notes: Each time you come in, we write down some things about how you are doing, what we notice about you, and what you tell us.
- Records we get from others who treated you or evaluated you.
- Psychological test scores, school records, and other evaluations and reports.
- Information about medications you took or are taking.
- Billing and insurance information.
There may also be other kinds of information that go into your health care records here.
We use PHI for many purposes. For example, we may use it here:
- To identify your goals and progress with your goals.
- When we talk with other health care professionals who are also treating you, such as your family doctor or the professional who referred you to us. We will only do so with your written consent by signing a release-of-information form, which will explain what information is to be shared and why.
- To show that you actually received services from us, which we billed to you or to your health insurance company.
When you understand what is in your record and what it is used for, you can make better decisions about what other persons or agencies should have this information, when, and why.
C. Privacy and the laws about privacy
We are required to tell you about privacy because of a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the HIPAA Omnibus Final Rule of 2013. HIPAA requires us to keep your PHI private and to give you this notice about our legal duties and our privacy practices.
This form is not legal advice. It is just to educate you about your rights and our procedures. It is based on current federal and state laws and might change if those laws or court decisions change. If we change our privacy practices, they will apply to all the PHI we keep. We will also post the new Notice of Privacy Practices in our office where everyone can see. You or anyone else can also get a copy from our office at any time. It is also posted on our website at www.couragehw.com. We will obey the rules described in this notice.
D. How your protected health information (PHI) can be used and shared
Except in some special circumstances, when we use your PHI in this office or disclose it to others, we share only the minimum necessary PHI needed for those other people to do their jobs. The laws give you rights to know about your PHI, to know how it is used, and to have a say in how it is shared. So now we will tell you more about what we do with your information.
Mainly, we will use it here and disclose/share your PHI for routine purposes to provide for your care, and we will explain more about these below. For other uses, we must tell you about them and ask you to sign a written Release of Information form. However, the HIPAA law also says that there are some uses and disclosures that don’t need your consent or authorization which we will explain below in section 3. However, in most cases we will explain the PHI and who it will go to and ask you to agree to this by signing a release-of-information form.
1. Uses and disclosures with your consent
We need information about you and your condition to provide care to you. In almost all cases, we intend to use your PHI here or share it with other people or organizations to provide treatment to you and/or arrange for payment for our services. You have to agree to let us use and share your PHI in the ways that are described in this Notice of Privacy Practices. To agree, we will ask you to sign a separate consent form before we begin to treat you. If you do not consent to this, we will not treat you because there is a risk of not helping you if we don’t have some information.
a. The basic uses and disclosures: For treatment, payment, and health care operations
Here we will tell you more about how your information will be used for these purposes.
For treatment. We use your information to provide you with psychological treatments or services. These might include individual, family, or group therapy; psychological, educational, or vocational testing; treatment planning; or measuring the benefits of our services.
If we want to share your PHI with any other professionals outside this office, we will need your permission on a signed release-of-information form. For example, we may refer you to other professionals or consultants for services we cannot provide. When we do this, we need to tell them things about you and your conditions. Later we will get back their findings and opinions, and those will go into your records here. If you receive treatment in the future from other professionals, we can also share your PHI with them. We can do this only when you give your permission by signing a release-of-information form. This is so that you will know what information is being shared and with whom. These are some examples so that you can see how we use and disclose your PHI for treatment.
For payment. We may use your information to bill you, your insurance, or others, so we can be paid for the treatments we provide to you. We may contact your insurance company to find out exactly what your insurance covers. We may have to tell them about your diagnoses, what treatments you have received, and the changes we expect in your conditions. We will need to tell them about when we met, your progress, and other similar things. Insurers may also look into a few of our patient records to evaluate the completeness of our record keeping.
b. Other uses and disclosures in health care
Appointment reminders. We may use and disclose your PHI to reschedule or remind you of appointments for treatment or other care. If you want us to call or write to you only at your home or your work, or you prefer some other way to reach you, we usually can arrange that. Just tell us.
Treatment alternatives. We may use and disclose your PHI to tell you about or recommend possible treatments or alternatives that may be of help to you.
Other benefits and services. We may use and disclose your PHI to tell you about health-related benefits or services that may be of interest to you.
Business associates. We hire other businesses to do some jobs for us. In the law, they are called our “business associates.” Such as a billing service to figure out, print, and mail our bills. These business associates need to receive some of your PHI to do their jobs properly. To protect your privacy, they have agreed in their contracts with us to safeguard your information just as we do.
2. Uses and disclosures that require your consent
If we want to use your information for any purpose besides those described above, we need your permission on a release-of-information form. If you do allow us to use or disclose your PHI, and then change your mind, you can cancel that permission in writing at any time. We will then stop using or disclosing your information for that purpose. Of course, we cannot take back any information we have used here already or disclosed to anyone with your permission.
3. Uses and disclosures that don’t require your consent or authorization
The HIPAA laws let us use and disclose some of your PHI without getting your consent or authorization in some cases. Here are some examples of when we might do this. We will almost always notify you if any of these situations occur.
a. When required by law
There are some federal, state, or local laws that require us to disclose PHI:
- We have to report suspected abuse [or neglect] of children [elders, frail/disabled persons, etc.] to a state agency.
- If you are involved in a lawsuit or legal proceeding, and we receive a subpoena, discovery request, or other lawful process, we may have to release some of your PHI. We will only do so after telling you about the request and will suggest that you talk to your lawyer.
- We have to disclose some information to the government agencies that check on us to see that we are obeying the privacy laws, and to organizations that review our work for quality and efficiency.
b. For specific government functions
We may disclose PHI of military personnel and veterans to government benefit programs relating to eligibility and enrollment. We may disclose your PHI to workers’ compensation and disability programs, or to other government agencies for national security reasons.
c. To prevent a serious threat to health or safety
If we come to believe that there is a serious threat to your health or safety, or that of another person or the public, we will disclose some of your PHI. We will only do this to those people who can prevent the danger.
If it is an emergency, we can disclose information if we believe it will help you. When we do share information in an emergency, we will tell you as soon as we can. If you don’t approve, we will stop, as long as it is not against the law.
4. Uses and disclosures where you have an opportunity to object
We can share some information about you with your family and anyone else you choose, such as close friends or clergy. We will ask you which persons you want us to tell, and what information you want us to tell them about your condition or treatment. You can tell us what you want, and we will honor your wishes as long as it is not against the law.
5. An accounting of disclosures we have made
When we disclose your PHI, we will keep a record of whom we sent it to, when we sent it, and what we sent. You can get an accounting (a list) of many of these disclosures. We may charge you a reasonable fee if you request more than one accounting in any 12-month period.
E. Your rights about your protected health information
- You can ask us to communicate with you about your health and related issues in a particular way or at a certain place that is more private for you. For example, you can ask us to call you at home, rather than at work, to schedule or cancel an appointment. We will try our best to do as you ask, and we don’t need an explanation. We ask that you be thoughtful before you put any information in an email and not use email for anything you want kept private. By signing the separate consent form, you agree to this use of email. Please note that anything you send us electronically becomes a part of your legal record, even if we do not place it in the chart. Be mindful of this, and please do not forward us emails from third parties or others in your life. It is better to print those out and bring them in to discuss them.
- You have the right to ask us to limit what we tell people involved in your care or with payment for your care, such as family members and friends. You can ask us face to face, and we may then ask for your written permission. We don’t have to agree to your request, but if we do agree, we will honor it except when it is against the law, when there is an emergency, or when the information is necessary to treat you.
- You have the right to prevent our sharing your PHI with your insurer or payer for its decisions about your benefits or some other uses, if you paid us directly (“out of pocket”) for the treatment or other services and are not asking the insurer to pay for those services unless we are under contract with your insurer (on their panel of providers).
- You have the right to look at the PHI we have about you, such as your medical and billing records.
- You can get a copy of these records, but we may charge you a reasonable cost-based fee. If your records are in electronic form, not on paper, you can ask an electronic copy of your PHI. Generally we do not recommend that you get a copy of your records, because the copy might be seen accidentally by others. We will be happy to review the records with you or provide a summary to you, or work out any other method that satisfies you.
- You have the right to add to (amend) your records to explain or correct anything in them. If you believe that the information in your records is incorrect or missing something important, you can ask us to make additions to your records or to include your own written statements to correct the situation. You have to make this request in writing.
- You have the right to a copy of this notice. If we change this notice, we will post the new one in our waiting area, and you can always get a copy from the compliance officer.
- If you have a problem with how your PHI has been handled, or if you believe your privacy rights have been violated, contact the owner, Meg McSherry. We will do our best to resolve any problems. You have the right to file a complaint with us and with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, DC 20201, or by calling 202-619-0257.
- We will not in any way limit your care here or take any actions against you if you complain or request changes.
F. If you have questions or problems
If you have any questions or problems our health information privacy policies, please contact Meg McSherry at 540-645-1655.
The effective date of this notice is August 23, 2017.