Notice of Privacy Practices for Psychotherapy + Resilience, PLLC

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. Effective date of this policy is January 1, 2018.

Purpose of this Notice: This Notice describes my privacy practices and how I protect the confidentiality of your health information. I am required by law to maintain the privacy of your health information and to give you this Notice. I must follow this Notice that is currently in effect. I reserve the right to change the terms of this Notice. Any changed Notice will be effective for health information I already have about you, as well as for new information.

Uses and Disclosures of Your Health Information:  I may use and disclose your health information for the following purposes:

Treatment: to provide, coordinate, or manage your health care and any related services or products. An example of this would be when I consult with your physician, case manager, or another therapist about your care.  Other than in an emergency, I will talk with you and have you sign a Release of Information (ROI) in order to coordinate care with other providers.

Payment: to obtain payment for your health care services. For example, I may tell your health plan or medical insurer about treatment you received or are going to receive in order to obtain payment or determine whether your plan will cover services – unless you ask that I not bill your insurer.

Health Care Operations: to support and improve my health care services. These activities include, but are not limited to, quality assessment activities, licensing, marketing, and business planning and management activities. Examples of this include contacting you to remind you of an appointment and disclosing your information to a third party business such as a medical biller.  I use TherapyNotes, a HIPAA-compliant electronic health record, which transmits the claims I enter to your insurance company. See www.therapynotes.com if you want more information about them.

Research: I will not use or disclose any health information that identifies you or can be used to identify you f r any research purposes without either obtaining your prior written consent or following state laws for attempting to notify you of my research request.

Individuals Involved in Your Care: If you agree, I may release certain health information about you to a friend or family member involved in your care or payment related to your care. If you are unable to agree due to your incapacity or emergency circumstances, I may disclose your health information as necessary if I determine that it is in your best interest, based on my professional judgment.

Other Uses and Disclosures Without Your Authorization or Consent: In addition to the above listed purposes, I may need to use or disclose your health information without your authorization for the following purposes:

  • to the government for public health activities as permitted or required by law to report child or vulnerable adult abuse or neglect;
  • to a health oversight agency for audits, investigations, inspections, and licensure activities; to prevent a serious and imminent threat to the health or safety of a person or the public; or to have the police apprehend an individual involved in a violent crime;
  • to a law enforcement official in response to a court order, subpoena or similar process; to identify or locate a suspect, witness or missing person; to identify the victim of a crime if, under certain limited circumstances, I am unable to obtain the victim’s agreement; or in emergency circumstances to report the location and perpetrator of a crime;
  • to comply with workers’ compensation laws and other similar legally-established programs;
  • to a coroner or funeral director as permitted by law to identify a deceased person, determine the cause of death, or otherwise as necessary to carry out their duties;
  • for military, national security or lawful intelligence activities;
  • or otherwise as permitted by law.

Other uses and disclosures of your health information will be made only with your written authorization. This would apply to release of your psychotherapy notes, for example. You may revoke that authorization in writing at any time, but I cannot take back any disclosures I have already made in reliance on your authorization.

Your Rights Regarding Your Health Information

Right to Access and Amend Your Health Information: With some exceptions, you have the right to inspect, amend, and request a copy of your medical records, billing records and records used to make decisions about your care if those records include health information about you and are maintained and used by me.  If these records are in electronic format, you may be able to get a copy in electronic format if that is easy to do. You may request in writing to inspect or amend your records or obtain a copy of your records. I may charge a reasonable administrative fee for copying your health information to the extent permitted by law. If I deny your request to review, amend, or copy your health information, I will explain the reason in writing.

Right to Receive and Accounting of Disclosures of Your Health Information: You have the right to request an accounting of certain disclosures that I make of your health information. You can request an accounting in writing. Certain disclosures, such as those made with your consent and/or for treatment, payment, or health care operations, need not be included in the accounting I provide to you.  Your request must include a time period, which may not be longer than six years, and may not include dates before January 1, 2016.

Right to Request Restrictions:  You have the right to request restrictions on how I use and disclose your health information for treatment, payment and health care operations. You have the right to restrict certain disclosures of protected health information to a health plan when you pay out of pocket in full for my services.

I may not be legally obligated to agree to your request. If I do agree, I will comply with your request unless the information is needed to provide you emergency treatment. To request a restriction, you must make your request in writing and it must include what information you want to limit, whether and how you want to limit my use, disclosure, or both, and to whom you want the limits to apply.

Right to Confidential Communications: You have the right to request that I provide your health information to you in a confidential manner. For example, you may request that I send your health information by an alternative means or to an alternate address.  I will attempt to accommodate any reasonable requests, unless they are administratively too burdensome or prohibited by law.

Right to Complain: If you have any questions about this Notice, believe your rights have been violated, or wish to file a complaint, please discuss this with me, Helena Mackenzie, PhD, LP, the manager and Privacy Officer of Psychotherapy & Resilience,PLLC, immediately. You also have a right to file a complaint directly with the Secretary of the United States Department of Health and Human Services. I can provide you with the appropriate address or you may visit www.hhs.gov/ocr. I will not retaliate against you for filing a complaint against me.

Right to be Notified of a Breach: You have the right to be notified in the event that we (or one of our Business Associates) discover a breach of your unsecured protected health information. Notice of any such breach will be made in accordance with legal requirements.

Additional information about the privacy laws upon which this Notice is based can be found on the following website: http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html.

We may change our policies at any time and reserve the right to make the change effective for all protected health information that we may maintain. In the event that we make a significant change to our policies, we will provide you with a revised copy of this notice. You can also request a copy of our notice at any time. It is also available on our website, at www.psychotherapyandresilience.com.