Notice of Privacy Practices | Internet Privacy Policy
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.
Your therapist is required by law to maintain the privacy and security of your protected health information (“PHI”) and to provide you with this Notice of Privacy Practices (“Notice”). Your therapist must abide by the terms of this Notice, and must notify you if a breach of your unsecured PHI occurs. The terms of this Notice can change, and such changes will apply to all information in your file. The new Notice will be available upon request, in the office, and on your therapist’s website.
Except for the specific purposes set forth below, disclosure of your PHI occurs only with your written authorization (“Authorization”). It is your right to revoke such Authorization at any time by providing written notice of your revocation.
Uses (Inside Practice) and Disclosures (Outside Practice) Relating to Treatment, Payment, or Health Care Operations Do Not Require Your Written Consent. Your therapist can use and disclose your PHI without your Authorization for the following reasons:
1. For your treatment. Your therapist can use and disclose your PHI to treat you, which may include disclosing your PHI to another health care professional. For example, if you are being treated by a physician or a psychiatrist, your therapist can disclose your PHI to him or her to help coordinate your care, although it is preferred to have Authorization to do so.
2. To obtain payment for your treatment. Your therapist can use and disclose your PHI to bill and collect payment for the treatment and services provided.
3. For healthcare operations. Your therapist can use and disclose your PHI for purposes of conducting health care operations pertaining to their practice, including contacting you when necessary.
Certain Uses and Disclosures Require Your Authorization.
1. Psychotherapy Notes. Your therapist keeps “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:
a. For use in treating you.
b. For use in legal proceedings defense instituted by you.
c. For use by the Secretary of Health and Human Services to investigate compliance with HIPAA.
d. Required by law, and the use or disclosure is limited to the requirements of such law.
e. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
f. Required by a coroner who is performing duties authorized by law.
g. Required to help avert a serious threat to the health and safety of others.
2. Marketing Purposes. Your therapist will not use or disclose your PHI for marketing purposes.
3. Sale of PHI. Your therapist will not sell your PHI.
Certain Uses and Disclosures Do Not Require Your Authorization. Subject to certain limitations in the law, your therapist can use and disclose your PHI without your Authorization for the following reasons:
- When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
- For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
- For health oversight activities, including audits and investigations.
- For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.
- For law enforcement purposes, including reporting crimes occurring on my premises.
- To coroners or medical examiners, when such individuals are performing duties authorized by law.
- For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
- Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
- For workers’ compensation purposes. Although it is preferred to obtain Authorization from you, your PHI may be provided in order to comply with workers’ compensation laws.
- Appointment reminders and health related benefits or services. Your therapist may use and disclose your PHI to contact you to remind you that you have an appointment. They may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits offered.
Certain Uses and Disclosures Require You to Have the Opportunity to Object.
1. Disclosures to your family, friends, or others. Your therapist may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
YOUR RIGHTS YOUR REGARDING YOUR PHI
You have the following rights with respect to your PHI:
- The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask your therapist not to use or disclose certain PHI for treatment, payment, or health care operations purposes. Your therapist is not required to agree to your request, and may say “no” if they believe it would affect your health care.
- The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
- The Right to Choose How PHI is Sent to You. You have the right to ask your therapist to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and they will agree to all reasonable requests.
- The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information in your file.Your therapist will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and may charge a reasonable, cost based fee for doing so.
- The Right to Get a List of the Disclosures Made. You have the right to request a list of instances in which your PHI has been disclosed for purposes other than treatment, payment, or health care operations, or for which you provided an Authorization.Your therapist will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list will include disclosures made in the last six years unless you request a shorter time. This will be provided at no charge, but if you make more than one request in the same year, you will be charged a reasonable cost based fee for each additional request.
- The Right to Corrector Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request corrections of the existing information or add the missing information. Your therapist may say “no” to your request, but they will tell you why in writing within 60 days of receiving your request.
- The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
HOW TO COMPLAIN ABOUT PRIVACY PRACTICES
If you think your therapist may have violated your privacy rights, you may file a complaint to your therapist, as the Privacy Officer for their practice, at: 705 Gold Lake Drive, Suite 250, Folsom, CA 95630; 916-840-9188.
You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:
- Sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201;
- Calling 1-877-696-6775; or,
- Visiting www.hhs.gov/ocr/privacy/hipaa/complaints.
Your therapist will not retaliate against you if you file a complaint about privacy practices.
This notice went into effect on November 13, 2020
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. If you have any questions about this Notice of Privacy Practices, please contact your therapist at 705 Gold Lake Drive, Suite 250, Folsom, CA 95630; 916-840-9188.
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Questions?
Please contact sherry@oasiskids.care or 916-840-9188.
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