1. This notice describes how health information about you may be used and disclosed electronically and how you can get access to this information. Please review it carefully.
2. I have a legal duty to safeguard your PHI when I transmit information electronically.
My Commitment to your Privacy: I understand that medical information about you and your health are personal and I am committed to protecting your medical information. I do not use or disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. As we become increasingly more reliant on technology, it’s important that we take extra steps to safe-guarding your protected health information (PHI). One of the ways in which I do this, is by using a secure platform called Simple Practice for the purposes of electronically signing all intake paperwork (this is the same platform that we’ll use if we decide telehealth is the best option for you, instead of in-person appointments). Since I cannot guarantee confidentiality when using text or email, I request that we only use text and email for scheduling purposes to best safe-guard your confidential information. You control how your private information gets transmitted to you, so should you choose to use text or email to connect with me, you are consenting for me to disclose PHI using those platforms.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on certain individually identifiable health information, known as protected health information (PHI), may be used and disclosed electronically. HIPAA generally permits use and disclosure of your health information without your permission for purposes of health care treatment, payment activities, health care operations, and to maintain safety throughout the counseling process. These uses and disclosures are more fully described blow:
Treatment: I may use or disclose medical information about you to provide and facilitate medical treatment or services. I may disclose medical information about you to health care providers, including doctors, nurses, technicians, and medical students who are involved in taking care of you. For example, I may disclose information about you with physicians who are treating you.
Payment: When and as appropriate, I may use and disclose medical information about you to facilitate payment for the treatment and services you receive from me, determine benefit/insurance responsibility and coverage, or to coordinate your coverage. For example, I may disclose information about your medical history to your health insurance company or third party. Additionally I may share medical information with another entity to assist me in collecting payments due for services provided, if necessary.
Health Care Operations: I may use and disclose your PHI to operate my business. For example, I may use your PHI to evaluate the quality of care you received from me, or to conduct cost-management and business planning activities for my practice. I may disclose your PHI to other health care providers and entities to assist in their health care operations.
Optional Appointment Reminders: I may use and disclose your PHI to contact you and remind you of an appointment.
To Comply with Federal and State Requirements: I will disclose medical information about you when required to do so by federal, state, or local law. For example, I may disclose medical information when required by a judicial order, subpoena, or other lawful process, and to address matters of public safety as required by law (for example, reporting child abuse and neglect, elder abuse, threats to public health and safety, or national security reasons).
To Avert a Serious Threat to Health or Safety: I may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would be only to someone able to health prevent the threat. For example, I may disclose medical information if you plan to harm yourself or others.
Your Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures” (a list of certain disclosures that I have made regarding your personal health information). To request an accounting of disclosures, you must submit your request in writing. You may be charged for the costs of providing this list of disclosures. You will be notified of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
You may request the Release of your PHI: You may request that I release specific personal health information by completing a Release of Information form.
I am legally required to follow the privacy practices described in this notice. However, I reserve the right to change the terms of this notice and my privacy policies at any time. Any changes will apply to PHI on file with me already. Before I make any important changes to my policies, I will promptly change this notice and post a new copy of it in my office and on my website. You can also request a copy of this notice from me, or you can view a copy of it in my office.