Privacy policy

You have the following rights regarding your medical information:

• The right to inspect and obtain a copy of your medical record. According to the rules of HIPAA, your consultations are documented in two ways:
  1. The clinical record (required) may include the date of your consultations, your reasons for seeking therapy, diagnosis, therapeutic goals, treatment plan, progress, medical and social history, treatment history, functional status, any past records from other providers, as well as any reports to your insurance carrier;
  2. Psychotherapy notes (optional), consisting of the specific content or analysis of therapy conversations, how they impact the therapy (including sensitive information that you may reveal that is not required to be included in your clinical record) and notes of your therapist that may assist in treatment.
• The right to inspect and obtain a copy of your clinical record. Viewing the record is best done during a professional consultation in order to clarify any questions that you might have at the time. Psychotherapy notes, however, if they are created, are not disclosed to third parties, HMOs, insurance companies, billing agencies, clients, or anyone else. They are for the use of a treating therapist in tracking the many details of the consultations that are far too specific to be entered into the clinical record.
• The right to request a correction or add an addendum to your record. If you believe that there is an inaccuracy in your clinical record you may request a correction. If the information is accurate, however, or if it has been provided by a third party (previous therapist, primary care physician, etc.), it may remain unchanged, and the request may be denied. In this case you will receive an explanation in writing with a full description of the rationale. You also have the right to make an addition to your record if you think it is incomplete.
• The right to an accounting of disclosures of your information to third parties. You have the right to know if, when and to whom your information has been disclosed (exclusive of treatment, payment and health care operations). However, you likely would already be aware of this, as you would have signed consent forms allowing such disclosures (e.g., disclosures to other psychotherapists, primary care physicians, specialists, etc.). This accounting must extend back for a period of six years.
• The right to request restrictions on how your information is used. You have the right to request restrictions on certain uses or disclosures of your information. These requests must be in writing. These requests will most likely be honored, although in some cases they may be denied. This office does not use or release your protected health information for marketing purposes or any other purpose aside from treatment, payment, healthcare operations and other exceptions specified in this notice.
• The right to request confidential communications. You have the right to request that your therapist communicate with you about your treatment in a certain way or at a certain location. For example, you may prefer to be contacted at work instead of at home to schedule or cancel an appointment, or you may wish to receive billing statements at a post office box rather than your home address.
• The right to receive a copy of this notice upon request. You have the right to have a copy of this Notice of Privacy Practices.
  The right to file a complaint. You have the right to file a complaint if you believe your privacy rights have been violated. You must do so in writing. Your complaint may be addressed directly to your clinician, our Clinical Director or the Secretary of the Department of Health and Human Services. If you have any questions or concerns about this notice or this health information privacy policy, please contact our Clinical Director at 984-200-2780.