Gentle Intensives, LLC, HIPAA Privacy Policy
Notice of Clinician’s Policies and Practices to Protect the Privacy of Patients’ Health Information THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT PATIENTS MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This is a standard description of privacy policies for all health care providers, required by both state and federal law for people who become patients of this agency. You’re probably familiar with it, having received one from your regular therapist and other health care providers. There’s a lot of detail here, but the information is important.
I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
Your clinician may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your written authorization. To help clarify these terms, here are some definitions:
“PHI” refers to information in your health record that could identify you. “Treatment, Payment, and Health Care Operations”
Treatment is when a clinician provides, coordinates, or manage your health care and other services related to your health care. An example of treatment would be when a clinician consults with another health care provider, such as your family physician or another psychologist.
Payment is when a clinician obtains payment for your healthcare. Examples of payment are when a clinician discloses your PHI when charging a 3rd party (such as a credit card) for the services provided, which links your name and address with this business.
Health Care Operations are activities that relate to the performance and operation of a clinical practice. Examples of healthcare operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.
“Use” applies only to activities within a clinical practice such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
“Disclosure” applies to activities outside of a clinical practice, such as releasing, transferring, or providing access to information about you to other parties.
“Authorization” is your written permission to disclose confidential mental health information. All authorizations to disclose must be on a specific legally required form often called a Release of Information.
II. Other Uses and Disclosures Requiring Authorization
-A clinician may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. In those instances when a clinician is asked for information for purposes outside of treatment, payment, or health care operations, they will obtain an authorization from you before releasing this information.
-You may revoke all such authorizations at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) the clinicians has relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy.
-Authorization will also be obtained from you before using or disclosing PHI in a way that is not described in this notice.
III. Uses and Disclosures without Authorization
A clinician may use or disclose PHI without your consent or authorization in the following circumstances:
–Child Abuse – If a clinician has reason to believe that a child has been subjected to abuse or neglect, they must report this belief to the appropriate authorities.
–Adult and Domestic Abuse – A clinician may disclose protected health information regarding you if they reasonably believe that you are a victim of abuse, neglect, self-neglect or exploitation.
–Health Oversight Activities – If a clinician receives a subpoena from the Maryland Board of Examiners of Psychologists because they are investigating the clinician’s practice, they must disclose any PHI requested by the Board.
–Serious Threat to Health or Safety – If you communicate to a clinician a specific threat of imminent harm against another individual or if the clinician believes that there is clear, imminent risk of physical or mental injury being inflicted against another individual, they may make disclosures that they believe are necessary to protect that individual from harm. If they believe that you present an imminent, serious risk of physical or mental injury or death to yourself, they may make disclosures they consider necessary to protect you from harm.
–Judicial and Administrative Proceedings – If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment or the records thereof, such information is privileged under state law, and the clinician will not release information without your written authorization or a court order. The privilege does not apply when you are being evaluated by a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.
–When the use and disclosure without your consent or authorization is allowed under other sections of Section164.512 of the Privacy Rule and the state’s confidentiality law. This includes certain narrowly defined disclosures to law enforcement agencies, to a health oversight agency (such as a state department of health) to a coroner or medical examiner, for public health purposed relating to disease or FDA-regulated products or for specialized government functions such as fitness for military duties, eligibility for VA benefits, and national security and intelligence.
V. Patient’s Rights and Therapist’s Duties
Patient’s Rights:
–Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosures of protected health information. However, a clinician is not required to agree to a restriction you request.
–Right to Restrict Disclosures When You Have Paid for Your Care Out of Pocket –You have the right to restrict certain disclosure of PHI to a health plan when you pay out of pocket in full for the healthcare service.
–Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – You have the right to request and receive mailed confidential communications of PHI by alternative means and at alternative locations.
–Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI in your mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. Your clinician may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. On your request, they will discuss with you the details of the request and denial process for PHI.
–Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. Your clinician may deny your request. On your request, the clinician will discuss with you the details of the amendment process.
–Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI. On your request, your clinician will discuss with you the details of the accounting process.
Right to a Copy – You have the right to obtain a paper copy or an electronic copy upon request, in a format agreed upon by the patient and the psychologist.
–Right to be notified if There is a Breach of Your Unsecured PHI- You have a right to be notified if: (a) there is a breach involving your PHI; 9b) that PHI has not been encrypted to government standards; and (c) risk assessment fails to determine that there is a low probability that your PHI has been compromised.
Clinician’s Duties:
– A clinician is required by law to maintain the privacy of PHI and to provide you with a notice of their legal duties and privacy practices with respect to PHI.
– Clinicians reserve the right to change the privacy policies and practices described in this notice. Unless they notify you of such changes, however, they are required to abide by the terms currently in effect.
V. Questions and Complaints
-If you have questions about this notice, disagree with a decision your clinician makes about access to your records, or have other concerns about your privacy rights, you may contact them directly.
-If you believe that your privacy rights have been violated and wish to file a complaint with your clinician, you may send your written complaint to the practice. You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. Your clinician can provide you with the appropriate address upon request.
-You have specific rights under the Privacy Rule. Your clinician will not retaliate against you for exercising your right to file a complaint.
VI. Effective Date, Restrictions, and Changes to Privacy Policy
This notice will go into effect on October 15, 2024.
Your clinician reserves the right to change the terms of this notice and to make the new notice provisions effective for all PHI that they maintain. They will provide you with a revised notice by giving you a copy of the revised notice at a session with you or by mailing you a copy of the revision.
For more information, please see https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html