As required by HIPAA and HITECH, Family Innovations, Inc. has prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your treatment information.
We may use and disclose your medical records only for each of the following purposes: treatment, payment and health-care operations.
Treatment means providing, coordinating, or managing health care and related services by one or more health-care therapists. An example of this would include treatment session notes. Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment. Health-care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, confirming appointments, and customer service. An example would be an internal quality assessment review. We may also create and distribute de-identified health information by removing all references to individually identifiable information.
We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Any other uses and disclosures (such as for marketing purposes, or disclosures that constitute the sale of protected health information) will be made only with your written authorization. Furthermore, any disclosure of psychotherapy notes will be made only with your written authorization. You may revoke such an authorization at any time by sending written notification to our Privacy Officer listed below. We are required to honor and abide by that written request except to the extent that we have already taken actions based on your previous authorization.
You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer:
The right to request restriction on certain uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree, in writing, to remove it. The right to restrict disclosure of protected health information to your health plan if you are paying out-of-pocket in full for services provided. The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations. The right to inspect and request an electronic or paper copy of your protected health information. The right to amend your protected health information. The right to obtain from us, and we have the obligation to provide to you, a paper copy of this notice at your first service delivery date. The right to provide, and we are obligated to receive, written acknowledgement that you have received a copy of our Notice of Privacy Practices. The right to receive, and we are obligated to provide, notice of any breach of confidentiality of your protected health information. We are required by law to maintain the privacy of your protected health information and to provide you with a notice of our legal duties and privacy practices with respect to protected health information.
This notice is effective as of April 14, 2003 and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of a revised Notice of Privacy Practices from this office.
You have recourse if you feel that your privacy protections have been violated. You have the right to file a formal written complaint with us at the address below or with the Department of Health & Human Services, Office of Civil Rights, about violations of the provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint.
For more information about HIPAA/HITECH or to file a complaint: U.S. Department of Health & Human Services Office of Civil Rights 200 Independence Avenue South West Washington, D.C. 20201 (202) 619-6775 (877) 696-6775
To be informed of fees for therapy and method of payment, including insurance reimbursements. To be informed of a therapist’s availability and the length of time you can expect to wait for an appointment. To be informed of the therapist’s areas of specialization and limitations. To ask questions about issues related to your treatment. To negotiate therapeutic goals and to renegotiate when necessary. To ask questions about written materials pertaining to your treatment. To refuse a specific intervention or treatment strategy. To discuss aspects of treatment with others outside of therapy, including obtaining a second opinion. To request a written report (with your written authorization) regarding services rendered to a qualified therapist or organization. To know the ethics code to which the therapist adheres. To solicit help from the appropriate board in the event of a grievance regarding the therapist’s conduct. To terminate therapy at any time.