The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
- Suspected child abuse or dependant adult or elder abuse, for which the therapist required by law to report this to the appropriate authorities immediately
- If a client is threatening serious bodily harm to another person(s), the therapist must notify the police and inform the intended victim.
- If a client intends to harm himself or herself, the therapist will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, the therapist will take further measures without their permission that are provided to me by law to ensure their safety.
- In response to a subpoena
Please feel free to ask if you have questions about confidentiality.
Notice of Privacy Practices
As part of my professional practice, I maintain personal information about you and your health. State and federal law protects your privacy by limiting me in how I may use and disclose such information. Protected health information (“PHI”) is information about you, including demographic information, that may identify you or be used to indentify you, and that relates to your past, present or future physical or mental health or condition, the provision of health care services, or past, present or future payment for the provision of health care.
Your Rights Concerning Your Protected Health Information are as follows:
Right of Access to Inspect and Copy. You have the right, which may be restricted only in certain limited circumstances, to inspect and receive a copy of the protected health information that I maintain. I may charge a reasonable, cost-based fee for the copying process. Your copy request may also include transmittal directions to a third party.
Right to Amend. If you feel the protected health information I have about you is incorrect or incomplete, you may ask in writing to amend the information although I am not required to agree to the amendment. You may write a statement of disagreement if your request is denied. The statement will be maintained as part of your protected information and will be included with any disclosure.
Right to an Accounting of Disclosures. I maintain a record of disclosures I have made of your protected health information. You have the right to request a copy of such an accounting.
Right to Request Restrictions. You have the right to request in writing a restriction or limitation on the use or disclosure of your protected health information for treatment, payment, or health care operations. I am generally not required to agree to such a request. If I have been paid in full for all the services covered by such a request, the I will honor a request to restrict disclosure to your insurance.
Right to Request Confidential Communication. You have the right to request that I communicate with you in a certain way or at a certain location. I will accommodate reasonable requests and will not ask why you are making the request.
Uses and Disclosures of Protected Health Information for Treatment, Payment and Health Care Operations
Treatment. I may use your protected health information, with your written authorization, for the purpose of providing you with health care treatment, including management, coordination and continuity of your care with other of your current providers.
Payment. I may use your protected health information in connection with billing statements sent to you. I may also use your protected health information in connection with billing statements sent to you as well as tracking charges and credits to your account. Unless you have requested and I have specifically agreed to restrict disclosure of your protected health information to your health plan, I may disclose your information to third party payors to obtain information concerning benefit eligibility, coverage, and remaining availability as well submit claims for payment.
Uses and Disclosures That Do Not Require Your Authorization or Opportunity to Object
Required by law. I may use or disclose your protected health information to the extent that the use or disclosure is required by law, made in compliance with the law, and limited to the relevant requirements of the law. Examples are public health reports, abuse and neglect reports, law enforcement reports, and reports to coroners and medical examiners in connection with investigation of deaths. I also must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining my compliance with the requirements of the Privacy Rule.
Threat to Health or Safety. I may disclose your protected health information when necessary to minimize an imminent danger to the health or safety of you or any other individual.
Disaster or Emergency Relief Purposes. In situations of your absence, incapacity or emergency and in accordance with good professional practice, I may disclose your protected health information necessary to a public or private entity authorized by law or by its charter to assist in disaster relief efforts, which are directly relevant to your identification and care.
Compulsory Process. I will disclose your protected health information if a court issues an appropriate order. I will also your protected health information if (1) you and I have been notified in writing at least fourteen days in advance of a subpoena or other legal demand, identifying the protected health information sought, and the date by which a protective order must be obtained to avoid compliance, (2) no qualified judicial or administrative protective order has been obtained, (3) I have received satisfactory assurances that you received notice of your right to seek a protective order, and (4) the time for your doing so has elapsed.
Uses and Disclosures of Protected Health Information With Your Written Authorization
I will make other uses and disclosures of your protected health information only with written authorization. You may revoke this authorization in writing at any time, unless I have take substantial action in reliance on the authorization such as providing you with health care services for which I must submit subsequent claim(s) for payment.