CRISIS RESOURCES |
pSYCHIATRIC HOSPITALS (aDA/cANYON COUNTIES) |
Notices of privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Carmen French Counseling LLC ('The Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.
EFFECTIVE DATE OF THIS NOTICE: 02 April 2022
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION IN COMPLIANCE WITH The Health Information Portability and Accountability Act (HIPAA). PLEASE REVIEW IT CAREFULLY.
UNDERSTANDING YOUR HEALTH INFORMATION
Every time you visit a healthcare provider (i.e., hospital, physician, etc.) a record of your visit is made. Typically, this record contains a list of your symptoms, examination and test results, diagnosis, treatment, and a plan for future treatment. This information, often referred to as your “health” or “medical records”, serves as a:
• Basis for planning your care and treatment
• Means of communication among the many health professionals involved in your care
• Legal document describing the care you received
• Means by which you or a third-party payer can verify that services billed were actually provided
• A tool in educating health professionals
• A source of data for medical research
• A source of information for public health officials whose duty it is to improve the health of the nation
• A source of data for facility planning and marketing
• A tool with which we can assess and continually work to improve the care rendered and outcomes achieved
Understanding what is in your record and how it will be used will help you to ensure its accuracy, better understand who, what, where and why others may access your health information, and make better-informed decisions when authorizing disclosure to others.
I will not use or disclose your health information without your authorization, except as described in this notice.
Release of client information, whether the information is released by Carmen French Counseling LLC ("The Practice") or requested by The Practice from a third party outside of The Practice, is preceded by and agreed upon with a signed and dated Release of Information (ROI) agreement, for separate person or agency with whom information exchanges are needed. Each ROI has specific information as to what information may be released, to whom, the purpose, as well as for what period of time. Generally, Releases of Information are good for one year and must be renewed annually. The client/guardian has the right to revoke the ROI at any time. The Practice strives to limit the amount of information shared to only what is necessary for the determined purpose.
I. MY PLEDGE REGARDING HEALTH INFORMATION: I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a
record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you and describe certain obligations I have regarding the use and disclosure of your health information.
I am required by law to:
• Make sure that protected health information (“PHI”) that identifies you is kept private.
• Give you this notice of my legal duties and privacy practices with respect to health information.
• Follow the terms of the notice that is currently in effect.
I can modify the terms of this Notice, and such changes will apply to all information I have about you. If this notice is revised, a new Notice will be available upon request, and on my website.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: The following categories describe different ways that I may use and disclose health information. Not every use or disclosure in a category will be listed. However, all the ways I am permitted to use and disclose information will fall within one of the categories.
For Treatment, Payment, or Health Care Operations: Federal privacy regulations allow healthcare providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the healthcare provider’s own treatment, payment, or healthcare operations.
I may also disclose your protected health information for the treatment activities of any other healthcare provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed healthcare provider about you, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist in diagnosis and treatment of your mental health condition. In these situations, I will protect your identity unless you have given me permission to disclose it. Disclosures for treatment purposes are not limited to the minimum necessary standard because therapists and other healthcare providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes the coordination and management of healthcare providers with a third party, consultations between healthcare providers, and referrals of a patient for healthcare from one healthcare provider to another, and other such provisions of service.
Lawsuits and Disputes: If you are involved in a lawsuit, I may be required to disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
1. Psychotherapy Notes. If I decide to keep “psychotherapy notes” as that term is defined in 45 CFR § 164.508, any use or disclosure of such notes requires your authorization unless the use or disclosure is: a) For my use in treating you, b) For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy, c) For my use in defending myself in legal proceedings instituted by you, d) For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA, e) Required by law and the use or disclosure is limited to the requirements of such law, f) Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes, g) Required by a coroner who is performing duties authorized by law, h) Required to help avert a serious threat to the health and safety of others.
2. Marketing Purposes. As a counselor, I will not use or disclose your PHI for marketing purposes.
3. Sale of PHI. As a counselor, I will not sell your PHI in the regular course of my business.
IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, I can use and disclose your PHI without your authorization for the following reasons:
1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
3. For health oversight activities, including audits and investigations.
4. For judicial and administrative proceedings, including responding to a court or administrative order. However, I will do everything I can to obtain an authorization from you before doing so.
5. For law enforcement purposes, including reporting crimes occurring during our sessions.
6. To coroners or medical examiners, when such individuals are performing duties authorized by law.
7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
9. For Workers’ Compensation purposes. Although my preference is to obtain prior authorization from you, I may provide your PHI in order to comply with Workers’ Compensation laws.
10. Appointment reminders and health-related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other healthcare services or benefits that I offer.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.
Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or responsible for the payment for your healthcare, unless you object in whole or in part. In the case of an emergency, I may disclose PHI if it is in your best interest to disclose it because you are unable to state your preference.
The opportunity to consent may be obtained retroactively in emergency situations.
VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or healthcare operations purposes. I am not required to agree to your request, and I may say “no” if I believed it would affect your healthcare.
2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid For In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or healthcare operations purposes if the PHI pertains solely to a healthcare item or a healthcare service that you have paid for out-of-pocket in full.
3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address. I will agree to all reasonable requests.
4. The Right to See and Receive Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I charge a reasonable, cost-based fee for doing so.
5. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.
6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right to obtain a paper copy of this Notice, and you have the right to receive a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.
VII OUR RESPONSIBILITIES
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
• The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website www.carmenfrenchcounseling.com .
• The Practice will inform you if PHI is compromised in a breach.
Carmen French Counseling LLC ('The Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.
EFFECTIVE DATE OF THIS NOTICE: 02 April 2022
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION IN COMPLIANCE WITH The Health Information Portability and Accountability Act (HIPAA). PLEASE REVIEW IT CAREFULLY.
UNDERSTANDING YOUR HEALTH INFORMATION
Every time you visit a healthcare provider (i.e., hospital, physician, etc.) a record of your visit is made. Typically, this record contains a list of your symptoms, examination and test results, diagnosis, treatment, and a plan for future treatment. This information, often referred to as your “health” or “medical records”, serves as a:
• Basis for planning your care and treatment
• Means of communication among the many health professionals involved in your care
• Legal document describing the care you received
• Means by which you or a third-party payer can verify that services billed were actually provided
• A tool in educating health professionals
• A source of data for medical research
• A source of information for public health officials whose duty it is to improve the health of the nation
• A source of data for facility planning and marketing
• A tool with which we can assess and continually work to improve the care rendered and outcomes achieved
Understanding what is in your record and how it will be used will help you to ensure its accuracy, better understand who, what, where and why others may access your health information, and make better-informed decisions when authorizing disclosure to others.
I will not use or disclose your health information without your authorization, except as described in this notice.
Release of client information, whether the information is released by Carmen French Counseling LLC ("The Practice") or requested by The Practice from a third party outside of The Practice, is preceded by and agreed upon with a signed and dated Release of Information (ROI) agreement, for separate person or agency with whom information exchanges are needed. Each ROI has specific information as to what information may be released, to whom, the purpose, as well as for what period of time. Generally, Releases of Information are good for one year and must be renewed annually. The client/guardian has the right to revoke the ROI at any time. The Practice strives to limit the amount of information shared to only what is necessary for the determined purpose.
I. MY PLEDGE REGARDING HEALTH INFORMATION: I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a
record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you and describe certain obligations I have regarding the use and disclosure of your health information.
I am required by law to:
• Make sure that protected health information (“PHI”) that identifies you is kept private.
• Give you this notice of my legal duties and privacy practices with respect to health information.
• Follow the terms of the notice that is currently in effect.
I can modify the terms of this Notice, and such changes will apply to all information I have about you. If this notice is revised, a new Notice will be available upon request, and on my website.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: The following categories describe different ways that I may use and disclose health information. Not every use or disclosure in a category will be listed. However, all the ways I am permitted to use and disclose information will fall within one of the categories.
For Treatment, Payment, or Health Care Operations: Federal privacy regulations allow healthcare providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the healthcare provider’s own treatment, payment, or healthcare operations.
I may also disclose your protected health information for the treatment activities of any other healthcare provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed healthcare provider about you, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist in diagnosis and treatment of your mental health condition. In these situations, I will protect your identity unless you have given me permission to disclose it. Disclosures for treatment purposes are not limited to the minimum necessary standard because therapists and other healthcare providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes the coordination and management of healthcare providers with a third party, consultations between healthcare providers, and referrals of a patient for healthcare from one healthcare provider to another, and other such provisions of service.
Lawsuits and Disputes: If you are involved in a lawsuit, I may be required to disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
1. Psychotherapy Notes. If I decide to keep “psychotherapy notes” as that term is defined in 45 CFR § 164.508, any use or disclosure of such notes requires your authorization unless the use or disclosure is: a) For my use in treating you, b) For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy, c) For my use in defending myself in legal proceedings instituted by you, d) For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA, e) Required by law and the use or disclosure is limited to the requirements of such law, f) Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes, g) Required by a coroner who is performing duties authorized by law, h) Required to help avert a serious threat to the health and safety of others.
2. Marketing Purposes. As a counselor, I will not use or disclose your PHI for marketing purposes.
3. Sale of PHI. As a counselor, I will not sell your PHI in the regular course of my business.
IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, I can use and disclose your PHI without your authorization for the following reasons:
1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
3. For health oversight activities, including audits and investigations.
4. For judicial and administrative proceedings, including responding to a court or administrative order. However, I will do everything I can to obtain an authorization from you before doing so.
5. For law enforcement purposes, including reporting crimes occurring during our sessions.
6. To coroners or medical examiners, when such individuals are performing duties authorized by law.
7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
9. For Workers’ Compensation purposes. Although my preference is to obtain prior authorization from you, I may provide your PHI in order to comply with Workers’ Compensation laws.
10. Appointment reminders and health-related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other healthcare services or benefits that I offer.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.
Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or responsible for the payment for your healthcare, unless you object in whole or in part. In the case of an emergency, I may disclose PHI if it is in your best interest to disclose it because you are unable to state your preference.
The opportunity to consent may be obtained retroactively in emergency situations.
VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or healthcare operations purposes. I am not required to agree to your request, and I may say “no” if I believed it would affect your healthcare.
2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid For In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or healthcare operations purposes if the PHI pertains solely to a healthcare item or a healthcare service that you have paid for out-of-pocket in full.
3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address. I will agree to all reasonable requests.
4. The Right to See and Receive Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I charge a reasonable, cost-based fee for doing so.
5. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.
6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right to obtain a paper copy of this Notice, and you have the right to receive a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.
VII OUR RESPONSIBILITIES
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
• The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website www.carmenfrenchcounseling.com .
• The Practice will inform you if PHI is compromised in a breach.
