Notice of Alanna Sadoff, LMHC Policies and Practices to protect the Privacy of Your Health Information.
This notice describes how mental health and medical information about you may be used and disclosed and how to get access to this information. Please review it carefully.
Uses and Disclosures for Treatment, Payment and Health Care Operations
I may used or disclose your protected health information (PHI) for treatment, payment and health care operations with your consent. To help clarify these terms, here are some definitions:
“PHI” refers to information in your health care record that could identify you.
“Treatment, Payment and Health Care Operations”
¨ Treatment is when I provide, coordinate or manage your health care and other services related to your health care. An example of treatment would be when I consult with another health care provider such as a primary care doctor or another counselor.
¨ Payment is when I obtain reimbursement for your healthcare. Examples of payment are when I disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.
“Disclosure” applies to activities outside my office, such as releasing, transferring, or providing access to information about you to other parties.
I may use or disclose PHI for purposes outside treatment, payment and health care operations when your appropriate authorization is obtained. An authorization is a written permission above and beyond the general consent that permits only specific disclosures. In those instances when I am asked for information outside of treatment, payment and health care operations, I will obtain an authorization from you before releasing this information.
Abuse of Children and Vulnerable Adults: If a client or parent/guardian suggests that he/she is abusing or harming a child or vulnerable adult, or has recently abused or harmed a child or vulnerable adult, or a child or vulnerable adult is in danger of abuse or harm, the health care provider is required to report this information to the appropriate social service and/or legal authorities.
Court Orders: Health care professionals are required to release records of clients when a valid court order has been issued. A subpoena from an attorney, absent a court order still requires client consent to release records, however. You will be informed in advance if this is the case.
Law Enforcement: I may be required to release medical information if asked to do so by a law enforcement officer.
In response to a court order, subpoena, warrant, summons or similar proces
To identify or locate a suspect fugitive, material witness, or missing person
About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement.
About a death I believe may be the result of criminal misconduct
In emergency circumstances to report a crime; the location of a crime or victims; or the identity, description or location of the person who committed the crime.
Medical Examiners: I may be required to release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.
National Security & Intelligence Activities: I may be required to release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Service for the President and Others: I may be required to disclose medical information about you to authorized federal officials so they may provide protection to the president of the United States.
Health Oversight: I may be required to disclose medical information to an authorized health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, licensure and accreditation. These activates are necessary for the government to monitor the health care system, and related government programs, as well as compliance with civil rights laws.
Minors/Guardianship: Parents or legal guardians of non-emancipated minors have the right to review the client’s records.
Right to Request Restrictions: You have the right to request restrictions on certain issues and disclosures of protected health information about you. However, I am not required to agree to a restriction of your request.
Right to Receive Confidential Communications by Alternative Means at Alternative Locations: You have the right to request and receive confidential communications of PHI by alternative means and alternative locations. For example, you may not want a family member to know you are seeing me. Upon request, I will send your bills or other correspondence to another address.
Right to Inspect and Copy: You have the right to inspect or obtain a copy (or both) of PHI in the mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. I may deny you access to PHI under certain circumstances, but in some cases, you may have this decision reviewed. On your request, I will discuss with you the details of the request and denial process.
A “breach” is defined as the acquisition, access, use or disclosure of PHI in violation of the HIPAA Privacy Rule. Examples, of breach include: stolen or improperly accessed PHI; PHI inadvertently sent to the wrong provider or PHI that is “unsecured” if it is not encrypted to government standards.
3. To whom the PHI may have been disclosed.
4. Whether the PHI was actually acquired or viewed.
5. The extent to which the risk to the PHI has been mitigated.
If you have any questions about this notice, disagree with a decision I make about access to your records, or have any other concerns about your privacy rights, you may contact me at (401) 829-9956 for further information.
If you believe your privacy rights have been violated and wish to file a complaint with me, you may send your written complaint to me at my office address noted above.
You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. I can provide you with the appropriate address upon request.