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Privacy
Policies
As of April 14, 2003, a Federal law (HIPAA) requires that we
post this notice on our website. It contains information
about how we handle the protected health information of our
private therapy clients. Please contact us if you have
any questions or would like to receive a printed copy of this
notice.
Notice of Policies and Practices
to Protect the Privacy of Your Health Information
THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. Uses and Disclosures for Treatment, Payment, and
Health Care Operations
Barbara Reichlin, M. Dorsey Cartwright, and Imagoworks, may
use or disclose your protected health information (PHI), for
treatment, payment, and health care operations purposes with
your generalconsent. 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 we provide, coordinate or
manage your health care and other services related to your health
care. An example of treatment would be consultation with another
health care provider, such as your family physician or a colleague.
Payment is when we obtain reimbursement for
your healthcare. Examples of payment are when we disclose your
PHI to your health insurer to obtain reimbursement for your
health care or to determine eligibility or coverage.
Health Care Operations are activities that relate
to the performance and operation of our practice. Examples of
health care operations are business-related matters such as
file management, and case management and care coordination.
• "Use"
applies only to activities within our offices utilizing information
that identifies you.
•
"Disclosure" applies to activities outside of our
offices, such as releasing, transferring, or providing access
to information about you to other parties.
II.
Uses and Disclosures Requiring Authorization
We may use or disclose PHI for purposes outside of treatment,
payment, and health care operations when your appropriate authorization
is obtained. An "authorization" is written permission
above and beyond the general consent that permits only specific
disclosures. In those instances when we are asked for information
for purposes outside of treatment, payment and health care operations,
we will obtain an authorization from you before releasing this
information. We will also need to obtain an authorization before
releasing your psychotherapy notes. "Psychotherapy notes"
are notes we have made about our conversation regarding a private,
group, joint, or family counseling session. These notes are
given a greater degree of protection than PHI.
You may revoke all such authorizations (of PHI or psychotherapy
notes) at any time, provided each revocation is in writing.
You may not revoke an authorization to the extent that (1) we
have relied on that authorization; or (2) if the authorization
was obtained as a condition of obtaining insurance coverage,
and the law provides the insurer the right to contest the claim
under the policy.
III. Uses and Disclosures
with Neither Consent nor Authorization
We may use or disclose PHI without your consent or authorization
in the following circumstances:
• Child Abuse: If we have cause to believe that
a child has been, or may be, abused, neglected, or sexually
abused, we must make a report of such within 48 hours to the
Texas Department of Protective and Regulatory Services, the
Texas Youth Commission, or to any local or state law enforcement
agency.
• Abuse
of the Elderly and Disabled: If we have cause to believe
that an elderly or disabled person is in a state of abuse, neglect,
or exploitation, we must immediately report such to the Department
of Protective and Regulatory Services.
• Regulatory Oversight: If a complaint is filed
against a therapist with a regulatory authority, they have the
authority to subpoena confidential mental health information
relevant to that complaint.
• Judicial or Administrative Proceedings: If
you are involved in a court proceeding and a request is made
for information about your diagnosis and treatment and the records
thereof, such information is privileged under state law, and
we will not release information, without written authorization
from you or your personal or legally appointed representative,
or a court order. The privilege does not apply when you are
being evaluated for a third party or where the evaluation is
court ordered. You will be informed in advance if this is the
case.
• Serious
Threat to Health or Safety: If we determine that there
is a probability of imminent physical injury by you to yourself
or others, or there is a probability of immediate mental or
emotional injury to you, we may disclose relevant confidential
mental health information to medical or law enforcement personnel.
• Worker’s Compensation:
If you file a worker's compensation claim, we may disclose records
relating to your diagnosis and treatment to your employer’s
insurance carrier.
IV. Client's Rights
and Our Professional Duties
Client’s
Rights:
• Right to
Request Restrictions –You have the right to request
restrictions on certain uses and disclosures of protected health
information about you. However, we are not required to agree
to a restriction you request.
• Right to Receive Confidential Communications by
Alternative Means and at Alternative Locations –
You have the right to request and receive confidential communications
of PHI by alternative means and at alternative locations. (For
example, you may not want a family member to know that you are
seeking our services. Upon your request, we will send 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 and psychotherapy
notes in our mental health and billing records used to make
decisions about you for as long as the PHI is maintained in
the record. We may deny your access to PHI under certain circumstances,
but in some cases you may have this decision reviewed. On your
request, we will discuss with you the details of the request
and denial process.
•
Right to Amend – You have the right to request an
amendment of PHI for as long as the PHI is maintained in the
record. We may deny your request. On your request, we 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 for which you have neither provided consent
nor authorization (as described in Section III of this Notice).
On your request, we will discuss with you the details of the
accounting process.
•
Right to a Paper Copy – You have the right to obtain
a paper copy of the notice from me upon request, even if you
have agreed to receive the notice electronically.
Our Professional Duties:
• We are required by law to maintain the privacy of PHI
and to provide you with a notice of our legal duties and privacy
practices with respect to PHI.
• We reserve the right to change the privacy policies
and practices described in this notice. Unless we notify you
of such changes, however, we are required to abide by the terms
currently in effect.
•
If we revise our policies and procedures, we will post a current
copy in our offices. A current copy will always be available
on our web site and you may request a personal copy.
V. Questions and Complaints
If you have questions about this notice, disagree with a decision
we make about access to your records, or have other concerns
about your privacy rights, you may contact Barbara Reichlin
at 713.660.9988 or M. Dorsey Cartwright at 1-512-444-7733.
If you believe that your privacy rights have been violated and
wish to file a complaint with Ms. Reichlin, you may send your
written complaint to her at 4500 Bissonnet, Ste 335, Bellaire,
Texas.
If you believe that your privacy rights have been violated and
wish to file a complaint with Ms. Cartwright, you may send your
written complaint to her at 1714 B Barton Hills Drive, Austin,
Texas, 78704.
You may also send a written complaint to the Secretary of the
U.S. Department of Health and Human Services. We can provide
you with the appropriate address upon request.
You have specific rights under the Privacy Rule. We 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 4/24/2003. We reserve the
right to change the terms of this notice and to make the new
notice provisions effective for all PHI that we maintain. We
will provide you with a revised notice in our lobby and on our
web site. You may request a personal copy at any time. |
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