Notice 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.
Privacy is a very important concern for all those who come to this office and for those who work here. Privacy is also complicated, because of the many federal and state laws that govern our practice and the professional ethics that guide us. Because the privacy rules are so complicated, some parts of this notice are very detailed, and you may have to read them several times to understand them. If you have any questions, Dr. KP Patrick (617-213-0064, kpatrick@discovering-balance.com) will be happy to help you understand their procedures and your rights.
Contents of this notice of privacy practices
A. Introduction: To Dr. Patrick’s clients
B. What Dr. Patrick means by “your medical information”
C. Privacy and the laws about privacy
D. How your protected health information (PHI) can be used and shared
1. Uses and disclosures with your consent
a. The basic uses and disclosures: For treatment, payment, and health care operations
b. Other uses and disclosures in health care
2. Uses and disclosures that require your consent and authorization
3. Uses and disclosures that do not require your consent or authorization
a. When required by law
b. For law enforcement purposes
c. For public health activities
d. For matters relating to deceased persons
e. For specific government functions
f. To prevent a serious threat to health or safety
4. Uses and disclosures where you have an opportunity to object
5. An accounting of disclosures Dr. Patrick has made
E. Your rights about your protected health information
F. If you have questions or problems
A. Introduction: To Dr. Patrick’s clients
This notice will tell you how Dr. Patrick will handle your medical information. It will explain how Dr. Patrick will use this information here in this office; how Dr. Patrick may disclose (share) it with other health care professionals and organizations; and how you can see it. Dr. Patrick wants you to know all of this so that you can make the best decisions for yourself and your family. If you have any questions or want to know more about anything in this notice, please ask Dr. Patrick for answers or explanations.
B. What Dr. Patrick means by “your medical information”
Each time you visit Dr. Patrick or any doctor’s office, hospital, clinic, or other health care provider, information is collected about you and your mental and/or physical health. It may be information about your past, present, or future health or conditions, or the tests or treatment you got from them or from others, or about payment for health care. All of this information is called “PHI,” which stands for “protected health information”, which means its privacy must be protected. This information goes into your medical or health care records in the office.
In this office, your PHI is likely to include these kinds of information:
· Your history: Things that happened to you as a child; your school and work experiences; your marriage, relationships, and other personal history.
· Your medical history of problems and treatments.
· Reasons you came for treatment: Your problems, complaints, symptoms, or needs.
· Diagnoses: These are the medical terms for your problems or symptoms.
· A treatment plan: This is a list of the treatments and other services that Dr. Patrick thinks will best help you.
· Progress notes: Each time you come in, Dr. Patrick will write down some things about how you are doing, what Dr. Patrick notices about you, and what you tell them.
· Records Dr. Patrick gets from others who treated you or evaluated you.
· Psychological test scores, school records, and other evaluations and reports.
· Information about medications you took or are taking.
· Legal matters.
· Billing and insurance information.
There may also be other kinds of information that go into your health care records here.
We use PHI for many purposes. For example, Dr. Patrick may use it:
· To plan your care and treatment.
· To decide how well Dr. Patrick’s treatments are working for you.
· When Dr. Patrick talks with other health care professionals who are also treating you, such as your family doctor or the professional who referred you to us. When Dr. Patrick does this, Dr. Patrick will ask for your consent. Almost always, Dr. Patrick will also ask you to sign a release-of-information form, which will explain what information is to be shared and why.
· For teaching and training other health care professionals or for medical or psychological research. If Dr. Patrick does this, your name will never be shown, and there will be no way they can find out who you are. Before Dr. Patrick does this, Dr. Patrick will ask for your consent and ask you to sign an authorization, so that you will know what information will be shared and why.
· To show that you actually received services from us, which Dr. Patrick billed to you or to your health insurance company.
· To improve the way Dr. Patrick does their job by measuring the results of their work.
When you understand what is in your record and what it is used for, you can make better decisions about what other persons or agencies should have this information, when, and why.
C. Privacy and the laws about privacy
Dr. Patrick is required to tell you about privacy because of a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the HIPAA Omnibus Final Rule of 2013. HIPAA requires them to keep your PHI private and to give you this notice about their legal duties and their privacy practices.
This form is not legal advice. It is just to educate you about your rights and their procedures. It is based on current federal and state laws and might change if those laws or court decisions change. If Dr. Patrick changes their privacy practices, they will apply to all the PHI Dr. Patrick keeps. Dr. Patrick will also post the new Notice of Privacy Practices in their office where everyone can see. You or anyone else can also get a copy from Dr. Patrick at any time. It is also posted on the website at www.discovering-balance.com. Dr. Patrick will obey the rules described in this notice.
D. How your protected health information (PHI) can be used and shared
Except in some special circumstances, when Dr. Patrick uses your PHI in this office or discloses it to others, Dr. Patrick will share only the minimum necessary PHI needed for others to do their jobs. The laws give you rights to know about your PHI, to know how it is used, and to have a say in how it is shared. So now Dr. Patrick will tell you more about what they will do with your information.
Mainly, Dr. Patrick will use it here and disclose (share) your PHI for routine purposes to provide for your care, and Dr. Patrick will explain more about these below. For other uses, Dr. Patrick must tell you about them and ask you to sign a written Release of Information form. However, the HIPAA law also says that there are some uses and disclosures that do not need your consent or authorization, which Dr. Patrick will explain below in section 3. However, in most cases Dr. Patrick will explain the PHI and who it will go to, and will ask you to agree to this by signing a release-of-information form.
1. Uses and disclosures with your consent
Dr. Patrick needs information about you and your condition to provide care to you. In almost all cases, Dr. Patrick intends to use your PHI here or share it with other people or organizations to provide treatment to you, arrange for payment for their services, or some other business functions called “health care operations.” You have to agree to let them use and share your PHI in the ways that are described in this Notice of Privacy Practices. To agree, Dr. Patrick will ask you to sign a separate consent form before they begin to treat you. If you do not consent to this, Dr. Patrick will not treat you because there is a risk of not helping you if Dr. Patrick doesn’t have some information.
a. The basic uses and disclosures: For treatment, payment, and health care operations
Here Dr. Patrick will tell you more about how your information will be used for these purposes.
For treatment. Dr. Patrick will use your information to provide you with psychological treatments or services. These might include individual, family, or group therapy; psychological, educational, or vocational testing; treatment planning; or measuring the benefits of their services.
We may share your PHI with others who provide treatment to you. Dr. Patrick may share your information with your personal physician, unless you tell them not to. If you are being treated by a team, Dr. Patrick can share some of your PHI with the team members, so that these providers will work best together. The other professionals treating you will also enter their findings, the actions they took, and their plans into your medical record so Dr. Patrick can decide what treatments work best for you and follow a treatment plan.
If Dr. Patrick wants to share your PHI with any other professionals outside this office, Dr. Patrick will need your permission on a signed release-of-information form. For example, Dr. Patrick may refer you to other professionals or consultants for services Dr. Patrick cannot provide. When Dr. Patrick does this, Dr. Patrick will need to tell them things about you and your conditions. Later, Dr. Patrick will get back their findings and opinions, and those will go into your records here. If you receive treatment in the future from other professionals, Dr. Patrick can also share your PHI with them. Dr. Patrick can do this only when you give your permission by signing a release-of-information form. This is so that you will know what information is being shared and with whom. These are some examples so that you can see how Dr. Patrick may use and disclose your PHI for treatment.
For payment. Dr. Patrick may use your information to bill you, your insurance, or others, so Dr. Patrick can be paid for the treatments Dr. Patrick provides to you. Dr. Patrick may contact your insurance company to find out exactly what your insurance covers. Dr. Patrick may be required to tell them about your diagnoses, what treatments you have received, and the changes Dr. Patrick expects in your conditions. Dr. Patrick will need to tell them about when you and Dr. Patrick met, your progress, and other similar things. Insurers may also look into a few of their patient records to evaluate the completeness of Dr. Patrick’s record keeping.
For health care operations. Using or disclosing your PHI for health care operations that go beyond Dr. Patrick’s care and payment for services. For example, Dr. Patrick may use your PHI to see where they can make improvements in the care and services they provide. Dr. Patrick may be required to supply some information to some government health agencies, so they can study disorders and treatment and make plans for services that are needed. If Dr. Patrick does, your name and all personal information will be removed from what they send.
b. Other uses and disclosures in health care
Appointment reminders. Dr. Patrick may use and disclose your PHI to reschedule or remind you of appointments for treatment or other care. If you want them to call or write to you only at your home or your work, or you prefer some other way to reach you, Dr. Patrick usually can arrange that.
Treatment alternatives. Dr. Patrick may use and disclose your PHI to tell you about or recommend possible treatments or alternatives that may be of help to you.
Research. Dr. Patrick may use or share your PHI to do research to improve treatments—for example, comparing two treatments for the same disorder, to see which works better or faster. In all cases, your name, address, and other personal information will be removed from the information given to researchers. Dr. Patrick will discuss this with you, and Dr. Patrick will not use your PHI unless you give your consent on an authorization form. If the researchers need to know who you are, Dr. Patrick will discuss the research project with you, and Dr. Patrick will not send any information unless you sign a special release-of-information form.
Business associates. Dr. Patrick may hire other businesses to do some jobs for them. In the law, they are called our “business associates.” Examples include a copy service to make copies of your health records, and a billing service to figure out, print, and mail the bills. These business associates need to receive some of your PHI to do their jobs properly. To protect your privacy, they have agreed in their contracts with them to safeguard your information just as Dr. Patrick does.
2. Uses and disclosures that require your consent and authorization
If Dr. Patrick wants to use your information for any purpose besides those described above, Dr. Patrick will need your permission on a release-of-information form. If you do allow them to use or disclose your PHI, and then change your mind, you can cancel that permission in writing at any time. Dr. Patrick will then stop using or disclosing your information for that purpose. Of course, Dr. Patrick cannot take back any information Dr. Patrick may have used here already or disclosed to anyone with your permission.
As a Clinical Psychologist licensed in this state, and as a member of this state’s Psychological Association (www.masspsych.org), Dr. Patrick will maintain your privacy more carefully than is required by HIPAA. The HIPAA rules are described below, but Dr. Patrick will almost always discuss these with you and ask you to sign a release-of-information so that you are fully informed.
3. Uses and disclosures that do not require your consent or authorization
The HIPAA laws let Dr. Patrick use and disclose some of your PHI without getting your consent or authorization in some cases. Here are some examples of when Dr. Patrick might do this. Dr. Patrick will almost always notify you if any of these situations occur.
a. When required by law
There are some federal, state, or local laws that require Dr. Patrick to disclose PHI, for example:
Dr. Patrick is required to report suspected abuse or neglect of children, elders and other vulnerable persons to a state agency.
If you are involved in a lawsuit or legal proceeding, and Dr. Patrick receives a subpoena, discovery request, or other lawful process, Dr. Patrick may have to release some of your PHI. Dr. Patrick will only do so after telling you about the request and will suggest that you talk to your lawyer.
Dr. Patrick is required to disclose some information to the government agencies that check on them to ensure that Dr. Patrick is obeying the privacy laws, and to organizations that review their work for quality and efficiency.
b. For law enforcement purposes
Dr. Patrick may release medical information if asked to do so by a law enforcement official to investigate a crime or criminal.
c. For public health activities
Dr. Patrick may disclose some of your PHI to agencies that investigate diseases or injuries.
d. For matters relating to deceased persons
Dr. Patrick may disclose PHI to coroners, medical examiners, or funeral directors, and to organizations relating to organ, eye, or tissue donations or transplants.
e. For specific government functions
Dr. Patrick may disclose PHI of military personnel and veterans to government benefit programs relating to eligibility and enrollment. Dr. Patrick may disclose your PHI to workers’ compensation and disability programs, to correctional facilities if you are an inmate, or to other government agencies for national security reasons.
f. To prevent a serious threat to health or safety
If Dr. Patrick comes to believe that there is a serious threat to your health or safety, or that of another person or the public, Dr. Patrick can disclose some of your PHI. Dr. Patrick will only do this to those people who can prevent the danger.
If it is an emergency, and Dr. Patrick is unable to get your agreement, Dr. Patrick can disclose information if they believe that it is what you would have wanted and if Dr. Patrick believes it will help you. When Dr. Patrick does share information in an emergency, Dr. Patrick will tell you as soon as they can. If you don’t approve, Dr. Patrick will stop, as long as doing so is not against the law.
4. Uses and disclosures where you have an opportunity to object
Dr. Patrick can share some information about you with your family and anyone else you choose, such as close friends or clergy. Dr. Patrick will ask you which persons you want them to tell, and what information you want them to tell them about your condition or treatment. You can tell them what you want, and Dr. Patrick will honor your wishes as long as doing so is not against the law.
5. An accounting of disclosures Dr. Patrick have made
When Dr. Patrick discloses your PHI, Dr. Patrick will keep a record of whom they sent it to, when they sent it, and what was sent. You can get an accounting (a list) of many of these disclosures. Dr. Patrick may charge you a reasonable fee if you request more than one accounting in any 12-month period. If the records were sent as electronic medical records, Dr. Patrick will always record that, and there will be no charge for an accounting.
E. Your rights about your protected health information
1. You can ask Dr. Patrick to communicate with you about your health and related issues in a particular way or at a certain place that is more private for you. For example, you can ask them to call you at home, rather than at work, to schedule or cancel an appointment. Dr. Patrick will try their best to do as you ask, and they don’t need an explanation. Sending your information in emails has some risk that these emails could be read by someone else. Dr. Patrick can set up a password-protected email service to prevent this, or you may just accept the risk of using emails just for simple messages like changing appointments, and not use it for any PHI or sensitive information. Dr. Patrick asks that you be thoughtful before you put any information in an email and not use email for anything you want kept private. By signing the separate consent form, you agree to this use of email. Please note that anything you send them electronically becomes a part of your legal record, even if Dr. Patrick does not place it in the chart. Be mindful of this, and please do not forward them emails from third parties or others in your life. It is better to print those out and bring them in to discuss them.
2. You have the right to ask Dr. Patrick to limit what they tell people involved in your care or with payment for your care, such as family members and friends. You can ask them face to face, and Dr. Patrick may then ask for your written permission. Dr. Patrick does not have to agree to your request, but if Dr. Patrick does agree, Dr. Patrick will honor it except when doing so is against the law, when there is an emergency, or when the information is necessary to treat you.
3. You have the right to prevent Dr. Patrick from sharing your PHI with your insurer or payer for its decisions about your benefits or some other uses, if you paid them directly (“out of pocket”) for the treatment or other services and are not asking the insurer to pay for those services, unless Dr. Patrick is under contract with your insurer (on their panel of providers).
4. You have the right to look at the PHI Dr. Patrick has about you, such as your medical and billing records. In some very unusual circumstances, if there is very strong evidence that reading this would cause serious harm to you or someone else, you may not be able to see all of the information.
5. You can get a copy of these records, but Dr. Patrick may charge you a reasonable cost-based fee. If your records are in electronic form, not on paper, you can ask for an electronic copy of your PHI. Contact Dr. Patrick to arrange how to see your records. Generally, Dr. Patrick does not recommend that you get a copy of your records, because the copy might be seen accidentally by others. Dr. Patrick will be happy to review the records with you or provide a summary to you, or work out any other method that satisfies you.
6. You have the right to add to (amend) your records to explain or correct anything in them. If you believe that the information in your records is incorrect or missing something important, you can ask them to make additions to your records or to include your own written statements to correct the situation. You have to make this request in writing and send it to Dr. Patrick.
7. You have the right to a copy of this notice. If Dr. Patrick changes this notice, Dr. Patrick will post the new one in their waiting area, and you can always get a copy from them.
8. If you have a problem with how your PHI has been handled, or if you believe your privacy rights have been violated, contact Dr. Patrick. Dr. Patrick will do their best to resolve any problems and do as you ask. You have the right to file a complaint with them and with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, DC 20201, or by calling 202-619-0257.
9. We will not in any way limit your care here or take any actions against you if you complain or request changes.
You may have other rights that are granted to you by the laws of our state, and these may be the same as or different from the rights described above. Dr. Patrick will be happy to discuss these situations with you now or as they arise.
F. If you have questions or problems
If you have any questions or problems about their health information privacy policies, please contact Dr. Patrick directly at 617-213-0064 or kpatrick@discovering-balance.com.
The effective date of this notice is 05/07/2024.