Washington
County Psychotherapy Associates, P.A.
NOTICE OF PRIVACY PRACTICES
Effective: April 14, 2003
This notice
describes how medical/behavioral health information about you may be used and
disclosed and how you can get access to this information. Please review it carefully.
Here at Washington County
Psychotherapy Associates, P.A., (WCPA) we use your Protected Health information
(PHI) to provide services and treatment generally, receive payment, and for use
in our daily operations regarding your care.
Treatment. We may disclose your PHI for treatment
purposes on an as-needed basis. For
example, your therapist may make a referral for psychological testing to
provide better treatment. Your
therapist would then need to speak with the evaluator about the results from
this testing.
Payment. In order to receive payment for services, we
are required to use or disclose PHI.
For example, when we bill your insurance provider, we will disclose the
minimum PHI necessary to receive payment for services rendered.
Health Care
Operations. We may use
and disclose PHI in some aspects of our everyday health care operations. For example, PHI may be used to assist in
evaluating the performance of a health care provider.
There are
certain situations where consent is not required to disclose PHI. These situations are:
1.
Disclosure of PHI to a public health authority in order to
prevent or control disease, to report birth or death, and for the purpose of
public health investigations, interventions, and other related matters.
2.
Mandated reporting related to abuse and neglect regarding a
child or dependent adult.
3.
For the purpose of audits, investigations, inspections, or other
activities where licensing bodies may require the disclosure of PHI.
4.
PHI will be released in response to a court order.
5.
In the event of death, PHI may be disclosed to a coroner or
medical examiner.
6.
As mandated by law and clinical ethics, PHI will be disclosed
to prevent an immediate threat to the health and/or safety of the public or a
client in our care.
Clients may
be contacted at the address and/or telephone number provided to this agency in order
to provide appointment reminders, information about treatment alternatives or
other health-related benefits and services that may be of interest.
This agency, or our Business Associates, may use demographic information, and/or dates that behavioral health care has been provided for the purposes of fundraising. This PHI will not contain a client’s name or any other information that could reasonably be used for identification.
All other uses or disclosures of PHI will be made only with written authorization. Authorization may be revoked at any time.
In addition to the Rights of
Recipients of Mental Health Services and the Rights of Recipients of Mental
Health Services for Children who are in Need of Treatment, there are federal
regulations identifying specific rights.
This section highlights those federal rights.
¨ You have
the right to have a paper copy of this Notice of Privacy Practices. If there are additions or changes to this
notice, you will either receive a copy at your next scheduled session or a copy
will be mailed to your residence of record.
¨ You have
the right to inspect and copy PHI in your record. This will be completed under supervision and
consent of your WCPA provider. This process
is outlined in the WCPA Clinical Policy and Procedure manual (CP&P C7 “Client
Review of Clinical Documentation”).
¨ You may
request additions and/or changes to the PHI contained in your record. We may not be able to accommodate your
request for changes in situations where we did not create the record, or if the
record contains factual information and is accurate and complete. If you are not able to make changes to your
chart, you may submit a note that then would become part of your record.
¨ You have
the right to request that restrictions be placed on us for the use and
disclosure of your PHI. WCPA reserves
the right to deny such requests based on the information outlined within this
notice.
¨ You may
also receive an accounting of disclosures of your PHI dating back six years
from your request. This
accounting will not include disclosures used to carry out treatment, payment,
and health care operations; disclosures to you regarding your treatment;
disclosures to national security or intelligence purposes; disclosures to
correctional institutions or law enforcement officials if they have lawful
custody.
¨ Finally,
you have the right to receive communications from us regarding your PHI in a
confidential manner. If you wish
to exercise any of these rights, please contact your provider for assistance.
If you
believe that any of these rights, or your privacy rights have been violated,
you have the right to make a complaint to WCPA by contacting the Compliance
Officer at 207-255-4990 or to the Department of Health and Human Services at
1-877-696-6775. You are protected under
federal law from retaliation for complaints you make.
WCPA has a duty under the
law to inform you of our legal obligations regarding your PHI. Our obligations are as follows: we must maintain the privacy of your PHI; we
must follow the terms of this notice; we have the right to change the terms of
this notice, but if we do so, we must give you a copy of the new notice.
This notice
shall be posted in a clear and prominent location where it is reasonable to
expect individuals seeking services, to be able to read this notice. Furthermore, all individuals receiving
services for the first time shall be given a copy of this notice at the initial
face-to-face meeting with a WCPA provider.
If you would like to receive
a copy of the Notice of Privacy Practices,
please contact (207)
255-4990.