Privacy Practices
Lisa Martin, Ph.D., Clinical Psychologist
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
This office is required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about the privacy practices, legal obligations, and your rights concerning your health information (“Protected Health Information “ or “PMI.”) This office will follow the privacy practices that are described in this Notice. For more information about these privacy practices please contact Dr. Martin by calling 302-893-3717.
I. USES AND DISCLOSURES OF PROTECTED HEALTH INFORAMTION
A. Permissible Uses and Disclosures without Your Written Authorization - HIPAA states that this office may use and disclose PHI without your written authorization, excluding Psychotherapy Notes as described in Section II, for certain purposes as described below. The examples provided in each category are not meant to be exhaustive, but instead are meant to describe the types of uses and disclosures that are permissible under this federal law. HIPAA also expects health care practitioners to follow more restrictive disclosure practices if mandated by state or federal law, or professional practice standards. With the exception of section 4 below, more restrictive laws and standards generally do govern the work of this office. Please refer to Section B. below.
1. Treatment: This office may use and disclose PHI (e.g. information we might obtain from another provider you have seen, or the like) in order to provide treatment to you. For example, this office may use PHI to diagnose and provide counseling service to you. In addition, this office may disclose PHI to other health care providers involved in your treatment.
2. Payment: This office may use or disclose PHI so that services you receive are appropriately billed to, and payment is collected from, your health plan. By way of example, we may disclose PHI to permit your heath plan to take certain actions, such as approving psychotherapy visits.
3. Heath Care Operations: This office may use and disclose PHI in connection with the office’s health care operations, including quality improvement activities, training programs, accreditation, certification, licensing, or credentialing activities.
4. Required or Permitted by Law. This office may use or disclose PHI when we are required or permitted to do so by law. For example, this office may disclose PHI to appropriate authorities if the clinician reasonably believes that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. In addition this office may disclose PHI to the extent necessary to avert a serious thereat to your health or safety or the heath or safety of others. Other disclosures permitted or required by law include the following: disclosures for public health activities; health oversight activities including disclosures to state or federal agencies authorized to access PHI; disclosures to judicial and law enforcement officials in response to a court order or other lawful process, disclosures for research when approved by an institutional review board; and disclosures to military or national security agencies, coroners, medical examiners, and correctional institutions or otherwise as authorized by law.
B. Uses and Disclosures Requiring Your Written Authorization - Delaware does not have a general, comprehensive statute granting a patient access to his/her medical records or protecting his/her confidential medical information. Rather, these privacy protections are contained in statutes governing specific entities or medical conditions. In addition, each of the professional disciplines (clinical social work, psychology and psychiatry) has explicit standards of care, which carefully mandate the protection of your privacy, and the requirement for written releases for information disclosure. Therefore, we are bound to always seek your permission to release any PHI.
1. Psychotherapy Notes: Notes recorded by your clinician documenting the contents of a psychotherapy session with you (“Psychotherapy Notes”) will be used only by your clinician and will not otherwise be used or disclosed without your written authorization.
2. Marketing Communications: This office will not use your health information for marketing communication.
3. Other Uses and Disclosures: Uses and disclosures other than those described in Section 1.A. above will only be made with your written authorization. For example, you will need to sign an authorization form before this office can send PHI to your life insurance company, to a school, or to your attorney. These authorizations are time limited and you may revoke any such authorization at any time.
II. YOUR INDIVIDUAL RIGHTS
A. Right to Inspect and Copy. You may request copies of your medical record and billing records maintained by this office. All requests for access must be made in writing. Under limited circumstances, this office may deny access to your records if the clinician believes it would be seriously detrimental to your health or treatment progress. In cases where access is denied, the records may be made available to a licensed mental health professional selected by the client. That professional may, in exercising professional judgment, provide you with access to any or all parts of the records. This office will charge a fee for the administrative costs of copying and sending you any records requested. The fee will be based on the pro-rated amount of the regular hourly fee and the cost of postage.
B. Right to Request Restrictions: You have the right to request a restriction on PHI used for disclosure for treatment, payment or health care operations. You must request any such restriction in writing addressed to Dr. Lisa Martin.
C. Right to Accounting of Disclosures. Upon written request, you may obtain an accounting of certain disclosures to PHI made by this office. This right applies to disclosures for purposes other than treatment, payment, or heath care operations, but excludes disclosures made you or disclosures otherwise authorized by you, and is subject to other restrictions and limitations.
D. Right to Request Amendment: You have the right to request that this office amend your health information. Your request must be in writing, and it must explain why the information should be amended. This office may deny your request under certain circumstances.
E. Right to Obtain Notice: You have the right to obtain a paper copy of this Notice by submitting a request to Dr. Lisa Martin at any time.
F. Questions and Complaints. If you desire further information about your privacy rights, or are concerned that this office has violated your privacy rights, you may contact the Privacy Officer of this office, Dr. Lisa Martin, at 1521 Concord Pike, Suite 301, Wilmington, Delaware 19803. (302-893-3717) You may also file written complaints with the Director, Office for Civil Rights of the US Department of Health and Human Services. This office will not retaliate against you if you file a complaint.
III. EFFECTIVE DATE AND CHANGES TO NOTICE
A. Effective Date: This Notice became effective on June 30,, 2018.
B. Changes to this Notice: This office may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all PHI that we maintain, including any information created or received prior to issuing the new Notice. If this Notice is changed, all clients will be informed upon coming to the office. You many also obtain any revised Notice by contacting Dr. Lisa Martin.