Privacy Policy

Any personal information you provide to us through our Web site, including your e-mail address,
is used for internal purposes.  We will only disclose information as required in the process of treating
your condition as outlined below:

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.

Notice of Privacy Practices
Privacy is a very important concern for all those who come to this office. It is also
complicated because of federal and state laws and our profession. Because the rules are so
complicated, some parts of this Notice are quite detailed and you probably will have to read
them several times to understand them. If you have any questions, our Privacy Officer will
be happy to help you. His or her name and address are at the end of this Notice.

Contents of this Notice

A.   Introduction - To Our Clients
B.   What we mean by your medical information
C.   Privacy and the laws about privacy
D.   How your protected health information 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 (TPO)
b. Other uses and disclosures in health care
2. Uses and disclosures requiring your Authorization
3. Uses and disclosures not requiring your Consent or
Authorization
4. Uses and disclosures requiring you to have an opportunity to
object
5. An Accounting of disclosures we have made
E.   If you have questions or problems

A. Introduction - To our clients

This notice will tell you about how we handle information about you. It tells how we use this
information here in this office, how we share it with other professionals and organizations, and
how you can see it. We want you to know all of this so you can make the best decisions for
yourself and your family. We are also required to tell you about this because of the privacy
regulations of a federal law, the Health Insurance Portability and Accountability Act of 1996
(HIPAA). Because this law and the laws of this state are very complicated and we don't want to
make you read a lot that may not apply to you, we have simplified some parts. If you have any
questions or want to know more about anything in this Notice, please ask our Privacy Officer
for more explanation or more details.

B. What we mean by your medical information

Each time you visit us or any doctor's office, hospital, clinic, or any other "healthcare provider,"
information is collected about you and your physical and mental health. It may be information
about your past, present or future health or conditions, or the treatment or other services you
got from us or from others, or about payment for healthcare. The information we collect from
you is called, in the law, PHI, which stands for Protected Health Information. This information
goes into your medical or healthcare record on file at our office. In this office this PHI is likely
to include these kinds of information:
• Your history. As a child, in school and at work, and marital and personal history.
• Reasons you came for treatment. Your problems, complaints, symptoms, needs, goals.
• Diagnoses. Diagnoses are the medical terms for your problems or symptoms.
• A treatment plan. These are the treatments and other services which we think will best help
you.
• Progress notes. Each time you come in we write down some things about how you are
doing, what we observe about you, and what you tell us.
• Records we get from others who treated you or evaluated you.
• Psychological test scores, school records, etc.
• Information about medications you took or are taking.
• Legal matters
• Billing and insurance information
This list is just to give you an idea; there may be other kinds of information that go into your
healthcare record here.
We use this information for many purposes. For example, we may use it:
• To plan your care and treatment.
• To decide how well our treatments are working for you.
• When we talk with other healthcare professionals who are also treating you, such as your
family doctor or the professional who referred you to us.
• To show that you actually received the services from us which we billed to you or to your
health insurance company.
• For teaching and training other healthcare professionals.
• For medical or psychological research.
• For public health officials trying to improve health care in this country.
• To improve the way we do our job by measuring the results of our work.
When you understand what is in your record and what it is used for, you can make better
decisions about who, when, and why others should have this information.
Although your health record is the physical property of the healthcare practitioner or facility
that collected it, the information belongs to you. You can inspect, read, or review it. If you want
a copy we can make one for you but may charge you for the costs of copying (and mailing if
you want it mailed to you). In some very unusual situations you cannot see all of what is in
your records. If you find anything in your records that you think is incorrect, or something
important is missing, you can ask us to amend (add information to) your record, although in
some rare situations we don't have to agree to do that. Our Privacy Officer, whose name is at
the end of this Notice, can explain more about this.




C. Privacy and the laws

The HIPAA law requires us to keep your PHI private and to give you this notice of our legal
duties and our privacy practices, which is called the Notice of Privacy Practices or NFP. We
will obey the rules of this notice as long as it is in effect, but if we change it, the rules of the new
NPP will apply to all the PHI we keep. If we change the NPP we will post the new Notice in our
office where everyone can see. You or anyone else can get a copy from our Privacy Officer at
any time and it will be posted on our website at www.drjulieann.com.

D. How your protected health information can be used and shared

When your information is read by me or others in this office, that is called, in the law, "use." If
the information is shared with or sent to others outside this office, that is called, in the law,
"disclosure." Except in some special circumstances, when we use your PHI here or disclose it to
others, we share only the minimum necessary PHI needed for the purpose. The law gives you
rights to know about your PHI, how it is used and to have a say in how it is disclosed and so
we will tell you more about what we do with your information.
We use and disclose PHI for several reasons. Mainly, we will use and disclose (share) it for
routine purposes and we will explain more about these below. For other uses we must tell you
about them and have a written Authorization Form, unless the law lets or requires us to make
the use or disclosure without your authorization. However, the law also says that we are
allowed to make some uses and disclosures without your consent or authorization.

1. Uses and disclosures of PHI in healthcare with your consent
After you have read this Notice you will be asked to sign a separate Consent Form to allow us
to use and share your PHI. In almost all cases we intend to use your PHI here or share your PHI
with other people or organizations to provide treatment to you, arrange for payment for our
services, or some other business functions called health care operations. Together these routine
purposes are called TPO and the Consent Form allows us to use and disclose your PHI for TPO.
Re-read that last sentence until it is clear because it is very important.

1a. For treatment, payment, or health care operations
We need information about you and your condition to provide care to you. You have to agree to
let us collect the information and to use it and share it as necessary to care for you properly. You
must sign the Consent Form before we begin to treat you because if you do not agree and
consent we cannot treat you.
When you come to see us, several people in our office may collect information about you and all
of it may go into your healthcare records here. Generally, we may use or disclose your PHI for
three purposes: treatment, obtaining payment, and what are called healthcare operations. Let's
see what these are about:
For treatment
We use your medical information to provide you with psychological treatment or services.
These might include individual, family, or group therapy, psychological, educational, or
vocational testing, treatment planning, or measuring the effects of our services.
We may share or disclose your PHI to others who provide treatment to you. We are likely to
share your information with your personal physician. If you are being treated by a team, we can
share some of your PHI with them so that the services you receive will be coordinated. They
will also enter their findings, the actions they took, and their plans into your record so we all
can decide what treatments work best for you and make up a Treatment Plan. We may refer
you to other professionals or consultants for services we cannot offer, such as special testing or
treatments. When we do this we need to tell them some things about you and your conditions.
We will get their findings and opinions and those will go into your records here. If you receive
treatment in the future from other professionals we can also share your PHI with them. These
are some examples so that you can see how we use and disclose your PHI for treatment.
For payment
We may use your information to bill you, your insurance, or others to be paid for the treatment
we provide to you. We may contact your insurance company to check on exactly what your
insurance covers. We may have to tell them about your diagnoses, what treatments you have
received, and what we expect as we treat you. We will need to tell them about when we met,
your progress, and other similar things.
For health care operations
There are some other ways we may use or disclose your PHI which are called health care
operations. For example, we may use your PHI to see where we can make improvements in the
care and services we provide. We 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 we do, your name and identity will be removed from what we send.

1b.   Other uses in healthcare
Appointment Reminders. We may use and disclose medical information to reschedule or
remind you of appointments for treatment or other care. If you want us to call or write to you
only at your home or your work or prefer some other way to reach you, we usually can arrange
that. Just tell us.
Treatment Alternatives. We may use and disclose your PHI to tell you about or recommend
possible treatments or alternatives that may be of interest to you.
Other Benefits and Services. We may use and disclose your PHI to tell you about health-
related benefits or services that may be of interest to you.
Research. We may use or share your information to do research and improve treatments. For
example, we may compare two treatments for the same disorder to see which works better or
faster or costs less. In all cases your name, address and other information that reveals who you
are will be removed from the information given to researchers. If they need to know who you
are, we will discuss the research project with you and you will have to sign a special
Authorization Form before any information is shared.
Business Associates. There are some jobs we hire other businesses to do for us. They are called
our Business Associates in the law. Examples include a copy service we use to make copies of
your health record and a billing service who figures out, prints, and mails our 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 contract with us to safeguard your information.

2. Uses and disclosures requiring your Authorization
If we want to use your information for any purpose besides the TPO or those we described
above, we need your permission on an Authorization Form. We don't expect to need this very
often.
If you do authorize us to use or disclose your PHI, you can revoke (cancel) that permission, in
writing, at any time. After that time we will not use or disclose your information for the
purposes that we agreed to. Of course, we cannot take back any information we had already
disclosed with your permission or that we had used in our office.

3. Uses and disclosures of PHI from mental health records Not requiring
Consent or Authorization
The laws lets us use and disclose some of your PHI without your consent or authorization in
some cases.

When required by law
There are some federal, state, or local laws which require us to disclose PHI.
• We have to report suspected child abuse.
• If you are involved in a lawsuit or legal proceeding and we receive a subpoena, discovery
request, or other lawful process, we may have to release some of your PHI. We will only do so
after trying to tell you about the request, consulting your lawyer, or trying to get a court order
to protect the information they requested.
• We have to release (disclose) some information to the government agencies which check on
us to see that we are obeying the privacy laws.

For Law Enforcement Purposes
We may release medical information if asked to do so by a law enforcement official to
investigate a crime or criminal.

For public health activities
We might disclose some of your PHI to agencies which investigate diseases or injuries.

Relating to decedents
We might disclose PHI to coroners, medical examiners or funeral directors, and to organizations
relating to organ, eye, or tissue donations or transplants.

For specific government functions
We may disclose PHI of military personnel and veterans to government benefit programs
relating to eligibility and enrollment, to Workers' Compensation programs, to correctional
facilities if you are an inmate, and for national security reasons.

To Prevent a Serious Threat to Health or Safety
If we come to believe that there is a serious
threat to your health or safety or that of another person or the public, we can disclose some of
your PHI. We will only do this to persons who can prevent the danger.

4. Uses and disclosures requiring you to have an opportunity to object
We can share some information about you with your family or close others. We will only share
information with those involved in your care and anyone else you choose, such as close friends
or clergy. We will ask you about who you want us to tell what information about your
condition or treatment. You can tell us what you want and we will honor your wishes as long as
it is not against the law.
If it is an emergency - so we cannot ask if you disagree - we can share information if we believe
that it is what you would have wanted and if we believe it will help you if we do share it. If we
do share information, in an emergency, we will tell you as soon as we can. If you don't approve
we will stop, as long as it is not against the law.

5. An accounting of disclosures
When we disclose your PHI we keep records of whom we sent it to, when we sent it, and what
we sent. You can get an accounting (a list) of many of these disclosures.

E. If you have questions or problems

If you need more information or have questions about the privacy practices described above,
please speak to the Privacy Officer, whose name and telephone number are listed below. If you
have a problem with how your PHI has been handled or if you believe your privacy rights have
been violated, contact the Privacy Officer. You have the right to file a complaint with us and
with the Secretary of the Federal Department of Health and Human Services. We promise that
we will not in any way limit your care here or take any actions against you if you complain.
If you have any questions regarding this notice or our health information privacy policies,
please contact our Privacy Officer who is Dr. Julie Allender and can be reached by
phone at 215-799-2220 or by e-mail at jaallender@comcast.net
 

The effective date of this notice is April 14,2007

Copyright 2007 by Edward Zuckerman, www.hipaahelp.info