Privacy Policy

Last updated December 26, 2021

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, HOW YOU CAN GET ACCESS TO THIS INFORMATION, YOUR RIGHTS CONCERNING YOUR HEALTH INFORMATION AND OUR RESPONSIBILITIES TO PROTECT YOUR HEALTH INFORMATION. PLEASE REVIEW IT CAREFULLY

State and Federal laws require me to maintain the privacy of your health information and to inform you about my privacy practices by providing you with this Notice. I am required to abide by the terms of this Notice of Privacy Practices. This Notice will take effect on February 1, 2022 and will remain in effect until it is amended or replaced by me. 

I reserve the right to change my privacy practices provided law permits the changes. Before I make a significant change, this Notice will be amended to reflect the changes and I will make the new Notice available upon request. I reserve the right to make any changes to my privacy practices and the new terms of my Notice effective for all health information maintained, created and/or received by me before the date changes were made. 

You may request a copy of my Privacy Notice at any time.

I will keep your health information confidential, using it only for the following purposes: 

Treatment: While I am providing you with psychotherapy services, I may share your protected health information (PHI) including electronic protected health information (ePHI) with business associates and their subcontractors or individuals who are involved in your treatment, billing, administrative support or data analysis. These business associates and subcontractors through signed contracts are required by Federal law to protect your health information. 

Payment: I may use and disclose your health information to seek payment for services provided to you.  This disclosure involves any current or future business office staff and computer generated payment processing programs. This may also include other third parties that may be responsible for such costs, such as family members. 

Health Insurance: I am not accepting or processing health insurance payments at this time. If I decide to accept health insurance payments in the future, your written authorization in order to communicate with them will be required.

Disclosure:. Health information about you may also be disclosed to your family, friends and/or other persons you choose to involve in your care, but only if you agree in writing that I may do so. If you become deceased, I may disclose your PHI to a family member or individual involved in your care or payment prior to your death. Psychotherapy notes will not be used or disclosed without your written authorization, unless mandated by law. Uses and disclosures not described in this notice will be made only with your signed authorization. 

Consultation:  I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name.

Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures” of your protected information if the disclosure was made for purposes other than providing services, payment, and or business operations. In light of the increasing use of Electronic Medical Record technology (EMR), the HITECH Act allows you the right to request a copy of your health information in electronic form if we store your information electronically. Disclosures can be made available for a period of 6 years prior to your request and for electronic health information 3 years prior to the date on which the accounting is requested. If for some reason we aren’t capable of an electronic format, a readable hardcopy will be provided. To request this list or accounting of disclosures, you must submit your request in writing. Lists, if requested, will be $0.20 for each page and the time charged will be $50 per hour including the time required to locate and copy your health information. May 23, 2016 OCR clarified a flat fee for electronic copies may not exceed $6.50 (including labor for copies, supplies and postage); this does not mean that the ceiling for all requests for access is $6.50.

Right to Request Restriction of PHI: If you pay in full out of pocket for your treatment, you can instruct me not to share information about your treatment with your health plan; if the request is not required by law. Effective March 26, 2013, The Omnibus Rule restricts provider’s refusal of an individual’s request not to disclose PHI. 

Non-routine Disclosures: You have the right to receive a list of non-routine disclosures I have made of your health care information. You can request non-routine disclosures going back 6 years. 

Emergencies: I may use or disclose your health information to notify, or assist in the notification of a family member or anyone responsible for your care, in case of any emergency involving your care, your location, your general condition or death. If at all possible I will provide you with an opportunity to object to this use or disclosure. Under emergency conditions or if you are incapacitated I will use my professional judgment to disclose only that information directly relevant to your care. 

Required by Law: I may use or disclose your health information when I am required to do so by law. (Court or administrative orders, subpoena, discovery request or other lawful process.) I will use and disclose your information when requested by national security, intelligence and other State and Federal officials and/or if you are an inmate or otherwise under the custody of law enforcement. 

National Security: The health information of Armed Forces personnel may be disclosed to military authorities under certain circumstances. If the information is required for lawful intelligence, counterintelligence or other national security activities, I may disclose it to authorized federal officials. 

Abuse or Neglect: I may disclose your health information to appropriate authorities if I reasonably believe that you are a possible victim or perpetrator of abuse, neglect, domestic violence or the possible victim of other crimes. This information will be disclosed only to the extent necessary to prevent a serious threat to your health or safety or that of others. 

Public Health Responsibilities: If we meet in person and I have reason to believe that you have been exposed to a communicable disease/infection, such as COVID-19, I may be required to notify local health authorities. If this disclosure is required, I will only provide the minimum information necessary for their data collection and will not disclose the reason(s) for your appointment.

Marketing Health-Related Services: I will not use your health information for marketing purposes. 

Appointment Reminders: I may use your health records to remind you of scheduled appointments. 

Access: Upon written request, you have the right to inspect and get copies of your health information (and that of an individual for whom you are a legal guardian.) I will provide access to health information in a form / format requested by you. There will be some limited exceptions. If you wish to examine your health information, you will need to complete and submit an appropriate request form. You may also request access by sending me an email to the address at the end of this Notice. Once approved, an appointment can be made to review your records. Copies, if requested, will be $ 0.20 for each page and the time charged will be $50 per hour including the time required to copy your health information. If you want the copies mailed to you, postage will also be charged. Access to your health information in electronic form if (readily producible) may be obtained with your request. If for some reason we aren’t capable of an electronic format, a readable hardcopy will be provided. If you prefer a summary or an explanation of your health information, we will provide it for a fee. May 23, 2016 OCR clarified a flat fee for electronic copies may not exceed $6.50 (including labor for copies, supplies and postage); this does not mean that the ceiling for all requests for access is $6.50. 

Amendment: You have the right to amend your healthcare information, if you feel it is inaccurate or incomplete. Your request must be in writing and must include an explanation of why the information should be amended. Under certain circumstances, your request may be denied. 

Breach Notification Requirements: It is presumed that any acquisition, access, use or disclosure of PHI not permitted under HIPAA regulations is a breach. We are required to complete a risk assessment, and if necessary, inform HHS and take any other steps required by law. You will be notified of the situation and any steps you should take to protect yourself against harm due to the breach. 

QUESTIONS AND COMPLAINTS 

You have the right to file a complaint with me if you feel I have not complied with my Privacy Policies. If you feel I may have violated your privacy rights, or if you disagree with a decision I made regarding your access to your health information, you can complain to me in writing. We support your right to the privacy of your information and will not retaliate in any way if you choose to file a complaint with me or with the U.S. Department of Health and Human Services. 

HOW TO CONTACT ME: 

Mary Elizabeth Wilkes Chand

(504) 355-1729 | mewc.lcsw@gmail.com