HIPAA - Privacy Statement

The law protects the privacy of all communications between a patient and a psychotherapist. In most situations, your therapist can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA.

Clients receiving drug and alcohol treatment: Records are protected under federal regulations governing Confidentiality of Alcohol and Drug Abuse Records, 42 CFI Part 2, and cannot be disclosed without written consent unless otherwise provided for in state or federal regulations. Consent may be revoked at any time except to the extent that action has been taken in reliance on it, and that in any event the consent expires automatically as follows: one year from the date signed unless otherwise specified.

There are other situations that require only that you provide written, advance consent. Your signature on this Agreement provides consent for those activities, as follows:

Communication: On occasion, your therapist may mail or leave phone messages regarding rescheduling of appointments, outstanding delinquent balances, practice changes, treatment newsletters or alternatives, workshops, or updates of services provided. This information will be directed to you and sensitive information will not be included in the notice or message. If you do not wish to receive messages or mail, please make sure you notify your the office or your therapist, in writing, of this request.

For Treatment: Your PHI may be used and disclosed by your therapist for the sole purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors and/or managing and administrative staff of Serenity Behavioral Health We may only disclose PHI to any other individual involved with your care with your specific authorization.

Consultation: Your therapist may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, every effort is made to avoid revealing the identity of a patient. Other professionals are also legally bound to keep the information confidential. If you don’t object, your therapist will not tell you about these consultations unless it is felt to be important to your work together. Consultations will be noted in your Clinical Record (which is called “PHI” in the HIPAA Notice).

Coverage: When your therapist is unavailable due to a scheduled vacation or illness, s/he may arrange for his/her practice to be covered by another licensed clinician or professional. This coverage is for emergencies and the professional will only access your information if contacted by you. This professional will only access information necessary to provide any assistance you might need during your therapists absence. This individual will also be HIPPA compliant.

For Payment: We may use and disclose PHI so that we can receive payment for the treatment services provided to you. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, we will disclose the minimum PHI necessary for purposes of collection.

For Health Care Operations: We may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, we may share your PHI with third parties that perform various business activities (e.g., billing or typing services) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI.

For training or teaching purposes: PHI will be disclosed only with your authorization.

Without Authorization

Following is a list of the categories of uses and disclosures permitted by HIPAA without an authorization. Applicable legal and ethical standards permit us to disclose information about you without your authorization only in a limited number of situations. It is the practice of the therapists of Serenity Behavioral Health to adhere to more stringent privacy requirements for disclosures without an authorization. The following language addresses these categories to the extent consistent with HIPAA.

Child Abuse or Neglect: If there is reasonable cause, on the basis of the professional judgment of the therapist, to suspect abuse of any child with whom the therapist comes into contact in his/her professional capacity and/or if a therapist should hear through a third party about abuse of a child, that therapist is required by law to report this to the Pennsylvania Department of Public Welfare.

Judicial and Administrative Proceedings: If you are involved in a court proceeding and a request is made about the professional services provided you or the records thereof, such information is privileged under state law and will not be released without your written consent or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case. If you file a complaint or lawsuit against any therapist at Serenity Behavioral Health, that therapist may disclose relevant information in order to defend him/herself.

Deceased Patients: We may disclose PHI regarding deceased patients as mandated by state law, or to a family member or friend that was involved in the deceased patient’s care (or payment for care) prior to death, based on the deceased patients prior consent. A release of information regarding the deceased patient may be limited to an executor or administrator of the deceased person’s estate or the person identified as next-of-kin. PHI of persons that have been deceased for more than fifty (50) years is not protected under HIPAA.

Medical Emergencies: We may use or disclose your PHI in a medical emergency situation to medical personnel only in order to prevent serious harm. Our staff will try to provide you notice of the release of PHI as soon as reasonably practicable after the resolution of the emergency.

Serious Threat to Health or Safety: If you express a serious threat, or intent to kill or seriously injure an identified or readily identifiable person or group of people, and it is determined by your therapist that you are likely to carry out the threat, the therapist must take responsible measures to prevent harm. Reasonable measures may include directly advising the potential victim of the threat or intent.

Family Involvement in Care: We may disclose information to close family members or friends directly involved in your treatment based only on your written authorization, or if you express a serious threat to self or others, and it is determined that you are likely to carry out that threat.

Health Oversight: If required, we may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that pay for treatment (such as third-party payers based on your prior consent) and peer review organizations performing utilization and quality control.

Law Enforcement: We may disclose PHI to a law enforcement official as required by law, in compliance with a subpoena (with your written consent), court order, administrative order or similar document, for the purpose of identifying a suspect, material witness or missing person, in connection with the victim of a crime, in connection with a deceased person, in connection with the reporting of a crime in an emergency, or in connection with a crime on the premises.

Public Health: If required, we may use or disclose your PHI for mandatory public health activities to a public health authority authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, or if directed by a public health authority, to a government agency that is collaborating with that public health authority.

Public Safety: We may disclose your PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat, it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

Worker’s Compensation: If you file a worker’s compensation claim, your therapist may be required to file periodic reports with your employer, which shall include, where pertinent, history, diagnosis, treatment, and prognosis.

Verbal Permission: At times, your therapist may obtain verbal permission to use or disclose your PHI upon your verbal request in emergency situations. A written authorization will be obtained as soon as possible. While this written information should prove helpful in informing you about your rights to privacy in a therapeutic relationship, it is important to discuss any questions or concerns that you may have now or in the future with your therapist. The laws governing confidentiality can be quite complex, and your therapist is not an attorney. In situations where specific advice is required, formal legal advice may be needed.

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