This notice describes how medical/mental health information about clients may be used and disclosed and how clients can get access to this information. Please review it carefully. Effective as of February 28, 2020.
I only release information about clients in accordance with state and federal laws governing the practice of counseling. Clients' information is kept strictly confidential with the following exceptions:
Use and disclosure of protected health information for the purposes of providing services. Providing treatment services, collecting payment, and conducting healthcare operations are necessary activities for quality care. State and federal laws allow me to use and disclose clients' health information for these purposes.
Treatment. I may use and disclose health information for the purposes of providing coordinated care with the providers indicated on clients' intake form or making referrals.
Payment. I may use and disclose health information for the purposes of verifying insurance and coverage, processing claims, and collecting fees and payment via electronic or other necessary means.
Other uses and disclosures. I may use and disclose health information for the purposes of mandated reporting and as required by law, criminal or civil damages, legal counsel, litigation or legal action, or in the event of emergencies.
Rights. Clients have the right to i) determine how I contact them (intake form), ii) consent to, request, or refuse the use of videoconferencing platforms or electronic payment methods for the purposes of rendering services remotely, iii) consent to or revoke the release of health information to other providers or individuals, and iv) request access and amendments to their record. Requests for amendments must occur in writing and may be denied. Such requests will be reviewed and a decision made promptly.
Acceptance of confidentiality and privacy risks and limitations stemming from use of technology for the purposes of your treatment. I do my best to ensure the confidentiality and privacy of electronic communications and transactions with clients. This includes but is not limited to sending emails in a secured format, password protected storage of information if stored on a device. Due to the involvement of third-parties in the provision of technology and web- or cloud-based services (including but not limited to internet service providers, e-mail and messaging services, video-conferencing platforms, and mobile phone carriers), I can neither personally guarantee the security of electronic/virtual communications and interactions nor be held liable for privacy breaches stemming from said communications and interactions. Clients understand, accept, and assume responsibility for the confidentiality and privacy risks and limitations of i) communicating with me about them and their treatment or ii) issuing payments for services via any and all electronic or virtual platforms that are provided, managed, serviced or maintained by third-parties, and release me from any professional and/or personal liability in the event that confidential information is compromised as a result of electronic communications, payment, or transactions with me.
Transfer of rights. Treatment records are kept in password-protected files on password-protected devices that only I can access. In the event that I become incapacitated, another licensed mental health professional previously designated by me will have access to client records and clients will be notified in writing that access to their record has been granted to the designated third-party.