We have a legal obligation to uphold the confidentiality of PHI and to furnish you with information about our legal responsibilities and privacy procedures concerning PHI. Our adherence to the directives outlined in this Notice of Privacy Practices is mandatory. We retain the authority to modify the contents of this Notice of Privacy Practices whenever necessary. Any updated Notice of Privacy Practices will be applicable to all PHI that we currently hold. We will ensure you receive the revised version by making it available on our website, mailing you a copy upon request, or providing one during your upcoming appointment.
Gonzalez Therapy is dedicated to safeguarding your privacy and ensuring the confidentiality of your personal and health information. This Notice of Privacy Practices describes how your information may be used and disclosed, as well as your rights concerning your protected health information (PHI).
USES AND DISCLOSURES OF PHI
For Treatment: We will only use and disclose your PHI for treatment, payment, and healthcare operations purposes, as permitted by law. Your PHI may be shared with other healthcare professionals involved in your care to ensure comprehensive treatment.
For Payment: Payment-related information will be used to process billing and insurance claims efficiently. We might utilize and reveal PHI to facilitate your efforts in obtaining reimbursement for the treatment services rendered to you. However, such actions will strictly require your written consent. Instances of payment-related actions encompass, but are not confined to, assessing services delivered to ascertain medical necessity or engaging in utilization review processes. Please be aware that payment for services rendered at Gonzalez Therapy is expected at the time of your appointment.
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, 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.
Required by Law: According to legal mandates, we are obligated to provide you with access to your PHI when requested. Furthermore, we are required to share information with the Department of Health and Human Services' Secretary as part of their investigations into our adherence to the Privacy Rule's stipulations.
Without Authorization
The subsequent enumeration outlines the classifications of permissible uses and disclosures under HIPAA without necessitating an authorization. Legal regulations and ethical norms allow us to reveal your information without seeking your authorization, but this is restricted to specific instances.
Being mental health practitioners licensed within this jurisdiction, we uphold heightened privacy standards when it comes to disclosures without an authorization. The ensuing text outlines these categories, aligning with both the NASW Code of Ethics and HIPAA regulations to the fullest extent possible.
Child Abuse or Neglect: We retain the authority to divulge your PHI to a state or local entity authorized by legislation to receive reports concerning child abuse or neglect.
Elderly/Disabled Person Abuse or Neglect: Your PHI may be disclosed to a state or local body, as stipulated by law, empowered to accept reports related to abuse or neglect of elderly or disabled individuals.
Suicidal Ideation: In situations where you express intentions of self-harm and are either unwilling or unable to create a safety plan with your therapist, we hold the right to share your PHI with law enforcement. Should your counselor find it necessary to pursue hospitalization on your behalf, they will make a concerted effort to engage in a discussion with you before any actions are taken.
Judicial and Administrative Proceedings: We may release your PHI as necessitated by legal obligations, in response to a judicial subpoena, or similar legal procedures.
Deceased Patients: Disclosures of PHI pertaining to deceased patients will adhere to state mandates, or if consent was previously given, to family members or friends who were part of your care or payment arrangements prior to the patient's passing. This may also extend to an estate's executor or administrator, as well as the designated next-of-kin. It's important to note that PHI of individuals deceased for over fifty (50) years is no longer safeguarded under HIPAA.
Medical Emergencies: In cases of a medical emergency aimed at averting severe harm, your PHI may be disclosed solely to medical personnel. Our team will make efforts to furnish you with a copy of this notice at the earliest possible time following the resolution of the emergency.
Involvement of Family in Care: Should you grant consent or when it becomes necessary to prevent serious harm, we have the capacity to share information with close family members or directly involved friends who are contributing to your treatment.
Law Enforcement: As compelled by legal obligations, we may reveal your PHI to law enforcement officials in alignment with subpoenas, court orders, administrative mandates, or analogous official documents. This action may be taken to identify suspects, essential witnesses, or missing individuals, or in relation to crime victims, the deceased, emergencies involving crime reports, or on-premises criminal activities.
Specific Government Functions: Requests from U.S. military command authorities for former armed forces personnel, authorized officials for national security and intelligence purposes, and the Department of State for medical assessments may prompt a review of your PHI. Any disclosures will be executed based on your written consent, obligatory disclosure regulations, or the imperative of averting significant harm.
Ensuring Public Safety: In instances where it becomes essential to forestall or mitigate an imminent and significant threat to the well-being of an individual or the general public, your PHI may be disclosed. If such a disclosure is necessary, it will be directed towards individuals reasonably capable of averting or lessening the threat, including the potential target.
Oral Consent: Your information may also be shared with family members actively participating in your treatment, provided you grant verbal permission for such disclosure.
With Your Authorization: Any uses or disclosures not explicitly authorized by pertinent regulations will only occur upon receipt of your written consent, which remains subject to revocation at any time. However, this exception does not apply to instances where a use or disclosure has already been executed based on your initial authorization. Specifically, two types of uses and disclosures will require your written authorization: (i) the majority of uses and disclosures involving psychotherapy notes, which are kept separate from the rest of your medical records, and (ii) other uses and disclosures not outlined in this Privacy Notice.
YOUR RIGHTS REGARDING YOUR PHI
You possess the following rights in connection with the PHI we hold about you. To exercise any of these rights, kindly submit a written request to our Privacy Officer at ileana.therapy@gmail.com
Right to Inspect and Copy: You hold the right, with rare exceptions, to review and obtain copies of your PHI maintained within a "designated record set." Such a set comprises mental health/medical and billing records, along with any other records utilized in making decisions about your care. This right may be constrained only if compelling evidence exists that access could result in serious harm to you or if the information resides within separately maintained psychotherapy notes. A reasonable, cost-based fee may apply for copies. Should your records be kept electronically, you may also request an electronic copy of your PHI. It is also within your prerogative to ask for a copy of your PHI to be given to another individual.
Right to Amend: Should you believe that the PHI we possess about you is erroneous or incomplete, you are entitled to request an amendment, although our agreement to such a request is not obligatory. Should your request for an amendment be denied, you maintain the right to submit a dissenting statement, to which we may provide a counterargument. Feel free to reach out to the Privacy Officer if you have inquiries.
Right to an Accounting of Disclosures: You have the right to seek an account of specific disclosures we make regarding your PHI. A reasonable fee may apply if you request more than one accounting within a 12-month period.
Right to Request Restrictions: It is within your rights to seek restrictions or limitations on the utilization or sharing of your PHI for treatment, payment, or health care operations. While we are not mandated to grant all requests, we are required to comply with restrictions regarding the disclosure of PHI to a health plan for payment or health care operations, provided the PHI pertains to a health care service you privately financed. In such cases, your request for a restriction will be honored.
Right to Request Confidential Communication: You have the prerogative to ask us to communicate with you about health matters in a particular manner or at a specific location. Reasonable requests will be accommodated. For compliance, we might need information regarding payment arrangements or specification of an alternative address or communication method. You are not obligated to provide an explanation for your request.
Breach Notification: Should an incident of unsecured PHI breach involving you occur, it might be obligatory for us to notify you about the breach, including details of the event and steps you can take to safeguard yourself.
Right to Obtain a Copy of this Notice: You are entitled to receive a copy of this notice.
COMPLAINTS
If you believe we have violated your privacy rights, you have the right to file a complaint in writing with our Privacy Officer at ileana.therapy@gmail.com or with the U.S. Department Health and Human Services Office of Civil Rights at 200 Independence Avenue, S.W. Washington, D.C. 20201 or by calling 1-800-368-1019 or by visiting their website at https://www.hhs.gov/ocr/complaints/index.html WE WILL NOT RETALIATE AGAINST YOU FOR FILLING A COMPLAINT.