You can ask me to communicate with you in a particular way or at a certain place. For example, you can ask me to call you at home rather than at work to schedule or cancel an appointment. I will try my best to do as you ask.
You have the right to ask me to to release your records to certain people involved in your care, such as family and friends, nonetheless you have a right to limit what I share. While I don’t have to agree to your request, if I do agree, I will keep our agreement except if it is against the law, or in an emergency, or when the information is necessary to treat you.
You have the right to look at the health information I have about you, such as your medical and billing records. You can get a copy of these records, however as stated in my Service agreement, I may wish to review the chart with you prior to release. However, I may not let you see or have certain psychotherapy notes if I feel the jargon can be misleading.
If you believe the information in your records is incorrect or incomplete, you can ask me to make some kinds of changes to your health information. You have to make this request in writing. You must tell me the reasons why you want to make the changes.
You have the right to a copy of this notice. If I change this NPP, I will make a copy of the changes available in my waiting room and you can always get a copy of it from me.
You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with me and with the Secretary of the Department of Health and Human Services. All complaints must be in writing. Filing a complaint will not change the health care I provide to you in any way.
If there is a breach of your confidentiality, then I must inform you as well as Health and Human Services. A breach means that information has been released without authorization or without legal authority unless I (the covered entity) can show that there was a low risk that the PHI has been compromised because the unauthorized person did not view the PHI or it was de-identified.
If you are self-pay, then you may restrict the information sent to insurance companies
Most uses and disclosures of psychotherapy notes and of protected health information require that you must sign an authorization (release of information form) for releases unless it is for purposes already mentioned in this Privacy Notice (such as mandated reporting of child abuse, reporting of elder abuse, reporting of impaired drivers, etc).
You have a right to receive a copy of your Protected Health Information in an electronic format or (through a written authorization) designate a third party who may receive such information. As I do not use electronic records, we will need to discuss such a request.