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Providing quality psychological services to children, adolescents, adults, and seniors.
2110 McFarland Blvd. E., Suite F; Tuscaloosa, Alabama 35404              205-758-7710

 

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Notice of Privacy Practices

(Version 1)

This Notice is effective as of April 14, 2003.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

We are required by law to maintain the privacy of protected health information, and must inform you of our privacy practices and legal duties. You have the right to obtain a paper copy of this Notice upon request.

We are required to abide by the terms of the Notice of Privacy Practices that is most current. We reserve the right to change the terms of the Notice at any time. Any changes will be effective for all protected health information that we maintain. The revised Notice will be posted in the waiting room and on our web site. You may request a copy of the revised Notice at any time.

We have designated a Privacy Officer to answer your questions about our privacy practices and to ensure that we comply with applicable laws and regulations. The Privacy Officer also will take your complaints and can give you information about how to file a complaint.

Our Privacy Officer is Joseph E. Maio, Ph.D. You can contact the Privacy Officer at 758-7710.

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Use and disclosure of your protected health information that we may make, with your consent, to carry out treatment, payment, and health care operations.

We may use information in your record to provide treatment to you. We may disclose information in your record to help you get health care services from another provider, a hospital, etc. For example, if we consult with another health care provider, such as your primary care physician, we may share information with him or her.

We may use or disclose information from your record to obtain payment for the services you receive. For example, we may submit information to your insurance company in order to demonstrate to the insurer that the service should be covered.

We may use or disclose information from your record to allow "health care operations." These operations include activities like reviewing records to see how care can be improved, contacting you with information about treatment alternatives, and coordinating care with other providers. For example, we may use information in your record if we are audited by a health oversight agency (such as Medicare) in order to prove that we provided the services we billed for.

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Your rights

You may ask us to restrict the use and disclosure of certain information in your record that otherwise would be allowed for treatment, payment, or health care operations. However, we do not have to agree to these restrictions.

You have a right to receive confidential communications from us. For example, if you want to receive bills and other information at an alternative address, please notify us.

You have a right to inspect the information in your record, and may obtain a copy of it. This may be subject to certain limitations and fees. Your request must be in writing. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. For this reason, we recommend that you initially review them in our presence, or have them forwarded to another mental health professional so you can discuss the contents. Patients under 14 years of age who are not emancipated and their parents should be aware that the law may allow parents to examine their child’s treatment records unless I decide that such access is likely to injure the child, or we agree otherwise.

If you believe information in your record is inaccurate or incomplete, you may request amendment of the information. You must submit sufficient information to support your request for amendment. Your request must be in writing.

You have the right to request an accounting of certain disclosures made by us.

You have the right to complain to us about our privacy practices (including the actions of our staff with respect to the privacy of your health information). You have the right to complain to the Secretary of the Department of Health and Human Services about our privacy practices. You will not face retaliation from us for making complaints.

Except as described in this Notice, we may not make any use or disclosure of information from your record unless you give your written authorization. You may revoke an authorization in writing at any time, but this will not affect any use or disclosure made by us before the revocation. In addition, if the authorization was obtained as a condition of obtaining insurance coverage, the insurer may have the right to contest the policy or a claim under the policy even if you revoke the authorization.

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Use or disclosure of your protected health information that we are required to make without your permission

In certain circumstances, we are required by law to make a disclosure of your health information. For example, state law requires us to report suspected child abuse or neglect (a child is anyone under age 18). We also must report suspected abuse, neglect, or exploitation of elders and other adults who may be considered "protected," such as disabled individuals and others who cannot take care of themselves. Also, we must disclose information to the Department of Health and Human Services, if requested, to prove that we are complying with regulations that safeguard your health information.

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Use or disclosure of your protected health information that we are allowed to make without your permission

There are certain situations where we are allowed to disclose information from your record without your permission. In these situations, we must use our professional judgment before disclosing information about you. Usually, we must determine that the disclosure is in your best interest, or we may have to meet certain guidelines and limitations.

Information related to mental health care, including treatment for substance abuse, may be more protected than other forms of health information. Communications between a psychotherapist and patient in treatment are privileged and may not be disclosed without your permission, except as required by law or as specified below.

We may use or disclose information from your record if we believe it is necessary to prevent or lessen a serious and imminent threat to the safety of a person or the public.

We may assist in health oversight activities, such as investigations of possible health care fraud. If the Alabama Board of Examiners in Psychology (the licensing authority for psychologists) ever chooses to conduct an investigation into our practice, we must disclose information from your record in response to a subpoena from the Board.

We may disclose information from your record as authorized by workers’ compensation laws. This information may be disclosed to your employer or the insurer.

We may disclose information from your record if ordered to do so by a court, grand jury, or administrative tribunal.

We may disclose information from your record if you file a complaint or lawsuit against us, in order to defend ourselves.

We may disclose information from your record if you are being evaluated by us for a third party (e.g., a lawyer) or if the evaluation is court-ordered. You will be informed in advance if this is the case.

We may disclose information from your record to a law enforcement official if certain criteria are met. For example, if you become a missing person and such information would help locate you, we are allowed to disclose it. We may disclose information from your record to a medical examiner or coroner.

If you tell us that you have committed a violent crime that caused serious physical harm to the victim, we may disclose that information to law enforcement officials. However, if you reveal that information in a counseling or psychotherapy session, or in the course of treatment for this sort of behavior, we may not disclose the information to law enforcement officials.

We may use or disclose information from your record for research under certain conditions.

Under certain conditions, we may disclose information for specialized government purposes, such as the military, national security and intelligence, or protection of the President.

We may contact you to provide appointment reminders as a courtesy. However, you are responsible for remembering your appointment.

We may contact you with information about treatment alternatives or other health-related benefits or services that may be of interest to you.

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Disclaimer:  You know, we see a disclaimer like this in every ad that lawyers put out, and it probably is a good idea for us to use one, too:  "No representation is made that the quality of the psychological services to be performed is greater than the quality of psychological services performed by other psychologists.  The outcome of assessments or psychotherapy, or individual client satisfaction, cannot be guaranteed and is dependent on many factors.  Material on this site regarding symptoms, disorders, and treatment is informational only.  Diagnosis and treatment of mental disorders requires the expertise of a trained professional."

The information on this site regarding psychological disorders and treatment comes from many sources that cannot be credited, simply because they have been integrated over the years into our general knowledge base. However, one important source is the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994) published by the American Psychiatric Association.