Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

All clients are required to sign a form at our office indicating that you have read and understand these policies.

Introduction to Clients

This notice will tell you about how Psychological Resource Associates (PRA) handles information about you and/or your child. It tells how we use this information in our office, how we share it with other professionals and organizations, and how you can see it. We are required to tell you about this because of a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

The law protects the privacy of all communications between a patient and a psychologist. In most situations we can only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by state law or HIPAA. Clients who are 13 or older must sign the written authorization form.

Your Medical Information

Each time you or your child visit us information is collected about you or you child's physical or mental health. It may be information about you or your child's past, present or future health or condition, the treatment or services received or about payment for health care. This information is called PHI, which stands for Protected Health Information. The information we obtain from you or your child goes into your or your child's medical record at out office. It is likely to include the following:

This information is used for many purposes. For example we may use it to:

Although your or your child's health record is the physical property of the health care practitioner or facility that collected it, the information belongs to you. You can inspect, read or review your record or your child's if he or she is under 13 (or 13 or older with the consent of the child). If you want a copy, we can make one for you, but we may charge you a reasonable fee for the costs of copying and mailing, if you want it mailed to you. In some very unusual situations you cannot see all of what is in the records. Except in the unusual circumstance that we conclude that disclosure of contents of that file could reasonably be expected to threaten your life or the life of another, or to endanger your safety or the safety of another, or that disclosure could reasonably be expected to lead to your identification of the person who provided information to me in confidence under circumstances where confidentiality is appropriate, you may examine and obtain a copy of your or your child's record, if you request it in writing.

Because the records are of a professional and technical nature, they can be misinterpreted or prove to be upsetting to an untrained reader. For this reason we recommend that you initially review them in the presence of your PRA service provider or have them forwarded to another mental health professional so you can discuss the contents. In most situations we are allowed to charge a reasonable fee for copying those records. If we refuse your request for access to your records, you have a right of review, which we will discuss with you upon request. In the event that your PRA service provider becomes incapacitated, Doctors Kahn and Cooper-Kahn will become custodian of the records and will assume their management. Their office phone number is 410-647-8840.

If you find anything in the records that you think is incorrect or something important is missing, you can ask your PRA service provider to amend (add information to) your record. In some rare situations, he or she does not have to agree to that.

How Protected Health Information Can Be Used and Shared

When your or your child's information is read by your PRA service provider or others in the PRA office, it is called “use.” If the information is shared with or sent to others outside this office, it is called “disclosure.” Except in some special circumstances, when we use your or your child's PHI or disclose it to others, we share only the minimum necessary PHI needed for the purpose. The law gives you rights to know about your PHI, how it is used, and to have a say in how it is disclosed.

Uses and Disclosures of PHI in Health Care with Your Consent

In almost all cases we intend to use your or your child's PHI here or share it with other people or organizations to provide an evaluation or treatment for you or your child, arrange for payment for my services, or some other business activities called “health care operations.”

We need information about you or your child in order to provide satisfactory care and evaluative services for you. You have to agree to let us collect that information and to use it and share it as necessary. Therefore, you must sign the Client Services Agreement before we begin to provide services for you or your child. If you do not agree and consent, we cannot treat or evaluate you or your child. Generally, we may use or disclose your or your child's PHI for three purposes: treatment, obtaining payment and communicating with third party payors about payment, and what are termed health care operations. If we have assistants helping with our practice, they will follow the same legal guidelines.

Treatment. Your PRA service provider might use your medical information to provide you or your child with psychological services or treatment. These might include individual, family, or group therapy, psychological or educational testing, treatment planning, or measuring the effects of his or her services.

She or he might share or disclose your or your child's PHI to others who provide treatment to you or your child, including a personal physician. He or she may occasionally find it helpful to consult other health and mental health professionals about a case. If she or he consults with a professional who is not involved in your treatment, she or he will make every effort to avoid revealing your identity. These professionals are legally bound to keep the information confidential. If you don't object, your PRA service provider will not tell you about these consultations unless he or she feels that it is important to our work together. However, he or she will note all consultations in your clinical record.

She or he may refer you or your child to other professionals or consultants for services that she or he cannot offer, such as special testing or treatments. When he or she doe this, he or she needs to tell those people things about your and your child's conditions. She or he will get back their findings and opinions and those will go into your records here. If you or your child receives treatment in the future from other professionals, your PRA service provider can also share your or your child's PHI with them.

Your PRA service provider may leave a message for you regarding an appointment. If you want him or her to call you only at work or only at home, he or she can usually arrange for that. We often leave messages on home answering machines. If this creates a problem, please let us know. We use cell and cordless phones, so privacy cannot be absolutely guaranteed with these devices.

Payment. We may use your information to bill you, your insurance, or others in order to be paid for the evaluation and treatment we provide to you or your child. We may contact your insurance company to determine what your insurance covers. We may have to tell them your or your child's diagnoses, dates of service, and what treatments you have received.

Health Care Operations. There are some other ways we may use or disclose your PHI, which are called health care operations. For example, we may be required to supply information to some government health agencies so they can study disorders and treatment and make plans for services that are needed. If we do, your or your child's name and identity will be removed from what we send.

PRA administrative staff may assist us with tasks like billing, filing, and taking messages. These assistants need to receive some of your or your child's PHI to perform these services properly. To protect your privacy, they will safeguard your and your child's information.

Uses and Disclosures Requiring Your Authorization

If we want to use your or your child's PHI for any purpose besides those described above, we need your written permission on an authorization form. If you do authorize us to use or disclose your or your child's PHI, you can revoke that permission in writing at any time (but be advised that we cannot undo any uses or disclosures prior to the revocation). If you want us to share information about you or your child with your family or close others, we will ask you what information you want me to share and with whom.

Uses and Disclosures of PHI from Mental Health Records Not Requiring Consent or Authorization

If you are involved in a court proceeding and a request is made for information concerning the professional services we provided you, such information may be protected by the psychologist-patient privilege law. We cannot provide any information without 1) your written authorization; 2) your informing us that you are seeking a legal restraint against our compliance with a subpoena that has been properly served on your PRA service provider and of which you have been notified; or 3) a court order requiring the disclosure. If you are involved in or contemplating litigation you should consult with your attorney about likely court disclosures.

If a governmental agency requests your or your child's PHI for health oversight activities, we may be required to provide it to them. If a patient files a complaint or lawsuit against us, we may disclose relevant information regarding that patient in order to defend ourselves. If a patient files a worker's compensation claim and the services we are providing are relevant to the injury for which the claim was made, we must, upon appropriate request, provide a copy of the patient's record to the patient's employer and the Department of Labor and Industries.

In some situations we are legally obligated to take actions that we believe are necessary to attempt to protect others from harm and we may have to reveal some information about a patient's treatment. These situations are unusual:

If we have reasonable cause to believe that a child has suffered abuse or neglect, the law requires us to file a report with the appropriate government agency, usually the Department of Social and Health Services. Once such a report is filed, we may be required to provide additional information. If we have reasonable cause to believe that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred, the law requires us to file a report with the appropriate government agency, usually the Department of Social and Health Services. Once such a report is filed, we may be required to provide additional information. If we reasonably believe that there is imminent danger to the health or safety of the patient or any other individual, we may be required to take protective actions. These actions may include notifying the potential victim, contacting the police, seeking hospitalization for the patient, or contacting family members or others who can help provide protection.

If such a situation arises, we will make every effort to discuss it fully with you before taking any action. We will limit our disclosure to what is necessary.

While this summary of exceptions to confidentiality should help inform you about potential problems, it is important that we discuss any questions or concerns that you now have or develop in the future. The law governing confidentiality can be complex. In situations where specific advice is required formal legal advice may be needed.

Patient Rights

In summary, HIPAA and Maryland State law provide you with certain rights regarding your clinical record and disclosure of protected health information about you. These rights include:

Minors

If your child is 13 or older and is not developmentally disabled, we will carry out the evaluation only if your child agrees to the evaluation and only if your child agrees to share the results with you and the agency that has retained my services.

An Accounting of Disclosures

When we disclose your or your child's PHI, we will keep a record of what was sent, when we sent it and to whom it was sent. You may ask for it at any time.

If you need more information or have questions about these privacy practices, please ask your PRA service provider. If you have a problem with how your or your child's PHI has been handled, or if you believe your or your child's privacy rights have been violated, please let us know. You have the right to file a complaint with PRA and with the Secretary of the Federal Department of Health and Human Services. PRA will not in any way limit your or your child's care or take any actions against you if you complain. The designated privacy officer for Psychological Resource Associates is Joyce Cooper-Kahn, Ph. D. She can be reached by phone at 410-647-8840.