This Notice describes how The Madeline Centre may use and disclose our clients protected health information (hereafter, “PHI”) to carry out treatment, payment, or agency operations, and for other purposes that are permitted or required by law. It also describes their rights to access and control their PHI. “PHI” means information about our clients, including demographic data that may identify them and relates to their past, present or future physical or mental health or condition and related health care services. Disclosure of their PHI for the purposes described in this Notice may be made in writing, orally, or electronically (e-mail), by facsimile or by other means.
We are required by law to abide by the terms of this Notice. We may change the terms at any time. The new notice will apply to all PHI we maintain at that time. At a client’s written or phone request, we will provide them with any revised Notice.
1. Uses and Disclosures of PHI.
Clients will be asked by their therapist to sign a consent form that allows Strategic therapists, office staff, and others outside of our office that are involved in their care, to use and disclose their PHI for treatment, payment, and agency operations.
- Treatment: We will use and disclose our client’s PHI to provide, coordinate, or manage their health care and any related services. This includes coordination with a third party that has already obtained their permission to have access to their PHI. For example, we will disclose PHI to our client’s physician to obtain a physical examination report.
- Payment: Our client’s PHI will be used, as needed, to obtain payment for their health care services. For example, their PHI may be disclosed to verify eligibility for funding.
- Agency operations: We may use or disclose, as needed, our client’s PHI in order to support the business activities of Strategic, including, but not limited to, quality assessment, employee reviews, training, licensing, and other activities. For example, we may call our clients by name in the waiting room when their therapist is ready to meet with them. We may use or disclose their PHI to contact them to remind them of their appointment.
- To provide client appointment reminders
- Client is in imminent danger to self or others
- To report child abuse or neglect
- Legal proceedings, such as subpoena of records
- We may disclose PHI about you when required to do so by federal or local law.
- Others involved in our clients’ health care. Unless our clients object, we may disclose to a member of their family, or any other person they identify, their PHI that directly relates to that person’s involvement in their health care. If they are unable to agree or object, we may proceed if we find such disclosure is in their best interest.
- Emergencies. We may use or disclose our clients PHI in an emergency situation. If this happens, we shall try to obtain their consent as soon as reasonably practicable.
2. Uses and disclosures beyond treatment, payment, and health care operations permitted without consent, but with our client’s opportunity to object. Federal privacy rules allow us to use or disclose their PHI without their consent for a number of reasons, including the following:
3. Other uses and disclosures of our client’s PHI, described below, will be made only with their written consent, unless otherwise allowed or required by law. Our clients may revoke this authorization, at any time, in writing, except to the extent that Strategic has acted in reliance on the use or disclosure indicated in the consent.
Our Clients’ Rights
Following is a statement of our clients’ rights with respect to their PHI, and description of how they may exercise them.
- They have the right to inspect and copy their PHI. This means they may inspect and obtain a copy of PHI about them, contained in a designated record set, for as long as we maintain it. A “designated record set” contains clinical, billing, and any other records that their therapist and the agency use for making decisions about them.
- Under federal law, however, our clients may not inspect or copy the following: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and PHI that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, our clients may have a right to have this decision reviewed. Our clients should please contact our Privacy Contact if they have questions about access to their case record.
- Our clients have the right to request a restriction of their PHI. This means they may ask us not to use or disclose any part of their PHI for the purposes of treatment, payment or healthcare operations. They may also request that any part of their PHI not be disclosed to family members or friends who may be involved in their care or for notification purposes as described in the Notice. Their request must state the specific restriction requested, and to whom they want the restriction to apply.
- Their therapist is not required to agree to a restriction that they may request. If the therapist believes it is in their best interest to permit use and disclosure, their PHI will not be restricted. If your therapist does agree to the requested restriction, we may not use or disclose their PHI in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, our clients should please discuss any restriction they wish to request with their therapist. Our clients may request a restriction by writing to their therapist, or this agency.
- They have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking them for information as to how payment will be handled, or specification of an alternative address or other method of contact. We will not request an explanation from our clients as to the basis for the request. Our clients should please make this request in writing to our Privacy Contact.
- They may have the right to have their therapist amend their PHI. This means they may request an amendment of PHI about them in a designated record set for as long as we maintain this information. In certain cases, we may deny our client’s request for an amendment. If we deny it, they have the right to file a statement of disagreement with us, and we may prepare a rebuttal to their statement and will provide them with a copy of it. Our clients should please contact our Privacy Contact if they have questions about amending their record.
- They have the right to receive an accounting of certain disclosures we have made, if any, of their PHI. This right applies to disclosures for purposes other than treatment, payment, or healthcare operations as described in the Notice. It excludes disclosures we may have made to our clients, to family members or friends involved in their care, or for notification purposes. They have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. They may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations.
- They have the right to obtain a paper copy of this notice from us upon request, even if they have agreed to accept this notice electronically.
This notice is effective 1/1/07 If you have any questions about this Notice, please call or write the Privacy Contact for The Madeline Centre, Inc.
18697 Forest Rd.
Lynchburg, VA 24502
Phone: (434) 239-0003