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NOTICE OF PRIVACY PRACTICES

We respect our clients’ confidentiality and only release information about you in accordance with state and federal laws.

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

Use and disclosure of protected health information

We use and disclose the minimum necessary health information about you for your treatment, for payment for your services, and for PeoplePsych’s health care operations per federal and state laws.

  1. For treatment. We use and disclose your health information internally in the course of your treatment at PeoplePsych.
  2. For payment. We may use and disclose your health information to arrange and obtain payment for your services.
  3. For health care operations. We may use and disclose your health information within PeoplePsych as a part of our internal health care operations.
  4. We require your written permission in order to share your personal health information for marketing and/or sale of client information.
  5. We will not use or disclose your clinical notes without your prior written authorization except for the following: 1) use by the originator of the notes for your treatment, 2) for training our staff, students, or other trainees, 3) to defend ourselves if you sue us or bring some other legal proceeding, 4) if the law requires us to disclose the information to you or the Secretary of HHS or for some other reason, 5) in response to health oversight activities concerning your therapist, or 6) to avert a serious and imminent threat to health or safety. To the extent that you revoke an authorization to use or disclose your psychotherapy notes, we will stop using or disclosing these notes.

Information disclosed without your consent

  1. Under Illinois and federal law, information about you may be disclosed without your consent in the following circumstances:
  2. Emergencies. Sufficient information may be shared to address an immediate emergency you are facing.
  3. Judicial and Administrative proceedings. We may disclose your personal health information in the course of a judicial or administrative proceeding in response to a valid court order or other lawful process, including if you were to make a claim for Workers Compensation.
  4. Public Health Activities. If we believe you are an immediate danger to yourself or others, we may disclose health information about you to the authorities, as well as alert any other person who may be in danger.
  5. Child/Elder Abuse. We may disclose health information about you related to the suspicion of child and/or elder abuse or neglect.
  6. Criminal Activity or Danger to Others. We may disclose health information if a crime is committed on our premises or against our personnel, or if we believe there is someone who is in immediate danger.
  7. National Security, Intelligence Activities, and Protective Services to the President and Others. We may release health information about you to authorized federal officials as authorized by law in order to protect the President or other national or international figures, or in cases of national security.
  8. Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These activities might include audits or inspections and are necessary for the government to monitor the health care system and assure compliance with civil rights laws. Regulatory and accrediting organizations may review your case record to ensure compliance with their requirements. The minimum necessary information will be provided in these instances.
  9. Scheduling Appointments. PeoplePsych may use your phone number to call you and leave messages to schedule or remind you of appointments.

Your rights regarding your health information

  1. Right to Inspect and Copy. You have the right to look at or get copies of your health information,
  2. with limited exceptions. Your request must be in writing. If you request a copy of the information, a reasonable charge may be made for the costs incurred. You also have the right to request and obtain an electronic copy of your personal health billing records. We will provide you with a copy or summary of your electronic billing records within 30 days of your request.
  3. Right to Amend. You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We have the right to deny your request under certain circumstances, and we will tell you why in writing within 60 days.
  4. Right to an Accounting of Disclosures. You have the right to receive a list of instances in which we have disclosed your health information for a purpose other than treatment, payment, or health care operations. To request an accounting of disclosures, you must submit your request in writing to the Privacy Officer. Such accountings are available for disclosures beginning April 14, 2003 and remain available for six years after the last date of services at PeoplePsych.
  5. Right to request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you. For example, you have the right to restrict certain disclosures of your personal health information to a health plan (e.g., insurance company) when you pay out-of-pocket in full for healthcare services. To request a restriction after therapy is completed, you must make your written request to the Privacy Officer.
  6. Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may ask that we contact you only by mail or at work. You must make this request in writing and it must specify the alternative means or location that you would like us to use to provide you information about your health care. We will make every attempt to accommodate reasonable requests.
  7. Right to Obtain Paper Copy of this Notice. You have the right to obtain a paper copy of this notice and any amended notice upon request. Copies will be available in each of our waiting rooms at PeoplePsych. You may also obtain a copy of this notice at our website, www.PeoplePsych.com/privacy-statement
  8. Right to Notification of a Breach of Confidentiality. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

Questions or Complaints

You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with our Privacy Officer listed below and with the Secretary of the Department of Health and Human Services by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/, sending a letter to 200 Independence Avenue, SW, Washington, DC 20201, or calling 1-877-696- 6775. All complaints must be in writing.  Filing a complaint will not change the health care we provide to you in any way.

Erin Johnston, LCSW
PeoplePsych, LLC Privacy Officer 312-448-7218 x701

 

We reserve the right to change our privacy practices provided such changes are permitted by applicable law.