NOTICE OF PRIVACY PRACTICES AND POLICIES, EFFECTIVE 12/11/2014

AS REQUIRED BY FEDERAL LEGISLATION, THIS NOTICE DESCRIBES HOW HEALTHCARE INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This notice applies to all of the paper and electronic records of your care maintained by Integrated Minds Wellness Center, whether created by myself, my personnel, or records acquired from outside resources such as other clinicians involved in your care and laboratory reports.

WAYS THE PRACTICE MAY USE AND DISCLOSE YOUR INFORMATION

The following categories describe ways that I use and share your confidential information. Confidential information includes Protected Health Information (PHI) (information that could be used to identify you). Not every use or disclosure in a category is listed. However, all of the ways the clinic is permitted to use and disclose information will fall within one of the following categories.

  • DISCLOSURES WHICH REQUIRE AUTHORIZATION
  • Psychotherapy notes are handled separately under HIPAA and have additional protections. Specifically, the regulations state that in most instances a practice must obtain an authorization for any use or disclosure of psychotherapy notes. No authorization is needed to carry out treatment, payment, healthcare operations, or the uses listed in routine situations. All other circumstances require a valid authorization from you for use and disclosure.
    Confidential information may be released for payment and healthcare operations only to health insurance plans and their agents, as well as business associates of the practice. The definition of a health insurance plan does not include life insurance companies, automobile insurance companies, or workers’ compensation carriers. These are not covered under HIPAA. If you would like information submitted to one of these companies, an authorization will be required, unless it is already mandated by state or federal law.

  • ROUTINE SITUATIONS
  • For Treatment I may use information about you in order to provide you with proper medical treatment or services. Treatment is when I provide, coordinate, or manage your healthcare and other services related to your healthcare. An example of treatment is when I consult with another healthcare provider, such as your primary care physician. Additionally, Integrated Minds may utilize Telepsychiatry service to conduct your face-face visits. This may in video chatting /conferencing, text messaging and e-mailing. These visits may be recorded.

    For Payment I may use and disclose information about you so that the treatment and services you receive may be billed and payment can be collected from you, an insurance company, or a third party (including a collection agency if necessary). For example, I may give your health insurance plan information about services you received at the practice, so your health insurance can pay my practice or reimburse you for the services. I may also tell your health insurance plan about a treatment you are going to receive, in order to obtain prior approval or determine if your plan will cover the treatment.

    For Healthcare Operations I may use and share information about you for administrative functions necessary to run my practice and promote quality care. I may share information with business associates who provide services necessary to run my practice, such as transcription companies or billing services. I will contractually bind these third parties to protect your information as I would. Also, I may permit your health insurance plan or other providers to review records that contain information about you to assist them in improving the quality of service provided to you.

    Communicating with You and Others Involved in Your Care My practice may contact you to provide appointment reminders, information about treatment alternatives, or other health-related benefits and services that may be of interest to you. In certain situations, I may share information about you with a friend or family member who is involved in your care or payment for your care unless you have requested that such disclosures not occur and I have agreed. Information disclosed will be directly relevant to such person’s involvement with your care or payment related to your care. Whenever possible, this person will be identified by you. However, in emergencies or other situations in which you are unable to indicate your preference, I may need to share information about you with other individuals or organizations to coordinate your care or notify your family.

  • SPECIAL SITUATIONS
  • As Required By Law: I will disclose information about you when required to do so by federal, state or local law. For example, I may release information about you in response to a valid court subpoena.

    Health Oversight Activities: I may disclose information to a health oversight agency for activities authorized by law. For example, these oversight activities include: audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the healthcare system, government programs, and compliance with civil rights laws.

    For Judicial or Administrative Proceedings: If you are involved in a court proceeding, and a request is made for information about the professional services that you have received within my practice and the records thereof, such information may be privileged under state law. I will not release information without the written authorization of you or your legal representative, or in instance of issuance. This may also be the case in the instance of a court subpoena, which requires the provision of such information, which you have been properly notified. In response, you have not opposed the court subpoena within the legally specified format and timeframe, or in the instance of the issuance of a court order compelling me to provide Protected Health Information (PHI). This privilege does not apply when you are being evaluated for a third party or where the evaluation is court-ordered. You will be informed in advance if this is the case.

    To Avert Serious Threat to Health or Safety: I may disclose your confidential mental health information to any person without authorization if I reasonably believe that disclosure will avoid or minimize imminent danger to your health or safety, or the health or safety of any other individual. These disclosures may be to law enforcement officials to respond to a violent crime or to protect the target of a violent crime. For example, threats of harming another individual may be reported to appropriate authorities.

    Worker’s Compensation: If you file a worker’s compensation claim with certain exceptions, I must make available at any stage of the proceedings, all PHI information in our possession that is relevant to that particular injury in the opinion of the Texas Department of Labor and Industries, to your employer, your representative, and the Department of Labor and Industries upon request.

    Public Health Risks: I may disclose information about you for public health activities. These activities generally include, but are not limited to, the following:

    • To prevent or control disease, injury, or disability
    • To report child abuse or neglect
    • To report adult and domestic abuse
    • To report reactions to medications or problems with products
    • To notify people of recalls of products they may be using
    • To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
    • To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.

    Law Enforcement: I may release information about you if asked to do so by a law enforcement official:

    • In response to a court order, subpoena, warrant, summons, or similar process
    • To identify or locate a suspect, fugitive, material witness, or missing person
    • If you are suspected to be a victim of a crime, generally with your permission
    • About a death we believe may be the result of criminal conduct
    • About criminal conduct at the hospital
    • In emergency circumstances involving a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime
    For More Details Download Notice of Privacy Practices & Policies