If you are a client/patient, your privacy is
protected by the Health Insurance Portability and Accountability Act (HIPAA).
NOTICE OF PRIVACY
PRACTICES FOR PERSONAL HEALTH INFORMATION
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.
This Notice describes how your personal health
information (PHI) is protected, and how a provider may use and disclose this
information. PHI includes personally identifiable information that relates to
your past, present, or future health, treatment, or payment for health care
services. All employees and professional staff are required to comply with this
appropriate reason to do so, such as to confer with other health care providers
or to submit claims for these services.
Under HIPAA, you are afforded privacy rights
regarding the use and disclosure of your health information. These include:
- a right to be informed of the potential
uses and disclosures of your protected health information, and to limit
those uses and disclosures of this protected health information;
- a right to receive this written notice that
explains how we may use and disclose your protected health information, your
rights under HIPAAís privacy rule, and Reid Minotís responsibilities as a
covered entity under HIPAA;
- a right to a paper copy of this notice, or to
have your legally designated representative receive a copy of this notice;
you are asked to acknowledge receipt of this notice;
- a right to amend your record, to restrict what
information from your record is disclosed to others, and to receive an
accounting of disclosures of this information that were made without your
authorization, other than for treatment, payment or health care
- a right to have your complaints about
my policies and procedures recorded in these records.
As a health care provider, Reid Minot is making a good faith effort to see
that you or your representative have received and acknowledged this notice
of privacy practices. If you are seen for emergency treatment, you will
receive this notice as soon as practically possible afterward.
I. Disclosures for Treatment, Payment, and Health
Reid Minot may use or disclose your protected
health information (PHI), for certain treatment, payment, and health care
operations purposes without your authorization. To help clarify these terms,
here are some definitions:
- PHI refers to information in your
health record that could identify you.
- Treatment is when Reid Minot or another
healthcare provider diagnoses or treats you. An example of treatment would
be when Reid Minot consults with another health care provider, such as
your family physician or a therapist, regarding your treatment.
- Payment is when Reid Minot obtains
reimbursement for your healthcare. Examples of payment are when Reid Minot
discloses your PHI to your health insurer to obtain reimbursement for your
health care or to determine eligibility or coverage.
- Health Care Operations is when Reid Minot
discloses your PHI to your health care service plan (for example your
health insurer), or to your other health care providers contracting with
your plan, for administering the plan, such as case management and care
- Use applies only to activities within Reid
Minotís office, such as sharing, employing, applying, utilizing,
examining, and analyzing information that identifies you.
- Disclosure applies to activities outside of
the office, such as releasing, transferring, or providing access to
information about you to other parties.
- Authorization means written permission
for specific uses or disclosures. All authorizations to disclose must be
on a specific, legally required form.
II. Uses and Disclosures Requiring Authorization
A provider may use or disclose PHI for purposes
outside of treatment, payment, and health care operations when your appropriate
authorization is obtained. In those instances when Reid Minot is asked for
information for purposes outside of treatment and payment operations, he will
obtain an authorization from you before releasing this information.
You may revoke or modify all such authorizations of
PHI at any time, provided each revocation is in writing; however, the
revocation or modification is not effective until Reid Minot receives it. You
may not revoke an authorization to the extent that (1) Reid Minot has relied on
that information; or (2) if the authorization was obtained as a condition of
obtaining insurance coverage, and the law provides the insurer the right to
contest the claim under the policy.
III. Uses and Disclosures with Neither Consent nor
Reid Minot may use or disclose PHI without your
consent or authorization in the following circumstances:
- Child Abuse: Whenever Reid Minot, in
his professional capacity, has knowledge of or observes a child he knows
or reasonably suspects, has been the victim of child abuse or neglect, he
must immediately report such to a police department or sheriffís
department, county probation department, or county or state welfare
- Adult and Domestic Abuse: If Reid Minot, in
his professional capacity, has observed or has knowledge of an incident
that reasonably appears to be physical abuse, abandonment, abduction, isolation,
financial abuse or neglect of an elder or dependent adult, or if
he is told by an elder or dependent adult that he or he has
experienced these, or if he reasonably suspects such, he must report the
known or suspected abuse immediately to the local ombudsman or the local
law enforcement agency.
- Health Oversight: If a complaint is filed
against Reid Minot with the State Board that licenses his profession, the
Board has the authority to subpoena confidential mental health information
from it deems relevant to that complaint.
- Serious Threat to Health or Safety: If you
communicate to Reid Minot a serious threat of physical violence against an
identifiable victim, he must make reasonable efforts to prevent harm,
which may include communicating that information to the potential victim,
and the police. If he has reasonable cause to believe that you are in such
a condition, as to be dangerous to yourself or others, he may release
relevant information as necessary to prevent the threatened danger.
Judicial or Administrative Proceedings: If you are involved in a court
proceeding and a request is made about the professional services that Reid
Minot has provided you, he must not release your information without:
- your written authorization or the
authorization of your attorney or personal representative; or
- a court order
The privilege does not apply when you are
being evaluated for a third party or where the evaluation is court-ordered.
Reid Minot will inform you in advance if this is the case.
IV. Patientís Rights and Providerís Duties
- Right to Request Restrictions You have
the right to request restrictions on certain uses and disclosures of
protected health information about you. However, Reid Minot is not
required to agree to a restriction you request.
- Right to Receive Confidential Communications
by Alternative Means and at Alternative Locations You have the right to
request and receive confidential communications of PHI by alternative
means and at alternative locations. (For example, you may not want a
family member to know that you are seeing Reid Minot and may request that
he not telephone your residence).
- Right to Inspect and Copy You have the right
to inspect or obtain a copy (or both) of PHI in Reid Minotís mental health
and billing records used to make decisions about you for as long as the
PHI is maintained in the record. Reid Minot may deny your access to PHI
under certain circumstances, but in some cases you may have this decision
reviewed. On your request, Reid Minot will discuss with you the details of
the request and denial process.
- Right to Amend You have the right to request
an amendment of PHI for as long as the PHI is maintained in the record.
Reid Minot may deny your request. On your request, he will discuss with
you the details of the amendment process.
- Right to an Accounting You generally have the
right to receive an accounting of disclosures of PHI for which you have
neither provided consent nor authorization (as described in Section III of
this Notice). On your request, Reid Minot will discuss with you the
details of the accounting process.
- Right to a Paper Copy You have the
right to obtain a paper copy of the notice upon request, even if you have
agreed to receive the notice electronically.
Duties of Provider:
- Reid Minot is required by law to
maintain the privacy of PHI and to provide you with a notice of his legal
duties and privacy practices with respect to PHI.
- Reid Minot reserves the right to change the
privacy policies and practices described in this notice. Unless he
notifies you of such changes, however, he is required to abide by the
terms currently in effect.
- If Reid Minot revises his policies and
procedures, he will provide you with a written copy of the revised
policies and procedures at the earliest possible opportunity following
this revision, in person or by mail.
If you are concerned that Reid Minot has violated
your privacy rights, or you disagree with a decision he made about access to
your records, you may contact the Compliance Officer for further information.
For complaints, contact Reid Minot at (512)
Reid Minot RN, APRN
1600 West 38th
Austin, Texas 78731
You may also send a written complaint to the
Secretary of the U.S. Department of Health and Human Services. Reid Minot will
provide the appropriate address upon request.
VI. Effective Date, Restrictions, and Changes to
This notice went into effect February 8, 2009. Reid
Minot reserves the right to change the terms of this notice and to make the new
notice provisions effective for all PHI that he maintains. He will provide you
with a revised notice by mail, at the earliest opportunity following the