THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
My Commitment to your Privacy
My practice is dedicated to maintaining the privacy of your personal health information. I am required also by law to do this. These laws are complicated, and I wish to provide you with this important information. This page is a shorter version of the full, legally required Notice of Privacy Practices (NPP), which I have printed out and placed for you to read in my waiting room. Please refer to the full notice for more information. Since I can not cover all possible situations in this notice, please contact me with any additional questions you may still have after reading this notice. My phone number and email address are listed at the end of this page.
I will use the information about your health, which I receive from you or from others, mainly to provide you with treatment, to arrange payment for my services, or for some other business activities, which are called in the law, health care operations. After you have read this NPP, I will ask you to sign a Consent Form to let me use and share your information. If you do not consent and sign this form, I cannot treat you.
If you or I want to use or disclose (send, share, release) your information for any other purposes, I will discuss this with you and ask you to sign an Authorization Form to allow this.
In all ordinary circumstances, I will keep your health information private. There are some unusual times when the law requires me to use or share it, such as:
1. When there is a serious threat to your health and safety or the health and safety of another individual or the public. I will only share information with a person or organization who is able to help prevent or reduce the threat.
2. Some lawsuits and legal or court proceedings.
3. If a law enforcement official requires me to do so.
4. For Workers Compensation and similar benefit programs.
There are some other situations like these but which do not happen very often. They are described in the longer version of the NPP.
Your Rights Regarding your Health Information
1. You can ask me to communicate with you about your health and related issues in a particular way or at a certain time. For example, you can ask me to call you at home, and not at work to schedule or cancel an appointment. I will try my best to do as you ask.
2. You have the right to ask me to limit what I tell certain individuals involved in your care or in the payment of your care, such as family members and friends. While I do not have to agree to your request, if I do agree, I will keep our agreement except if it is against the law, or in an emergency, or when the information is necessary to treat you.
3. You have a right to look at the health information I have about you such as your medical and billing record. You can even get a copy of these records but I may charge you. Contact me to arrange how to see your records.
4. If you believe the information in your records is incomplete or incorrect, you can ask me to make some kinds of changes (called amending) to your health information. You have to make this request in writing and send it to me. You must tell me the reason you want to make these changes.
5. You have a right to a copy of this notice. If I change this notice, I will post it in the waiting room, or you can request a copy of the current notice from me at any time.
6. You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with the Secretary of the Department of Health and Human Services. All complaints must be in writing. Filling a complaint will not change the health care I provide to you in any way.
If you have any questions regarding this notice or my health information privacy policies, please contact your therapist: Mindy McHugh, at (925) 855-1320 by phone, or by email at Mindy@MindyMcHugh.com.
The effective date of this notice is April 14, 2003.