The Health Insurance Portability and Accountability Act (HIPAA) requires that I provide you with a Notice of Privacy Practices (NPP) for use and disclosure of Protected Health Information (PHI) for treatment, payment, and health care operations. The law requires that I obtain your signature acknowledging that I have provided you with his information. It is very important that you read these documents carefully, and we can discuss any questions that you have. I will give these to you at our first session.
Confidentiality and Patient Rights
Federal and state law protects the privacy of communications between a patient and a psychologist. In most situations I can only release information about your treatment to others if you sign a written Authorization Form that meets certain legal requirements imposed by HIPAA and/or Colorado law. However, there are situations in which I am permitted, required, or legally obligated to disclose information without either your consent or Authorization, and these, as well as your rights, are described in the NPP that I will give you. If these situations arise, I will make every effort to fully discuss them with you before taking any action, and I will limit my disclosure to what is necessary. Laws governing confidentiality can be quite complex, and in situations where specific advice is required, legal consultation may be needed.
Professional Records
Pursuant to HIPAA, I may keep PHI about you in 2 sets of professional records. One set constitutes your Clinical Record. It includes information about your problems, reasons for seeking treatment, diagnosis, medical, social, and treatment history, treatment goals and progress towards those goals, test results, past treatment or consultation records received from other providers, billing records, and letters or reports. Except in unusual circumstances you may examine and/or receive a copy of your Clinical Record, if requested in writing, and I am allowed to charge a copying fee. Exceptions to this policy are contained in the attached NPP. Because these are professional records, they can be misinterpreted and/or be upsetting to untrained readers. For this reason, I recommend that you initially review them with me.
I may also keep a set of Psychotherapy Notes that are for my own use to assist me in providing you the best treatment and are kept separate from your Clinical Record. My psychotherapy notes are not available to you and cannot be sent to anyone else, including insurance companies, without your written, signed Authorization. Insurance companies cannot require your authorization to disclose Psychotherapy Notes as a condition of coverage nor penalize you in any way for your refusal to release them.
Minors and Parents
Parents of un-emancipated children under 15 years of age are allowed to examine and obtain a copy of their child's treatment records, unless I decide this would injure the child. Because privacy in psychotherapy is often crucial to successful progress, particularly with teenagers, I sometimes request that parents consent to give up their access to their child’s records. If they agree, during treatment, I will provide them only with general information about the progress of their child’s treatment and their attendance at scheduled sessions. Other communications will require the child’s Authorization, unless I feel that the child is in danger or is a danger to someone else. Before giving parents information, I will discuss the matter with the child, if possible, and do my best to handle any objections he or she may have.
Conclusion
I hope this summary helps you understand my professional services and business policies, and I welcome and invite you to discuss with me any aspects of my treatment with you. I would consider it a privilege to be chosen to be your psychologist, and I am fortunate in that I love my work and profession. I want to do everything I can in the ways that I can to help you.
Professional Records
Pursuant to HIPAA, I may keep PHI about you in 2 sets of professional records. One set constitutes your Clinical Record. It includes information about your problems, reasons for seeking treatment, diagnosis, medical, social, and treatment history, treatment goals and progress towards those goals, test results, past treatment or consultation records received from other providers, billing records, and letters or reports... more
Minors and Parents
Parents of un-emancipated children under 15 years of age are allowed to examine and obtain a copy of their child's treatment records, unless I decide this would injure the child. Because privacy in psychotherapy is often crucial to successful progress, particularly with teenagers, I sometimes request that parents consent to give up their access to their child’s records... more