NEW ENGLAND COUNSELING CENTER
Psychiatry · Therapy · Counseling
Phone: (508) 261-7111
Patient Privacy Policies
Patient Privacy Policies
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental condition and related health care services.
We are required by law to maintain the privacy of your health information and to provide you with this notice of New England Counseling Center P.C.’s legal duties and privacy practices with respect to your health information.
If you have a legal guardian, we will also provide them with this information, including their right to act on your behalf in these matters.
II. Uses and Disclosures of Your Health Information, with your Permission.
You will be asked by our office to sign a consent form. Once you have consented to use and disclosure of your protected health information for treatment, payment, and health care operations by signing the consent form, your clinician will use or disclose your protected information as needed to others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may be used and disclosed to pay your health care bills and to support the operation of the group practice. You may revoke an authorization at any time.
Examples of the types of uses and disclosures of your protected health care information that New England Counseling Center P.C. is permitted to make once you have signed the consent form include:
a) Your Treatment. We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. We will have to disclose protected health information to another clinician/physician who may be treating you when we have the necessary permission from you to disclose your protected health information.
b) Your Payment. Your protected health information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend and provide to you such as making a determination of eligibility or coverage for insurance benefits as well as utilization review activities to allow New England Counseling Center P.C. to provide services to you.
c) Healthcare Operations. We may use or disclose, as needed, your protected health information in order to support the business activities of our practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing and conducting, case management, care coordination, or arranging for other business activities, such as audits and administrative services. We may use or disclose your protected health information to provide you with information about treatment alternatives or other health related benefits and services that may be of interest to you.
III. Uses and Disclosures of Protected Health Information
We may use and disclose your protected health information for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, when we are asked for information for purposes outside of treatment, payment and health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your psychotherapy notes, as these notes are given a greater degree of protection than PHI.
You may revoke all such authorizations (of PHI and/or psychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverages, and the law provides the insurer the right to contest the claim under the policy.
Patient Privacy Policies
IV. In the following instances we may use or disclose PHI without your consent or authorization:
a) Emergencies: In emergency situations. We may use or disclose your protected health information in an emergency treatment situation. If this happens, your clinician shall try to obtain your consent as soon as possible. b) Judicial or Administrative Proceedings: When we are required by law to provide your protected health information. If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and we will not release such information without written authorization from you or your legally-appointed representative, or a court order. You will be notified, as required by law, of any such disclosures.
c) Serious Threat to Health or Safety: If you communicate to us an explicit threat to kill or inflict serious bodily injury upon an identified person and you have the apparent intent and ability to carry out the threat, we must take reasonable precautions. Reasonable precautions may include warning the potential victim, notifying law enforcement, or arranging for your hospitalization. We must also do so if we know you have a history of physical violence and we believe there is a clean and present danger that you will attempt to kill or inflict bodily injury upon an identified person. Furthermore, if you present a clear and present danger to yourself and refuse to accept further appropriate treatment, and we have a reasonable basis to believe that you can be committed to a hospital, we must seek said commitment and may contact members of our family or other individuals if it would assist in protecting you.
d) Abuse or Neglect: We may disclose your protected health information to a public health authority this is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect, or domestic violence. Further, if you have reasonable cause to believe that an elderly person (age 60 or older) is suffering from or has died as a result of abuse, we must immediately make a report to the Massachusetts Department of Elder Affairs.
e) Health Oversight: We may disclose protected health information to a health oversight agency for the activities authorized by law, such as audits, investigations, and inspections.
f) Workers Compensation: If you file a worker’s compensation claim, your records relevant to that claim may not be confidential to entities such as your employer, the insurer, and the Department of Industrial Accidents.
V. Your Rights Regarding Protected Health Information.
Below is a description of your rights with respect to your protected health information.
a) You have the right to inspect and copy your protected health information. This means that you may inspect and obtain a copy of protected health information about you that is contained in a designated record. Under federal law, however, you may not necessarily be entitled to inspect or copy your psychotherapy notes. We may deny your access to PHI under certain circumstances, but in some case, you may have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical and/or psychotherapy records.
b) You have the right to have your clinician amend your protected health information. This means that you may request an amendment of protected health information about you in a designated record set for as long as we maintain this information. This request to amend may be denied. On your request, we will discuss with you the details of the amendment process.
c) You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for the purposes other than treatment, payment, or healthcare, operations as described in this Notice of Privacy Practices.
d) You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, we are not required to agree to a restriction you request.
e) You have the right to request and receive confidential communication of PHI by alternative means and at alternative locations (For example, you may not want a family member to know that you are seeking treatment with us. Upon your request, we will send your bills to another address.
f)You have the right to obtain a paper copy of the notice from us upon request.
VI. Our Duties Regarding Protected Health Information
a) We are required by law to maintain the privacy of PHI and to provide you with a notice of my legal duties and privacy practices with respect to PHI.
b) We reserve the right to change the privacy policies and practices described in this notice. Unless we notify you of such changes, however, we are required to abide by the terms currently in effect.
c) IF we revise our policies and procedures, we will notify you in person, via mail, or via another method agree to in advance.
If you have questions about this notice, disagree with a decision we make about access to your records, or have other concerns about your privacy rights, you may contact our Privacy Officer at New England Counseling Center P.C., 800 South Main Street, Suite 103, Mansfield, MA 02048. The Privacy Officer can be contacted at (508) 261-7111. You may also file a complaint with the United States Department of Health and Human Services. You have specific rights under the Privacy Rule and we will not retaliate against you for exercising your right to file a complaint.
This notice will go into effect on January 1st, 2010; we reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI that we maintain. Changes in policy will be posted in our office.