The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that all medical records and other individually identifiable health information are kept properly confidential. This notice describes how medical information about you may be used and disclosed by myself. If you have any questions, please contact me. (Please note that there are some differences for DOT Return to Duty clients - those will be discussed at initial assessment.)
I am required by law to:
- Maintain the privacy of protected health information.
- Provide you with notice of our legal duties and privacy practices.
- Abide by the terms of the notice currently in effect.
I reserve the right to change terms of this notice and make it effective for your protected health information I already have, as well as new information. Described further are the ways I may use and disclose your health information. Your written permission will be required for me to use or disclose your health information for any purposes other than described below. Such permission can be revoked at any time by writing to Kelly Y. Hancock - CAP, CMHP, CET. During your first visit you will be asked if you would like to sign a notice authorizing me to use and disclose your protected health information (e. g., name, address, SSN, medical records content) for one or all of the following areas:
- To others involved in your treatment or care, such as other doctors, nurses, technicians or other personnel, including those outside our office, in order to provide you with treatment or coordinate your care.
HEALTH CARE OPERATIONS:
- In order to evaluate and improve the quality of care and to operate and manage our office (e.g., to a health plan or a peer review organization).
- To contact you for an appointment reminder or to inform you about treatment alternatives and other health related benefits or services that may be of interest to you.
- To contact you I may call the phone numbers you provide and leave a message (either on answering machine or with the person answering the phone), mail a letter or postcard; I may call you by name in the waiting room.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT:
- Your family or a close friend, who is involved in your care or helping you to pay, or for the purpose of supporting your treatment or as an emergency contact.