How your Personal Health Information (PHI) may be used, disclosed, and protected, and how you can access it.
This notice describes your rights and how your Personal Health Information (PHI) may be used and disclosed, and how you can access this information. Please take time to carefully review this document.
You have the right to: get a copy of your medical record, correct your medical record, request confidential communication, ask me to limit the information I share, get a list of those with whom I've shared your information, get a copy of this privacy notice, choose someone to act for you, and file a complaint if you believe your privacy rights have been violated.
You have some choices in how I use and share your information when I: tell family and friends about your condition; provide disaster relief; include you in a hospital directory; provide mental health care; market services or sell your information; and raise funds.
I may use and share your information as I: treat you; run my practice; bill for your services; help with public health and safety issues; do research; comply with the law; respond to organ and tissue donation requests; work with a medical examiner or funeral director; address workers' compensation, law enforcement, and other government requests; and respond to lawsuits and legal actions.
You can ask for a paper copy of your medical record and other health information I have about you. I'll provide a copy or summary, usually within 30 days of your request. I may charge a reasonable, cost-based fee. This right does not include psychotherapy notes or substance use disorder (SUD) counseling notes, which I keep separately and do not share without your written permission.
You can ask me to correct health information about you that you think is incorrect or incomplete. I may say no to your request, but I'll tell you why in writing within 60 days.
You can request that I contact you in a specific way (for example, cell phone or office phone) or to send mail to a different address. I'll say yes to all reasonable requests.
You can ask me not to use or share certain health information for treatment, payment, or operations. I'm not required to agree, and may say no if it would affect your care.
Since you pay for service or health care items entirely out-of-pocket, without billing your health insurer, I do not share your PHI with any insurer for payment or health care operations. If you elect to use your health insurance through the Headway platform, you authorize Abby Myers Therapy to share the minimum necessary PHI with Headway and your insurer to verify benefits, submit claims, process payment, and conduct utilization review. Headway is a HIPAA-covered Business Associate under a Business Associate Agreement and will safeguard your PHI in accordance with HIPAA requirements.
You can ask for a list of the times I've shared your health information for six years prior to the date you ask, who I shared it with, and why. I'll include all disclosures except those about treatment, payment, and operations, and certain other disclosures (such as any you asked me to make). I'll provide one list per year for free, but may charge a reasonable, cost-based fee if you ask for another within 12 months. You can also ask for an accounting of any disclosures I've made of your substance use disorder (SUD) records that are protected under the federal rule 42 C.F.R. Part 2.
You can ask for a paper copy of this notice at any time, even if you've agreed to receive it electronically. I'll provide a paper copy promptly.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. I'll confirm the person has this authority and can act for you before I take any action.
You can complain if you feel I've violated your rights by contacting me using the information at the bottom of this page. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:
I will not retaliate against you for filing a complaint.
For certain health information, you can tell me your choices about what I share. If you have a clear preference for any of the situations below, talk to me, tell me what you'd like, and I'll follow your instructions. In these cases, you have both the right and choice to tell me to: share information with your family, close friends, or others involved in your care; share information in a disaster relief situation; or include your information in a hospital directory.
If you're not able to tell me your preference, for example, if you are unconscious. I may share your information if I believe it's in your best interest. I may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, I will never share your PHI unless you give me written permission: marketing purposes, sale of your information, and most sharing of psychotherapy notes. I will not sell your PHI unless you give me written permission. For fundraising, I may contact you, but you can tell me not to contact you again.
If I keep substance use disorder (SUD) counseling notes about you, I will not use or share them without your separate written permission, which cannot be combined with permission for other records. You can change your mind at any time, except where I have already acted on your permission.
I typically use or share your health information in the following ways:
I'm allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and research. I must meet many conditions in the law before I can share your information for these purposes. I can share health information about you for situations such as: preventing disease; helping with product recalls; reporting adverse reactions to medications; reporting suspected abuse, neglect, or domestic violence; or preventing or reducing a serious threat to anyone's health or safety. For more information, visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
I may also use or share your information for health research, share information if state or federal law requires it (including with HHS to confirm I'm complying with federal privacy law), share information with organ procurement organizations, share information with a coroner, medical examiner, or funeral director when a person dies, share information for workers' compensation claims, for law enforcement purposes, with health oversight agencies, and for special government functions such as military, national security, and presidential protective services. I can also share information in response to a court or administrative order, or in response to a subpoena.
If any of your records are protected under the federal rule 42 C.F.R. Part 2, which applies to certain substance use disorder treatment records, stricter limits apply. I cannot use or share those records for treatment, payment, or health care operations as broadly as HIPAA otherwise allows, and once they are shared, the person who receives them may not be permitted to share them again. I also will not use those records, or testimony about their content, against you in any civil, criminal, administrative, or legislative proceeding unless you give specific written permission or a court orders it in accordance with 42 C.F.R. Part 2.
I'm required by law to maintain the privacy and security of your PHI. I'll let you know promptly if a breach occurs that may have compromised the privacy or security of your information. I must follow the duties and privacy practices described in this notice and give you a copy of it. I will not use or share your information other than as described here unless you tell me I can in writing. If you give written permission, you may change your mind at any time, just let me know in writing. If I create or maintain any records protected under the federal rule 42 C.F.R. Part 2, I am also required by law to give you adequate notice of your rights and my legal duties for those records.
For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Abby Myers Therapy may change the terms of this notice, and any changes will apply to all information I have about you. The new notice will be available online and upon request.