Washington Psychological Center, P.C.
The Federal Health Insurance Portability and Accountability Act (HIPAA) requires us to make available a copy of our privacy policies. They are described in detail below. In addition, you can download a PDF version of these policies if you would like a copy to save or print.
Notice of the Policies and Practices of the Washington Psychological Center, P.C., to Protect the Privacy of Your Health Information
THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
By law, we may disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your written authorization. We may use your PHI without your authorization. To help clarify these terms, here are some definitions:
• “PHI” refers to information in your health record that could identify you.
• “Treatment, Payment and Health Care Operations”
– Treatment is when we provide, coordinate or manage your health care and other services related to your health care. An example of treatment would be when we consult with another health care provider, such as your family physician or another mental health professional.
– Payment refers to the process of obtaining reimbursement for your healthcare. Examples of payment are when we disclose your PHI to your health insurer to facilitate reimbursement for your health care or to determine eligibility or coverage.
– Health Care Operations are activities that relate to the performance and operation of our practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.
• “Use” applies only to activities within this practice group, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
• “Disclosure” applies to activities outside of this practice group, such as releasing, transferring, or providing access to information about you to other parties.
• “Authorization” is your written permission to disclose confidential mental health information. All authorizations to disclose must be on a specific legally required form.
II. Other Uses and Disclosures Requiring Authorization
We may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. In those instances when we are asked for information for purposes outside of treatment, payment, or 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 1 Psychotherapy Notes. “Psychotherapy Notes” are notes your therapist may have made about the conversation during a private, group, joint, or family counseling session, which have kept separate from the rest of your record. These notes are given a greater degree of protection than PHI.
You may revoke all such authorizations (of PHI 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 coverage, law provides the insurer the right to contest the claim under the policy.
III. Uses and Disclosures without Authorization
By law, we may use or disclose PHI without your consent or authorization in the following circumstances:
• Child Abuse – If we know or have reasonable cause to suspect in our professional capacity that an identified child has been or is in immediate danger of being a mentally or physically abused or neglected child, we must immediately report such knowledge or suspicion to the appropriate authority.
• Adult and Domestic Abuse – If we believe that an adult is in need of protective services because of abuse or neglect by another person, we must immediately report this belief to the appropriate authorities.
• Health Oversight Activities – If the D.C. Boards of Psychology or Social Work is investigating your therapist or his or her practice, he or she may be required to disclose PHI to the Board.
• Judicial and Administrative Proceedings – If you are involved in a court proceeding and a request is made for information about the professional services we provided you and/or the records thereof, such information is privileged under D.C. law, and we will not release information without the written authorization of you or your legally appointed representative or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.
• Serious Threat to Health or Safety – If we believe disclosure of PHI is necessary to protect you or another individual from a substantial risk of imminent and serious physical injury, we may disclose the PHI to the appropriate individuals.
• Worker’s Compensation – If we are treating you for Worker’s Compensation purposes, we must provide periodic progress reports, treatment records, and bills upon request to you, the D.C. Office of Hearings and Adjudication, your employer, or your insurer, or their representatives.
IV. Patient’s Rights and the Mental Health Professional's Duties
• Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosures of protected health information. However, we are not required to agree to a restriction you request.
• Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, on your request, we will send your bills to another address.)
• Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI in our mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. We may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. You may be denied access to Psychotherapy Notes if we believe that a limitation of access is necessary to protect you from a substantial risk of imminent psychological impairment or to protect you or another individual from a substantial risk of imminent and serious physical injury. We shall notify you or your representative if we do not grant complete access. On your request, we will discuss with you the details of the request and denial process.
• Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. We may deny your request. On your request, we will discuss with you the details of the amendment process
• Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI. On your request, we will discuss with you the details of the accounting process.
• Right to a Paper Copy – You have the right to obtain a paper copy of the notice from us upon request, even if you have agreed to receive the notice electronically.
Mental Health Professional’s Duties:
• We are required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI.
• 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.
• If we revise these policies and procedures, we will provide you with a revised notice of privacy policies and procedures either in person or by mail.
If you are concerned that we have violated your privacy rights, or you disagree with a decision we made about access to your records, you may contact any other mental health provider of the Washington Psychological Center, P.C., at the address and telephone number listed on this notice, who will consult with the Privacy Officer for the Washington Psychological Center, P.C.
You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. Any partner of the Washington Psychological Center, P.C., can provide you with the appropriate address upon request.
This notice will go into effect on April 14, 2003.