THIS NOTICE DESCRIBES HOW MENTAL HEALTH AND MEDICAL 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:
Niara Eans, LMFT Associate, LPC Associate may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. 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 provider. - Payment is when we obtain reimbursement for your healthcare. Examples of payment are when we disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage. - Health Care Operations are activities that relate to the performance and operation of my 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 my office, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
- “Disclosure” applies to activities outside of my office, such as releasing, transferring, or providing access to information about you to other parties.
Mental Health Provider 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 our policies and procedures, we will post a revised copy in the office and provide you with a copy upon request.
If you are concerned that any therapist at Niara Eans, LMFT Associate, LPC Associate has violated your privacy rights, or you disagree with a decision we made about access to your records, you may contact the Texas State Board of Examiners of Licensed Professional Counselors, Licensed Marriage and Family Therapists or Licensed Social Workers by writing to:
Complaints Management and Investigative Section
P.O. Box 141369
Austin, Texas 78714-1369
By calling 1.800.942.5540.
You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services.
Effective Date-This notice will go into effect on June 1, 2013.