Patient privacy and legal documents

Your health information; our duties

This notice explains how the practice may use or disclose protected health information (PHI) and how you can exercise your privacy rights. We are required to protect the privacy and security of your PHI, follow the notice currently in effect, provide you a copy, and notify you when a breach of unsecured PHI requires notice under applicable law.

Our records may include contact information, clinical evaluations, diagnoses, treatment plans, progress, medications, insurance claims, billing information and electronic communications. Special rules can apply to psychotherapy notes and certain substance-use disorder records.

Uses and disclosures usually permitted without a separate HIPAA authorization

Treatment: We may use and share appropriate information with health professionals involved in your care, subject to stricter laws when they apply. Payment: We may use information to verify benefits, submit claims, receive payment or resolve billing matters. Health care operations: We may use information for quality review, compliance, practice administration and authorized professional consultation.

The law may permit or require disclosure for public health and safety, reporting suspected abuse or neglect, serious threats to health or safety, health oversight, certain law-enforcement purposes, workers’ compensation, legal proceedings under valid authority, coroners and medical examiners, and other specifically authorized circumstances. We evaluate applicable legal requirements before disclosing.

Other uses may require your written authorization. We do not treat a privacy-notice acknowledgment or a general treatment consent as an authorization for unrelated disclosures. We will obtain separate authorization when required for marketing, sale of PHI or most uses or disclosures of separately maintained psychotherapy notes.

Your individual privacy rights

You may ask to inspect or obtain copies of records in the designated record set, including eligible electronic copies; request corrections to records; request confidential communications by alternative means or at alternative locations; request restrictions on certain uses or disclosures; request an accounting of certain disclosures; obtain a paper copy of this notice; and designate a legally authorized personal representative.

We generally may decline a requested restriction unless law requires us to honor it. For example, where HIPAA conditions are met, we must honor your request not to disclose information to a health plan for payment or health care operations when you have paid in full out of pocket for the relevant service. We will explain any lawful denial of a record-access or amendment request and available review rights.

You may raise questions or file a privacy complaint without retaliation. Contact the Privacy Officer at Indian Creek Psychological Services, Inc., 15022 W. 128th St., Olathe, KS 66062, telephone 913-636-5657; or complain to the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/hipaa/filing-a-complaint or 1-877-696-6775.

Sensitive mental-health information, psychotherapy notes and Kansas confidentiality

We apply HIPAA and applicable Kansas confidentiality and privilege laws to mental-health records. Some disclosures permitted by HIPAA may be restricted by more protective state law. We assess subpoenas, court orders, mandatory reporting, personal-representative authority and other exceptions case by case rather than assuming every legal request permits immediate disclosure.

Psychotherapy notes are a narrow category of notes kept separately by the clinician to document or analyze counseling-session conversations. They generally require a separate authorization for use or disclosure, subject to limited legal exceptions. The separate psychotherapy-notes form in this packet is voluntary.

Additional safeguards when 42 CFR Part 2 applies

If we are a Part 2 program or create or maintain records subject to 42 CFR Part 2, those records receive the additional federal protections applicable to substance-use disorder patient records. Most disclosures by a Part 2 program require written consent or a specific regulatory exception. A consent may authorize treatment, payment and health care operations when properly obtained, but an ordinary intake signature does not itself supply such consent.

Part 2 records generally cannot be used or disclosed to investigate or prosecute a patient in civil, criminal, administrative or legislative proceedings without a qualifying patient consent or a court order that satisfies Part 2 and an appropriate subpoena or similar legal mandate. Recipients and redisclosures remain subject to the applicable limitations. Ask the Privacy Officer whether particular records are covered by Part 2 and for a Part 2-specific consent when needed.

Additional Part 2 rights, such as certain recipient lists and accounting rules, apply as provided in current regulations and their implementation schedules. Where HIPAA and Part 2 overlap, applicable protections govern rather than a blanket waiver in this notice.

Choices, changes and the notice itself

Where the law gives you a choice, you can object to certain family/friend disclosures or give or withdraw authorization as permitted. We ordinarily honor a valid written revocation prospectively; prior actions lawfully taken in reliance on an authorization cannot always be undone. A recipient who is not governed by HIPAA may be able to redisclose information, subject to other applicable laws.

We may change this notice and apply a revised notice to records we maintain to the extent permitted by law. Updated notices will be available at our office and website. This notice is available in paper or electronic form and is not a consent to treatment or an authorization to release records.