805 Holcomb Boulevard Ocean Springs, MS 39564
HIPAA Privacy Notice
Uses and Disclosures of Health Information: We can use health information about you for:
Treatment decisions, Payment decisions, Office decisions, such as improvement of our services.
We may use your health information without your permission for the following:
Public health issues, Audits, Emergencies, when required by law. In other situations we will request your permission in writing. You may choose not to give permission, and you may take back permission at any time. We can change our polices and will post any new policy. You may request a copy of this notice. For more information or if you have any questions about our privacy practices or this notice, contact Marcia C. Barksdale, LPC, NCC, the designated privacy contact, at 228 324-5767
Your Individual Rights—You have the right to:
• Receive a copy of your information (You may be charged a fee for this service.)
• To see the occasions we have disclosed your mental health information
• To request we correct information you believe is incorrect
• To add information you believe is missing
• You can request that we not use your information for treatment, payment or administration, and we will consider your request, but we are not legally bound to accept it.
Complaints--If you feel your privacy rights have been violated or if you disagree with a decision we made about access to your records, you may contact the Secretary of the Department of Health and Human Services.
DETAILED NOTICE WHO WILL FOLLOW THIS NOTICE.
This notice describes the information privacy practices followed by this practice, professionals, staff and other office personnel including any practitioner who might provide "call coverage" for your practitioner.
YOUR HEALTH INFORMATION:
This notice applies to the information and records we have about your health, health status, and the services you receive from this practice. We are required by HIPAA law to give you this notice.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.
By State law and the ethics of our mental health professions, we must have your written, signed Consent to use and disclose health information for the following purposes:
… For Treatment. We use health information about you to provide you with clinical services. We may disclose health information about you to office staff or other personnel who are involved in taking care of you and your health.
… For Payment. We may use and disclose health information about you so that the treatment and services you receive at this office may be billed to and payment may be collected from you, an insurance company or a third party. It is our policy to release only diagnoses, date, and type of service when we have your consent to bill third party payers. If a payer requests more information, we will request your written authorization for that disclosure.
… For Health Care Operations. We may use health information about you in order to run the practice and make sure you receive quality care:
…Appointment Reminders. We may contact you as a reminder that you have an appointment. Please notify us if you do not wish to be contacted for appointment reminders, or if there are restrictions you want to make about such contact.
We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations:
… To Avert a Serious Threat to Health or Safety. Based on professional judgment, we may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
… Required By Law. Based on professional judgment, we will disclose health information about you when required to do so by federal, state or local law. Disclosures may be compelled by DHHS for compliance and enforcement purposes
… Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena. Such disclosures would be based on professional judgment.
… Law Enforcement. We may release health information if required to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements.
… Family and Friends. In situations where you are not capable of giving authorization (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest.
… Research. Health information about you can be used for research projects that are subject to a special approval process.
… Military. Veterans. National Security and Intelligence. If you are or were a member of the armed forces, or part of the national security or intelligence communities, military command or other government authorities may require the release of health information about you.
… Workers' Compensation. Health information about you may be released for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
… Public Health Risks. Health information about you may be disclosed for public health reasons in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products.
… Health Oversight Activities. Health information about you may be disclosed to a health oversight agency for audits, investigations, inspections, or licensing purposes. … Information Not Personally Identifiable. Health information about you may be disclosed in a way that does not personally identify you or reveal who you are.
OTHER USES AND DISCLOSURES OF HEALTH INFORMATION: This practice will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization.