THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.
is dedicated to protecting your medical information (also referred to as “health information”). We are required by law to maintain the privacy of your protected health information and to provide you with this Notice of our legal duties and privacy practices with respect to you protected health information. We will follow applicable laws and the terms of the notice that are currently in effect.
HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED:
The following describes how we may use and disclose your protected health information for treatment, payment, and health care operations purposes. These uses and disclosures, unless otherwise stated, do not require your written authorization.
We may use health information about you to provide you with health care treatment or services. We may disclose health information about you to doctors, nurses, or other essential personnel who are involved in your care. For example, our office may disclose health information about you to a specialist who has been asked to provide a consultation regarding your care.
We may use and disclose health information about you to receive payment for services provided to you. For example, our office may disclose certain information to your health insurance provider in order to receive payment for services provided to you. However, pursuant to Florida law, we will obtain your consent before billing any third party for services provided to you.
Health Care Operations
may use and disclose health information about you for operational purposes related to our office. For example, our office may use or disclose information about you for quality of care purposes. Such activities are confidential and are designed to allow our office to improve and continue to provide a high quality of care to you and our other patients.
We may also use and disclose your information for the following:
We may contact you to provide appointment reminders. This may include leaving a message on your answering machine and/or voicemail unless you advise us otherwise.
We may contact you with information about treatment alternatives or other health-related benefits and services related to your that may be of interest to you.
Disclosure to Department of Health and Human Services
We may disclose medical information when required by the United States Department of Health and Human Services as part of an investigation or determination of our compliance with relevant laws.
We may disclose your medical information to a public or private entity, such as the American Red Cross, for the purpose of coordinating with that entity to assist in disaster relief efforts.
Health Oversight Activities
We may disclose your medical information to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings.
Abuse or Neglect
We may disclose your medical information when it concerns abuse, neglect or violence to you in accordance with federal and state law.
Judicial and Administrative Proceedings
We may disclose your medical information as allowed by law in the course of certain judicial or administrative proceedings.
We may disclose your medical information for certain law enforcement purposes as required by law.
If you are an organ donor, we may disclose your medical information to an organ donation and procurement organization.
We may use or disclose your medical information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research and granted a waiver of the authorization.
Public Health Activities
We may use or disclose your medical information for public health activities, including the reporting of disease, injury, vital events and the conduct of public health surveillance, investigation and/or intervention.
We may use or disclose your medical information to prevent or lessen a serious threat to the health or safety of another person or to the public.
We may disclose your medical information as authorized by laws relating to workers’ compensation or similar programs.
We may disclose your health information to a business associate with whom we contract to provide services on our behalf. To protect your health information, we require our business associates to appropriately safeguard the health information of our patients. Additionally, business associates are subject to many of the same legal requirements as as it relates to protecting your health information.
Health Information Exchange
We may disclose your health information through a health information exchange organization. If we do plan to disclose your health information through a health information exchange organization we will provide you with the opportunity to either opt-in or opt-out of the disclosure.
Occasionally, there are circumstances that are not related to treatment, payment, and health care operations or otherwise required by law in which your health information may be used or disclosed. In such, cases we will obtain your written authorization before releasing your health information. For example, the following uses and disclosures will only be made with your written permission: 1) Most uses and disclosures of psychotherapy notes; 2) Disclosures that would constitute the sale of your health information; and 3) Uses and disclosures for marketing purposes. Additionally, you have the right to revoke any prior authorization by notifying us in writing.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION:
You have the following rights with respect to your medical information:
You may ask us to restrict certain uses and disclosures of your medical information. While we will generally try to accommodate reasonable requests for restrictions, we are not required to agree to your request, excepting requests involving “out of pocket” payments. If we do agree to a requested restriction the we must honor that agreement unless we notify you in writing. If you pay for a health service “out of pocket” you may request that we not notify your health insurer regarding the service provided and we are required to honor your request. You have the right to receive communications from us in a confidential manner.
Generally, you may request, in writing, to inspect and copy your medical information. This right is subject to certain specific exceptions, and you may be charged a reasonable fee for any copies of your records. If we deny your request you may request that we review the reasons for the denial. Additionally, if your medical information is contained in our electronic health record you have the right to receive a copy of your record in electronic format subject to our form and formatting capabilities. You may ask us to amend medical information about you in a medical record that we created. We may deny your request for certain specific reasons. If we deny your request, we will provide you with a written explanation for the denial and information regarding further rights you may have at that point.
You have the right to receive an accounting of the disclosures of your medical information as required by law You have the right to be notified of any breach of your unsecured health information.
If you received this Notice electronically, you may request a paper copy of this Notice of Privacy Practices for Protected Health Information You have the right to complain to us and/or to the United States Department of Health and Human Services if you believe that we have violated your privacy rights. If you choose to file a complaint, you will not be retaliated against in any way.
If you would like further information regarding your rights or regarding the uses and disclosures of your medical information, you may contact:
Therapist:Diana Gonzalez Joya, LCSW
7241 SW 63rd Ave, Ste.102A Miami, FL 33143
THIS NOTICE IS EFFECTIVE AS OF MARCH 10, 2015 REVISION OF NOTICE OF PRIVACY PRACTICES
We reserve the right to change the terms of this Notice, making any revision applicable to all the protected health information we maintain. If we revise the terms of this Notice, we will post a revised notice on our website. We will make paper copies of the revised Notice of Privacy Practices available upon request.