HIPAA Compliance
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully. This information will include Protected Health Information (PHI), as that term is defined in privacy regulations issued by the United States Department of Health and Human Services pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and, as applicable, RCW Chapter 70.02 entitled “Medical Records - Health Care Access and Disclosure.” Your privacy is respected and your personal health information is very sensitive. Your information will not be disclosed to others unless you approve the release, or unless the law authorizes or requires us to do so. The effective date of this document began on March 1, 2017.
The law protects the privacy of the health information that is created and obtained in providing care and services to you. For example, your protected health information includes your symptoms, test results, diagnoses, treatments, health information from other providers, and billing and payment information relating to these services. Federal and state law allows us to use and disclose your protected health information for purposes of treatment and health care operations. State law requires us to get your authorization to disclose this information for payment purposes.
Protected Health Information: Protected health information means individually identifiable health information:
• Transmitted by electronic media;
• Maintained in any medium described in the definition of electronic media; or
• Transmitted or maintained in any other form or medium.
Examples of Uses and Disclosures of PHI for Treatment, Payment and Health Care Operations- Treatment. I may use your PHI for the purpose of providing you with health care treatment, including management, coordination and continuity of your care with other of your current providers. Payment. I may use your PHI in connection with billing statements I send you. I may use your PHI for the purpose of tracking charges and credits to your account. Health Care Operations. I may use and disclose your PHI for the health care operations of my professional practice in support of the functions of treatment and payment. Such disclosures would be to Business Associates for book keeping and accounting. Threat to Health or Safety. I may disclose your PHI when necessary to minimize an imminent danger to the health or safety of you or any other individual.
Your Health Information Rights:
The health and billing records created and stored are the property of the Watson Counseling Services, PLLC and the health care provider. The protected health information in it, however, generally belongs to you. The following are rights you have regarding PHI that I maintain about you:
Request Where We Contact You. You have the right to indicate how I may contact you.
✓Access to Inspect and Copy. You have the right, which may be restricted only in certain limited circumstances, to inspect and receive a copy of the PHI that I maintain. I may charge a reasonable, cost-based fee for the copying process. As to your PHI that I maintain in electronic form and format, you may request a copy to which you are otherwise entitled in that electronic form and format if it is readily producible, but if not, then in any readable form and format as we may agree (e.g., PDF).
✓ Accounting of Disclosures. I am required to create and maintain a prescribed accounting of certain disclosures I may have made of your PHI. You have the right to request a copy of such an accounting.
✓ Request Restrictions. You have the right to request in writing a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. I am generally not required to agree to such a request. If I have been paid in full for all of the services covered by such a request, then I will honor a request to restrict disclosure to your insurance.
Request Confidential Communication. You may request that I communicate with you in a certain way or at a certain location. I will accommodate reasonable requests and will not ask why you are making the request.
Complaint. You have the right to file a complaint in writing with me or with the Secretary of Health and Human Services if you believe I have violated your privacy rights. I will not retaliate against you for filing a complaint. If you have any questions about this Notice of Privacy Practices or complaints about how your PHI has been utilized, please contact me or my supervisor during normal business hours. My contact information is: Jaclyn Watson, MA, LMHCA, 1460 NW 73rd St NW, Seattle, WA 98117, Tel: (253) 987-6425. My supervisor: Mary Phillips-Green, PhD, LMHC, 18512 93rd Ave E, Puyallup, WA 98375, Tel: (253) 875-8590.
Our Responsibilities:
We are required to:
• Keep your protected health information private;
• Give you this Notice;
• Follow the terms of this Notice.
Watson Counseling Services, PLLC has the right to change its practices regarding the protected health information maintained. If changes are made, and this Notice is updated, you may receive the most recent copy of this Notice by requesting it from your counselor.
To Ask for Help or Complain
If you have questions, want more information, or want to report a problem about the handling of your protected health information, you may contact myself or supervisor at the contact information above.
If you believe your privacy rights have been violated, you may discuss your concerns with how your request was addressed. You may send a written complaint to my supervisor, Mary Philips-Green, PhD, LMHC.
Uses and Disclosures of PHI with Your Written Authorization
I will make other uses and disclosures of your PHI only with your written authorization. One example is my psychotherapy notes from our sessions (unless I am otherwise required by law). Unless I have taken a substantial action in reliance on the authorization such as providing you with health care services for which I must submit subsequent claim(s) for payment, you may revoke an authorization in writing at any time. You have the right to object to this use or disclosure of your information. If you object, it will not be used or disclosed. We may use and disclose your protected health information without your authorization as follows:
• For Public Health and Safety Purposes as Allowed or Required by Law:
• to prevent or reduce a serious, immediate or imminent threat to the health
or safety of yourself, another, or the public.
• to public health or legal authorities
• to protect public health and safety
• To Report Suspected Abuse or Neglect to public authorities.
For Law Enforcement Purposes such as when we receive a subpoena, court order, or other legal process, or you are the victim of a crime.
Special Authorizations Certain federal and state laws that provide special protections for certain kinds of personal health information call for specific authorizations from you to use or disclose information. If your personal health information falls under these special protections, we will contact you to secure the required authorizations to comply with federal and state laws such as:
• Uniform Health Care Information Act (RCW 70.02)
• Sexually Transmitted Diseases (RCW 70.24.105)
• Drug and Alcohol Abuse Treatment Records (RCW 70.96A.150)
• Mental Health Services for Minors (RCW 71.05.390-690)
• Communicable and Certain Other Diseases Confidentiality (WAC 246-100-016)
• Confidentiality of Alcohol and Drug Abuse Patients (42 CFR Part 2)
Other Uses and Disclosures of Protected Health Information If we need your health information for any other reason that has not been described in this notice, we will ask for your written authorization before using or disclosing any identifiable health information about you. Most important, if you choose to sign an authorization to disclose information, you can revoke that authorization at a later time to stop any future use and disclosure. Uses and disclosures not in this Notice will be made only as allowed or required by law or with your written authorization.