Seedling Psychotherapy - HIPAA Privacy Notice - Your or Your Child's Medical Records
Security
Client medical records are stored in a locked file cabinet to which only I have the key. Your medical/therapy records and personal health information are not made available to other people except for the exceptions to Confidentiality as described in the TREATMENT CONSENT FORM.
Review or Copies of Your Medical Records
You have the right to request to inspect, review, and/or receive a copy of your medical records. Your medical record consists of your diagnosis, treatment plan, any test results, dates of treatment sessions, fees and payments, and records gathered from other providers. You do not have the right to access the psychotherapy notes that I write during or after each session.
Please inform me at least two weeks in advance of your desire to review your records which may then occur at a subsequent session. To obtain a copy of your medical records, or a Treatment Summary, please submit to me a request in writing at least four weeks in advance and be prepared to pay the following costs at the time you receive the copies: Records/copies: 15c per page plus $24 an hour for time spent making copies plus postage or other cost of delivery. Treatment Summary: $150 an hour for time spent writing the summary.
Review or Copies of Your Child's Medical Records
In most cases, you have the right to request to inspect, review, and/or receive a copy of your child's medical records. There are some exceptions regarding, for example, older minors, children at risk of harm, or if I believe sharing their medical information may be detrimental to them in some way. Your child's medical record consists of her/his diagnosis, treatment plan, any test results, dates of treatment sessions, fees and payments, and records gathered from other providers. You do not have the right to access the psychotherapy notes that I write during or after each session.
Please inform me two weeks in advance of your desire to review your child's records which may then occur at a subsequent parenting session. To obtain a copy of your child's medical records, or a Treatment Summary, please submit to me a request in writing at least four weeks in advance and be prepared to pay the following costs at the time you receive the copies: Records/ copies: 15c per page plus $24 an hour for time spent making copies plus postage or other cost of delivery. Treatment Summary: $150 an hour for time spent writing the summary.
Corrections
If you think the information in your (or your child's) medical or billing record is incorrect, you can request a change, or amendment, to your (or your child's) record. If I cannot agree to your request, you may submit a statement of disagreement that I will add to your (or your child's) record.
Complaints
If you have any complaints about compliance with these privacy policies and procedures please do bring your concerns to my attention either in person, by letter or by voicemail message.
To report a complaint to the Department of Health and Human Services, go to:
www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html
or call the DHHS OCR toll free at 1-800-368-1019.
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