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.
The Complaint and Privacy Officer is Lynnette Breeden. She can answer your questions about our privacy practices, accept any complaints you might have, and help you file a complaint. She can be contacted at 540-658-0888 or at the address listed above.
Get an electronic or paper copy of your medical record: You can ask to see, obtain, or have sent to someone else, a copy of your medical record. If you are requesting a personal copy of your records, we may ask to review your records with you. We will provide a copy or a summary of your health information, usually within two weeks of your written request. We may charge a reasonable, cost-based fee. Please remember that electronic media is not always safe from unauthorized access and your confidentiality cannot be guaranteed in these circumstances.
Ask us to correct your medical record : You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
Request confidential communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will agree to all reasonable requests. Ask us how to do this.
Ask us to limit what we use or share: We do not sell your personal information, nor do we use it for marketing. Except for the disclosures listed below, we do not share your information, including psychotherapy notes, without a signed release of information that allows us to do so. You are allowed to retract that request at any time to stop any future disclosure of your information. Further, you can ask us to limit, or not use, certain health information for treatment, payment, or business operations (data collection, auditing, etc.). We are not required to agree to this request if it would affect your care. If you pay for a service or health care item out-of-pocket in full, we will not disclose that information to your health insurer, unless we are required to do so by law.
Get a list of those with whom we’ve shared information: You can ask for a list (accounting) of the times we’ve shared your health information for up to six years prior to the date you ask, with whom we shared the information and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). This request will need to be submitted in writing and may take up to 60 days to fulfill the request.
Get a copy of this privacy notice: You have the right to receive copies of this notice electronically (which can be obtained from our website) and/or in paper format.
Choose someone to act for you: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action, within the limits of the law.
File a complaint if you feel your rights are violated: You can file a complaint if you feel we have violated your rights by contacting Lynnette Breeden at (540) 658-0888. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints or by contacting the Virginia Department of Health Professions at http://www.dhp.virginia.gov or (800) 533-1560 . We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information, please tell us. In these cases, you have both the right and choice to tell us to: Share information with your family, close friends, or others involved in your care (with a valid release, in a clinically appropriate format). If you are not able to tell us your preference, for example if you are significantly impaired, we may share your information if we believe it is in your best interest or your desire. Retroactive consent may be obtained in emergency situations.
Our Uses and Disclosures
We typically use or share your health information in the following ways.
Treat you: We can use your health information and share it with other professionals within Insight Psychological Services. We will not release information to another health care provider without your consent, except as noted below. Example: A doctor treating you for an injury contacts us about your treatment, we will first require a written release of information from you.
Operation of our practice: We can use and share your health information to operate our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services .
Bill for your services: We can use and share your health information to bill and get payment from health plans or other payment entities. Example: We give information about you to your health insurance plan for payment for counseling services provided .
How else can we use or share your health information?
We are allowed or required to share your information in other ways, without a written consent, usually in ways that contribute to the public good, such as public health. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html .