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Karner Psychological Associates
Notice Of Privacy Practices
April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT
YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION.
PLEASE CAREFULLY REVIEW THIS NOTICE
Privacy is a primary concern of all those who came
to Karner Psychological Associates. It can be complicated because of
the many federal and state laws and our professional ethics. This
Notice of Privacy Rights will tell you how KPA handles your medical
information. It tells how we use this information within this
office, how we share it with other professionals and organizations,
and how you yourself can gain access to it. We want you to know that
these procedures have been established to help you make the best
decisions for yourself and your family. Because the state and
federal laws are complicated and parts of them may not apply to you,
we have removed a few small sections. If you have any questions or
want to know more about anything in this Notice just ask.
WHAT WE MEAN BY YOUR MEDICAL INFORMATION
Each time you visit Karner Psychological
Associates or any other healthcare providers; information is
collected about you and your physical and/or mental health. It may
be information about your past, present or future health or
conditions, or the treatment or tests you received from us or from
others, or about your payments for healthcare. The information we
collect is called, in the law, Protected Health information or PHI.
This information goes into your treatment record or file at our
office.
At Karner Psychological Associates PHI is
likely to include these kinds of information:
- Your history. (Your history may include information about your
childhood, work, marriage, and personal experiences.)
- Reasons you came to KPA for treatment. (Your problems,
complaints, symptoms or needs.)
- Diagnoses. (Diagnoses are the medical terms for your problems
and symptoms.)
- Treatment Plan. (A Treatment Plan is a list of the treatments
and other services which we think will be best to help you.)
- Progress Notes. (At each meeting, your therapist writes
a note about how you are doing and sets goals that are reachable
with you for your next meeting.)
- Records we get from others who treated you or evaluated you.
- Psychological test scores, school records and other similar
reports.
- Information about the medications you are taking or took in
the past.
- Legal matters.
- Billing and insurance information.
This list is just to give you an idea of what your
PHI contains. However, there may be other kinds of information that
goes into your KPA healthcare record.
We use this information for many purposes. For
example, we may us it:
- To plan your treatment.
- To decide how well your treatment is working for you.
- When we talk to other healthcare professionals who are
treating you, such as your family doctor or the professional who
referred you to us.
- To document that you actually received the services from us
which we billed to you or your health insurance company.
- For teaching and training of healthcare professionals.
- For medical or psychological research.
- For public health officials trying to improve health care in
the Capital Region.
- To improve the way we do our job by measuring the results of
our work.
When you understand what is in your record and
what it is used for, you can make better decisions about whom, when
and why others should have this information.
Although your healthcare record is the physical
property of Karner Psychological Associates (or the healthcare
practitioner or facility that collected it), the information belongs
to you. You can read it, and, if you want a copy, we can make one
for you. If you request a copy, there will be a charge for the costs
of copying ($0.75 per page), and postage, if you want the records
mailed to you.
In some rare situations you will not be able to
see all of what is in your records. You may discuss with your
therapist any possible limitations to your ability to see all of
his/her notes.
If you find anything in your records that you
think is incorrect or believe that something important is missing
you can ask KPA to amend or add information to your record. In
some rare situations, we do not have to agree to do that but we will
inform you in writing of the reasons. If you request, our Privacy
Officer, whose name appears at the end of this Notice, can explain
more about this.
PRIVACY AND THE LAW
KPA is required to inform you about your privacy
rights in conformity with the privacy regulations issued by the
Health Insurance Portability and Accountability Act of 1996, which
is also known as HIPPA. HIPPA requires us to keep your Personal
Healthcare Information (or PHI) private and to give you notice about
our legal duties and our privacy practices in a Notice of Privacy
Practices (or NPP).
Karner Psychological Associates is committed to
obeying the letter and spirit of HIPPA as evidenced in this Notice
of Privacy Practices. We will follow HIPPA rules and these privacy
practices as long as they are in effect. If we make any changes in
our privacy practices, a new Notice of Privacy Practices will be
published and posted at the offices of Karner Psychological
Associates. You or anyone else can get a copy of our Notice of
Privacy Practices from our Privacy Officer at any time. The
NPP will be posted on our website at: www.karnercare.com.
HOW YOUR PROTECTED HEALTH INFORMATION CAN BE USED
AND SHARED
When your PHI is read by your therapist or others
at Karner Psychological Associates that act is called, in the law,
"USE." If the information is shared with or sent to others outside
KPA, that is called in the law, "DISCLOSURE." Except in some
circumstances, when we use your PHI here or disclose it to others we
share only the minimum necessary PHI needed for those people to do
their jobs. The law gives you the right to know about your PHI, how
it is used and to have a say in how it is disclosed.
KPA uses and discloses Personal Health Information
for several reasons. Mainly we use and disclose PHI for
routine purposes described below. For other uses we must tell you
about them and receive a written authorization from you, unless the
law specifically allows the disclosure without your authorization.
These exclusions are also described below.
USES AND DISCLOSURES OF YOUR PHI IN HEALTHCARE THAT
REQUIRE YOUR WRITTEN CONSENT
We need information about you and your condition
to provide care to you. Unless you agree to let us collect this
information and to use it and share it to care for you properly, we
will be unable to treat you. Therefore, we must have your written
Agreement (Consent Form) before we begin treatment.
After you have read this notice and had your
questions answered you will be asked to sign a separate Consent
Form. The Consent Form allows KPA to use and share your PHI with
other people or organizations who provide treatment to you, arrange
for payment of our services, or some other business functions called
healthcare operations. Together these routine functions are called
TPO and the Consent Form allows KPA to use and disclose your PHI for
TPO.
TPO functions include:
- Treatment: We use your personal and medical information
to provide you with treatment services. These might include
individual, family or group therapy, psychological, educational or
vocational testing, developing treatment plans, or measuring
progress or the benefits of our services.
Therefore, we may
share or disclose your PHI to others who provide treatment to you,
such as your personal physician. If you are being treated by more
than one KPA therapist, they can share your PHI so as to better
coordinate the services you are receiving. Therapists will enter
their findings, the actions they took, and their plans into your
record so that they can collectively decide what treatments work
best for you and to develop a Treatment Plan for you. We may refer
you to other professionals or consultants for services we cannot
provide. When we do this we need to tell them some things about
you and your conditions. We will receive from them their findings
and opinions and those will be entered into your KPA records. If
you receive treatment in the future from other professionals we
can also share your PHI with them. These are some examples of how
we use and disclose your PHI to optimize your treatment.
- Payment: We may use you information to bill you, your
insurance carrier or others so we can be paid for the treatment we
provide to you. We may contact your insurance company to check on
exactly what your insurance covers. We may have to tell them about
your diagnoses, what treatments you have received and the changes
we expect in your conditions. We will need to tell them about when
we provided services, your progress and other similar
things.
- Healthcare Operations: We may use your PHI to see where
we can make improvements in the care and services we provide. We
may be required to supply some information to some governmental
health agencies so they can study disorders and treatment and to
make plans for services that are needed. If we do, your name and
personal information will be removed from from the information we
provide.
OTHER USES OF YOUR PHI COVERED BY THE WRITTEN
CONSENT FORM
- Appointment Reminders: We may use and disclose contents
of your PHI to reschedule or remind you of appointments for
treatments or other services. If you want us to call or write to
you only at a specific site or prefer some other way to reach you,
you must inform us of the preferred phone number, address, etc. in
writing and you can request the appropriate form from your
Therapist.
- Treatment Alternatives: KPA may use and disclose your
PHI to inform you or recommend possible treatments or alternatives
that may be of help to you.
- Other Benefits and Services: We may use and disclose
your PHI to tell you about health-related benefits or services
that may be of interest to you.
- Research: We may share or use your information to do
research to improve treatment. For example, we may compare two
treatment modalities for the same disorder to see which works
better or faster or costs less. In all cases, when such research
is conducted, your name, address, and other personal information
will be removed from the information given to researchers. If they
need to know who you are we will discuss the research project with
you and have you sign a special Authorization form before any
information is shared.
- Business Associates: There are some jobs we may hire
outside contractors or other businesses to do for us. In the law,
these entities are called Business Associates. Business Associates
might include a billing service or a medical transcription
service. To do their jobs properly, Business Associates need to
receive some information from your PHI. To protect your privacy
each Business Associate must agree within their contract with us
to safeguard all personal information they receive from KPA.
USES AND DISCLOSURES OF YOUR PHI THAT REQUIRE YOUR
WRITTEN AUTHORIZATION
IF KPA wants to use your Personal Health
Information for any purpose besides TPO or those other uses
described above, we need your written permission on an authorization
Form. We do not expect to need this very often.
If you do authorize us to disclose your PHI, you
can revoke that permission, in writing, at any time. Once a
cancellation of your authorization is received, no further
disclosures of your PHI for that purpose will be made. Of course, we
cannot take back any information disclosed prior to the receipt of
your revocation of Authorization.
USES AND DISCLOSURES OF YOUR PHI THAT DO NOT
REQUIRE A WRITTEN CONSENT OR AUTHORIZATION
In some cases HIPPA allows us to use and disclose
some of your PHI without your consent or authorization. The
following are some examples:
- When Required By Law: There are some federal, state or
local laws that require us to disclose personal information:
- We are mandated to report suspected child abuse.
- If you are involved in a lawsuit or legal proceeding and we
receive a subpoena, request for discovery or other lawful
process we may have to release your PHI.
- KPA is required to disclose some information to government
agencies which are charged with enforcing compliance with
privacy laws..
- For Law Enforcement Purposes: We may release personal
information to law enforcement officials on receipt of a subpoena
or court order as part of an investigation of a crime or
criminals.
- For Public Health Activities: We might disclose some of
your PHI to agencies that investigate diseases or injuries.
- For Specific Government Functions: KPA may disclose PHI
of military personnel and veterans to federal benefit programs
relating to eligibility and enrollment. We also may disclose your
PHI to New York State Workers Compensation and Disability
programs, to correctional facilities if you are an inmate, and for
national security reasons.
- To Prevent A Serious Threat To Health And Safety: If we
come to believe that there is a serious threat to your health or
safety or that of another person or the public we can disclose
some of your PHI. We will only do this to persons who can prevent
the danger.
USES AND DISCLOSURES OF PHI WHERE YOU HAVE AN
OPPORTUNITY TO OBJECT
KPA can share some information about you with your
family or close others. However, we will only share information with
those involved with your care and anyone else you choose such as
close friends or clergy. We will ask you about who you want us to
tell what information about your condition or treatment. You can
tell us what you want and we will honor your request as long it is
not against the law.
If it is an emergency, and we are unable to ask
you if you disagree, we can share information if we believe it is
what you would have wanted and if we believe it will help you if we
do share the information. If we do share information in an emergency
situation, we will inform you in writing as soon as we can. Should
you not approve we will immediately cease the disclosure, as long as
it is not against the law.
ACCOUNTING OF DISCLOSURES
Whenever we disclose your PHI we will keep a
detailed record of the action. You can get an accounting (list) of
many of these disclosures. The accounting will include, who we
disclosed to, what was disclosed and when the disclosure was
made.
IF YOU HAVE QUESTIONS OR PROBLEMS RELATING TO KPA'S
PRIVACY PRACTICES
If you need more information or have questions
about the privacy practices described above, you make speak to your
Therapist or to KPA's Privacy Officer.
If you have a problem with how your PHI has been
handled or if you believe your privacy rights have been violated,
immediately contact the KPA Privacy Officer. You have a right to
file a complaint with us and with the Secretary of the Federal
Department Of Health and Human Services in Washington, DC. We
promise you that we will not in any way limit your care at KPA or
take any actions against you if you complain.
The KPA Privacy officer is:
FRANK DOBERMAN, Ph.D
Phone: 456-5056
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