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With the exception of certain specific situations described below, you have the absolute right to confidentiality in your psychotherapy.  Your therapist cannot and will not tell anyone else what you have told him or her without your prior permission.

Under the provisions of the federal legislation, your therapist may legally speak to another health care provider or a member of your family about you without your prior consent.  It is Psychotherapy Associates policy, however, not to do so unless the situation is an emergency.

You may direct your therapist to share information with whomever you chose, and you can change your mind and revoke that permission at any time.

You may request anyone you wish to attend a therapy session with you.


Confidentiality Exceptions

The following are legal exceptions to your right to confidentiality.

If there is good reason to believe that you will harm another person, your therapist is required to warn that person of your intentions and to notify law enforcement officials to ask that your intended victim be protected.

If there is good reason to believe that you are abusing or neglecting a child or vulnerable adult, or if you provide information about someone else who is doing so, your therapist is required to inform law enforcement officials and/or child welfare officials.

If there is good reason to believe that you are in imminent danger of harming yourself, your therapist may inform law enforcement officials to ask that you be taken into protective custody for your own safety.  Your therapist will explore all other options with you prior to resorting to this step.


Privileged Communication

If you are involved in a court case or proceeding, you may prevent your therapist from testifying in court about what you have said in therapy sessions.  Called "privilege," this allows you to allow or prevent you therapist from giving testimony, as you see fit.  However, there are some situations in which a judge or court may require your therapist to testify.  The following are exceptions to privileged communication.

In a civil commitment hearing to decide if you present a danger to yourself or others. 

If your fitness as a parent is questioned in a child custody or adoption proceeding.

To authorized federal officials for the purpose of conducting national security investigations.

During a malpractice case or an investigation of your or another therapist by a professional group.

If you are seeing your therapist for court-ordered evaluation or treatment.

If you were to file a complaint or are a plaintiff in a lawsuit in which your therapist or Psychotherapy Associates as a practice is named as a defendant.

If you were to file a complaint or are a plaintiff in a lawsuit in which you bring up the question of your mental health, you will have automatically waived your right to the confidentiality of these records in the context of the complaint or lawsuit.  It is Psychotherapy Associates policy, however, to release such information only with your written consent or a court order.

If you were to default on payment of your account, your therapist may provide such basic identifying information to collection service representatives or officers of the court as is necessary to settle your debt.

Relative Confidentiality

While you can expect your therapist to guard your privacy carefully, there are some limits to confidentiality which are an expected part of treatment within a group office practice.

Psychotherapy Associates therapists share emergency after-office-hours duty.  If your situation dictates, your therapist may provide the on-call clinician with advance briefing regarding your needs and difficulties as a means of providing you with the best possible care.

Your therapist may sometimes consult with another health care professional about particulars of your diagnosis or treatment plan, with the goal of ensuring that you receive the best possible care.  In such cases, the professional who is consulted shares with your therapist the duty to maintain confidentiality.

Many aspects of practice management are delegated by Psychotherapy Associates therapists to office staff members and contracted service providers.  Transcribing clinical records and correspondence, filing materials in patient charts, preparing insurance-mandated records, and relaying messages between patient and therapist are examples of delegated tasks.  Support staff are trained to protect your confidentiality.

If your therapist is active in publishing for professional journals and texts, conducting clinical research, or educating mental health practitioners, he or she may wish to refer to some aspects of your treatment for professional purposes.  In such cases, focus will be placed upon symptoms, treatment approach, and treatment outcome rather than individual details of your situation.  All information which might identify you will be deleted or modified.

Confidentiality of Insurance Records

If you use health insurance to pay part of you therapy fees, or are a member of a managed care plan, your plan requires you to authorize release of all treatment records to plan representatives whenever you submit a claim for benefits.

Most insurance companies require information regarding diagnosis, session format, date of onset and duration of symptoms, and dates seen in therapy.  Managed care organizations, however, ask for much more information about you and your symptoms, as well as a detailed treatment plan.  It is common for managed care organizations, and some fee-for-service insurance plans, to require photocopies of individual session treatment records.

In order to protect patient privacy to the extent possible, Psychotherapy Associates policy is to respond to requests for chart photocopies by instead offering to send a brief summary of symptoms and treatment progress.  If this is not acceptable to managed care reviewers, photocopies from your cart will be reviewed by your therapist prior to submission to the managed care organization.  When information of a particularly sensitive nature is involved, you will be consulted before any information is released.

If you request, you will be provided with a copy of any report which your therapist submits to your insurance carrier.

Some managed care programs, including all Nebraska Medicaid programs, require the involvement of a overseeing psychiatrist or psychologist to approve treatment provided by our Licensed Mental Health Practitioner clinicians.  Required supervision includes periodic review of your chart and consultation with you in person.

In most cases, you have the right to pay for services personally to avoid submission of information to you insurer.  Medicare and some other insurers, however, do not allow clinicians who provide services to those they insure to treat their insureds privately.

Provisions of the Health Insurance Portability and Accountability Act (HIPAA)

Passed in 1996, HIPAA standards became effective in April 2003. One of the purposes of this legislation was to adopt consistent standards for transmitting uniform electronic health care claims. In order to fulfill this purpose, Congress adopted related standards for securing the storage of that information and for protecting individual patient's privacy. HIPAA uses the term Protected Health Information (PHI) to refer to confidential information.

In most cases, Psychotherapy Associates policy regarding management of confidential information is more stringent than standards set by HIPAA. We are required by law, however, to provide all patients with the following information regarding HIPAA-mandated standards regarding how your protected health information may be used:

Health information you provide to Psychotherapy Associates clinicians and staff will be recorded in your clinical records. Information regarding your treatment may be included in your records for the use of your therapist as well as any other Psychotherapy Associates clinician who might be called upon to provide care to you.

Information regarding your health and care may be used to obtain payment for your psychotherapy. We may use or disclose your diagnosis, treatment, and outcome information in order to improve the quality or cost of care we deliver. These activities may include evaluating the performance of our clinicians, examining the effectiveness of the treatment provided to you when compared to patients in similar situations, and providing education to mental health professionals.

If relatives or significant others are helping care for you or helping you pay your psychotherapy bills, we may release important health information about you to them. The information released may include dates and types of treatment provided.

Persons or organizations who provide services for us under contract may have access to your health information. We might, for instance, contract with a medical records management company to convert your outdated clinical records to microfilm. Our business associates are required to protect all clinical information we provide to them.

We may use or disclose your health information when required to do so by local, state or federal law. An example is the mandatory reporting of child abuse.

We may disclose your health information to a health oversight agency for activities authorized by law such as audits and licensure investigations. These agencies might include government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights law.

We may disclose your health information to coroners or medical examiners so that they can carry out their duties including identifying your body and determining cause of death.

We may provide health information for law enforcement purposes, including but not limited to crimes occurring on-site; and emergency situations to report a crime, the location of the crime, or victims involved.

We may disclose your health information to authorized federal officials for conducting national security activities.

We may disclose your health information in response to a court or administrative order and, in certain conditions, in response to a subpoena or other lawful process.

We may disclose your health information to comply with workers' compensation laws and similar programs that pay for your psychotherpay connected to a work-related illness or injury.

We may use and disclose your health information when needed to prevent a serious threat to your health and safety or the health and safety of the other people. The information may be provided only to someone able to help prevent the threat.

HIPAA legislation specifies that you have these rights with regard to your protected health information:

You may ask for restrictions on how your health information is used or disclosed for treatment, payment, research and education. Your request must be in writing and must include (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply. HIPAA does not require us to agree with your requested restrictions.

You have the right to ask that we communicate your health information to you using alternative means or an alternative location. For example, you may wish to receive information through a written letter sent to a private address.

In some limited instances, you have the right to ask for a list of the disclosures we have made of your protected health information. All such requests must be made in writing. The disclosure must have been made after April 14, 2003 and no more than six years from the date of your request for an accounting. We are not required to list disclousres made for treatment, payment, research, education, national security, certain health oversight activities, or disclosures authorized by you or your legal guardian.

You may withdraw your authorization to release confidential information at any time, as long as your withdrawal is in writing. You may ask us to give you a paper copy of this listing at any time.

If you believe your privacy rights have been violated, you have a right to file a complaint with us and with the federal Department of Health and Human Services. We may not retaliate against you for filing such complaints.