Examples of uses of your health information for treatment purposes are: 

• An employee of the provider's office obtains treatment information about you and records it in a health record
• During the course of your treatment, the provider determines that he/she will need to consult with another specialist in the area.  He/She will share the information with such specialist and obtain his/her input.

An example of use of your health information for payment purposes: 

• We submit a request for payment to your health insurance company.  The health insurance company requests information from us regarding services rendered.  We will provide that information to them about you and the care you receive.
• We verify insurance coverage prior to your first appointment and obtain prior authorization and pre-certification when required to do so by your policy coverage.

An example of use of your health information for health care operations: 

• The state licensing authority wants to review records to assure that we have acted consistent with state law regarding your care.  In doing so, it wants to take a sampling which includes review of your chart.  At the licensing authority's request, we will provide it with a copy of your chart.

Your health information rights:
The health record and billing records we maintain are the physical property of this office.  The information in it, however, belongs to you.  You have a right to: 

• Request a restriction on certain uses and disclosures of your protected health information by delivering the request in writing to our office.  We are not required to grant the request, but we will comply with any request granted.
• Obtain a paper copy of that Notice of Privacy Practices for Protected Health Information by making a request at our office.
• Request that you be allowed to inspect and receive a copy of your health record and billing record.  You may exercise this right by delivering the request in writing to our office using the form we provide to you upon request.
• Appeal a denial of access to your protected health information except in certain circumstances.
• Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office using the form we provide to you upon request
• File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information
• Obtain an accounting of disclosures of your health information as required to be maintained by law delivering a written request to our office using the form we provide to you upon request. The accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request.
• Request that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office using the form we provide to you upon request.
• Revoke any authorizations that you made previously to use or disclose information except to the extent information or actions has already been taken by delivering a written revocation to our office.

You have the right to review this Notice before signing the consent authorizing use and disclosure of your protected health information for treatment, payment and health care operations purposes.

If you want to exercise any of the above rights, please contact Bari Baitch, LMHC, PA