HIPPA Privacy Policy:

THIS NOTICE DESCRIBES HOW MEDICAL OR PROGRAM RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

General Information

Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 (“HIPPA”), and the confidentiality Law. Under these laws, an employee of Mountain Home Montana may not say to a person outside of this office that you attend the program or disclose any other protected information except as permitted by federal law.

This program must obtain your written consent before it can disclose any information about you for payment purposes. For example, this case manager/program manager must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before this representative can share information for treatment purposes or for health care operations. However federal law permits this representative to disclose information without your permission:

  1. Pursuant to an agreement with a qualified service organization/business associate;
  2. For research, audit, or evaluation;
  3. To report a crime committed on these premises or against employees of this program;
  4. To medical personnel in a medical emergency;
  5. To appropriate authorities to report suspected child abuse or neglect;
  6. As allowed by court order

For example, this program can disclose information without your consent to obtain legal or financial services or to another medical facility to provide health care to you, as long as there is a qualified service organization/business agreement in place.

Before this program can use or disclose any information about your health in a manner that is not described above, it must first obtain your specific written consent allowing it to make the disclosure. You may revoke any such written consent in writing.

Your Rights

Under HIPPA you have the right to request restrictions on certain uses and disclosures of your health information. This counselor is not required to agree to any restrictions that you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency.

You have the right to request that we communicate with you by alternative means or at an alternative location. This counselor will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPPA you also have the right to inspect and copy your own health information maintained by this counselor, except to the extent that the information contains psychotherapy notes or information compiled for use in civil, criminal, or administrative proceedings or in other limited circumstances. Under HIPPA you also have the right, to some exceptions, to amend health care information maintained in these records and to request and receive a paper copy of this notice.

Program Duties

This program is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. This program is required by law to abide by the terms of this notice. We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the office area of this program.

Complaint and Reporting Violations

If you believe that your privacy rights have been violated you may file a complaint with the Secretary of the Department of Health and Human Services. All complaints must be filed in writing.

Notice of Privacy Practices:

THIS NOTICE DESCRIBES HOW MEDICAL OR PROGRAM RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Please review this notice carefully. It describes how information about you may be used and disclosed and how you can get access to this information.

This notice of Privacy Practices describes how I may use and/or disclose your Protected Health Information (PHI) to carry out treatment, to obtain payment, for healthcare operations and for other purposes that are permitted or required by law.  It also describes your rights to access and control your Protected Health Information.  “Protected Health Information” is information about you and your treatment, including information that may identify you.  I am required to abide by the terms of this Notice.  I may change the terms of this notice at any time.  If I do so, the new notice will be effective for all PHI that I maintain at that time.  Upon your request, I will provide you with any revised Notice of Privacy Practices.

It is my responsibility to maintain records about you and your treatment in a manner that protects confidentiality as required by law.  In most cases, information about you or your treatment can only be disclosed when you have signed a Release of Information allowing this to occur.  For example, in most cases, I cannot release my psychotherapy notes about your treatment without obtaining an explicit authorization from you allowing me to do so.  You have the right to revoke any authorizations to release information about you at any time by putting a request in writing.

There are certain circumstances under which I may be required to use of disclose PHI without our consent or authorization.  These include: child abuse, elder abuse, health oversight activities, judicial and administrative proceedings, serious threat to health or safety, or worker’s compensation.

Client’s Rights to PHI

Right to Request Restrictions–You have the right to request restrictions on certain uses and disclosures of protected health information.  I will make every effort to comply with your request but I am not bound to agree to the request.

Right to Receive Confidential Communications by Alternative Means and at Alternative Locations–You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations.  For example, you may not want a family member to know that you are consulting with me.  On your request, I will call you at a different phone number or will send information to another address.

Right to Inspect and Copy–You have the right to inspect or obtain a copy (or both) of PHI in my mental health and billing records used to make decisions about you for a long as the PHI is maintained in the record.  I may deny your access to PHI under certain circumstances.  On your request, I will discuss with you the details of the request and denial process.

Right to Amend–You have the right to request an amendment of PHI for as long as the PHI is maintained in the record.  I may deny your request.  On your request, I will discuss with you the details of the amendment process.

Right to an Accounting–You have a right to receive an accounting of disclosures of PHI.  On your request, I will discuss with you the details of the accounting process.

Mountain Home Montana