THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

I. USES AND DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS

Emotional Wealth may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. Here are some definitions to help clarify these terms:

• Disclosure applies to releasing, transferring, or providing access to information about you to other parties.
• PHI refers to information in your health record that could identify you.
• Treatment is when Emotional Wealth provides, coordinates, or manages your health care and other services related to your health care. For example, consulting with another health care provider, such as your family physician or another psychologist.
• Payment is when Emotional Wealth LLC obtains reimbursement for your healthcare, such as disclosing your PHI to your health insurer to obtain reimbursement or to determine eligibility or coverage.
• Health Care Operations are activities related to the performance and operation of our practice, including quality assessment, business-related matters, case management, and care coordination.
• Use applies only to activities within our practice, such as sharing and analyzing information that identifies you.

II. USES AND DISCLOSURES REQUIRING AUTHORIZATION

Emotional Wealth may use or disclose PHI for purposes outside of treatment, payment, and healthcare operations when your appropriate authorization is obtained. This includes releasing your psychotherapy notes which are given a greater degree of protection. You may revoke such authorizations at any time, but this will not affect any prior reliance on the authorizations.

III. USES AND DISCLOSURES WITH NEITHER CONSENT NOR AUTHORIZATION

Emotional Wealth may use or disclose PHI without consent or authorization in the following circumstances

• Child Abuse
• Health Oversight
• Judicial or Administrative Proceedings
• Serious Threat to Health or Safety
• Worker’s Compensation

IV. PATIENTS’ RIGHTS AND PSYCHOLOGISTS’ DUTIES

• Right to Request Restrictions – You may request restrictions on certain uses and disclosures of PHI about you, although we are not required to agree to a restriction you request.
• Right to Receive Confidential Communications – You can receive PHI by alternative means or at alternative locations.
• Right to Inspect and Copy – You have the right to inspect or copy PHI and psychotherapy notes in our records used to make decisions about you.
• Right to Amend – You can request an amendment of PHI for as long as the PHI is maintained in our records.
• Right to an Accounting – You can receive an accounting of disclosures of PHI for which consent or authorization was not provided.
• Right to a Paper Copy – You can obtain a paper copy of this notice upon request.
• Breach Notification – You will be notified of any breach of unsecured PHI concerning you.

V. QUESTIONS AND COMPLAINTS

If you have questions or complaints, you may contact our office below:

VI. EFFECTIVE DATE, RESTRICTIONS AND CHANGES TO PRIVACY POLICY

This notice is effective as of August 2020. We reserve the right to change the terms of this notice and will inform you of any changes.

This notice provides an overview of our privacy practices and your rights. Please reach out if you need more information or have any concerns about your privacy rights.