Notice of Privacy Practices
I. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW TO GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
II. LEGAL DUTY TO SAFEGUARD THE CLIENT’S PROTECTED HEALTH INFORMATION (PHI)
Denali Psychological Services (DPS) is legally required to protect the privacy of client’s PHI, which includes information that can be used to identify the client that has been created or received about client’s past, present, or future health or condition, the provision of health care to you, or the payment of this health care. DPS must provide the client with this Notice about DPS’s privacy practices, and such Notice must explain how, when, and why DPS will "use" and "disclose" your PHI. A "use" of PHI occurs when DPS shares, examines, utilizes, applies, or analyzes such information within DPS; PHI is "disclosed" when it is released, transferred, has been given to, or is otherwise divulged to a third party outside of DPS. With some exceptions, DPS may not use or disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. DPS is legally required to follow the privacy practices described in this Notice.
DPS reserves the right to change the terms of this Notice and privacy policies at any time. Any changes will also apply to PHI already on file. Before making any important policy changes, I will promptly change this Notice and post a new copy of it in DPS offices and on the DPS website. The client may request a copy of this Notice, or view a copy in DPS offices or on the DPS website.
III. PHI USE AND DISCLOSURE
DPS may use and disclose the client’s PHI for many different reasons. Some of these uses or disclosures will require prior authorization while others do not. Listed below are the different categories of uses and disclosures along with some examples of each category.
A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Not Requiring Prior Written Consent. DPS may use and disclose the client’s PHI without consent for the following reasons:
For current treatment. DPS may disclose the client’s PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who also provide the client with health care services or are involved in the client’s care. For example, if the client is being treated by a psychiatrist, DPS may disclose the client’s PHI to the client’s psychiatrist to coordinate care.
To obtain payment for treatment. DPS may use and disclose the client’s PHI to bill and collect payment for the treatment and services provided by DPS. For example, DPS may send PHI to the client’s insurance company for payment for the health care services provided to the client. DPS may also provide the client’s PHI to business associates, such as billing companies, credit card companies, claims processing companies, and others that process health care claims.
For health care operations. DPS may disclose your PHI for operations. For example, DPS may use PHI to evaluate the quality of health care services received or to evaluate the performance of the health care professionals who provided such services to you. DPS may also provide PHI to our accountants, attorneys, consultants, and others to ensure DPS complies with applicable laws.
Emergency Situations. DPS may also disclose your PHI to others without your consent in certain situations. For example, consent is not required if client requires emergency treatment, as long as DPS attempts to gain consent after treatment is rendered, or if DPS attempts to gain consent but client is unable to communicate (for example, if client is unconscious or in severe pain) and it is determined the client would consent to such treatment if you were able to do so.
B. Certain Uses and Disclosures Not Requiring Consent. DPS may use and disclose your PHI without your consent or authorization for the following reasons:
When disclosure is required by federal, state or Local law; judicial or administrative proceedings; or law enforcement. For example, DPS may make a disclosure to applicable officials when a law requires DPS to report information to government agencies and law enforcement personnel about victims of abuse or neglect; or when ordered in a judicial or administrative proceeding.
For public health activities. For example, DPS may have to report information about the client to the county coroner.
For health oversight activities. For example, DPS may have to provide information to assist the government when it investigates or inspects a healthcare provider or organization.
For research purposes. In certain circumstances, DPS may provide PHI to conduct medical research.
To avoid harm. To avoid a serious threat to the PHI to law enforcement personnel or persons able to prevent or lessen such harm.
For specific government functions. DPS may disclose PHI of military personnel and veterans in certain situations. DPS may disclose PHI for national security purposes, such as protecting the President of the United States or conducting intelligence operations.
For workers' compensation purposes. DPS may provide PHI to comply with workers' compensation laws.
Appointment reminders and health related benefits or services. DPS may use PHI to provide appointment reminders or give the client information about treatment alternatives, or other health care services.
C. Certain Uses and Disclosures Require Client to Have the Opportunity to Object.
Disclosures to family, friends, or others. DPS may provide the client’s PHI to a family member, friend, or other person that the client indicates is involved in their care or the payment for their healthcare, unless the patient objects in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
D. Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in sections III A, B, and C above, DPS will ask for the client’s written authorization before using or disclosing any of the client’s PHI. If the client chooses to sign an authorization to disclose PHI, the client can later revoke such authorization in writing to stop any future uses and disclosures of your PHI by DPS.
IV. CLIENT RIGHTS REGARDING PHI
The client has the following rights with respect to PHI:
A. The Right to Request Limits on Uses and Disclosures of PHI. The client can ask that DPS limit the use and disclosure of PHI. DPS will consider this request, but is not legally required to accept it. If DPS accepts the client’s request, DPS will put any limits in writing and abide by them except in emergency situations. The client may not limit the uses and disclosures that DPS is legally required or allowed to make as outlined above.
B. The Right to Choose How DPS Sends PHI. The client has the right to ask that DPS send information to an alternate address (for example, sending information to your work address rather than your home address) or by alternate means (for example, e-mail instead of regular mail). DPS must agree to the client’s request so long as DPS can easily provide the PHI in the requested format.
C. The Right to See and Get Copies of PHI. In most cases, the client has the right to look at or obtain copies of their PHI. This request must be made in writing. DPS has up to 30 days after receiving the written request to provide the client the requested PHI. In certain situations, DPS may deny your request and must tell the client in writing. The client has the right to have this denial reviewed by another licensed psychologist. Requested copies of PHI will cost not more than $.25 for each page. Instead of providing the requested PHI, DPS may provide you with a summary or explanation of the PHI as long as it is agreed upon in advance.
D. The Right to Get a List of the Disclosures DPS Has Made.
The client has the right to get a list of instances in which DPS has disclosed the client’s PHI. The list will not include uses or disclosures that the client has already consented to, such as those made for treatment, payment, or health care operations, directly to the client, or to their family. The list also won't include uses and disclosures made for national security purposes, to corrections, or to law enforcement personnel.
DPS will respond to the client’s request for an accounting of disclosures within 60 days of receiving this request. The list will include disclosures made in the last six years unless the client requests a shorter time frame. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. DPS will provide the list to the client at no charge, but if more than one request is made in the same year, DPS will charge the client a reasonable cost-based fee for each additional request.
E. The Right to Correct or Update PHI. If the client believes that there is a mistake with their PHI or that a piece of important information is missing, they have the right to request that DPS correct the information. The client must provide the request and reason for the request in writing. DPS will respond within 60 days of receiving the request to correct or update the client’s PHI. DPS may deny the request in writing if the PHI is (i) correct and complete, (ii) not created by DPS, (iii) not allowed to be disclosed, or (iv) not part of DPS’s records. The written denial will state the reasons for the denial and explain the client’s right to file a written statement of disagreement with the denial. If the client does not file one, they have the right to request that their request and DPS’s denial be attached to all future disclosures of the client’s PHI. If DPS approves the request, the requested change will be made to the PHI, the client will be notified, and notice will be given appropriately to others that need to know about the change to PHI.
F. The Right to Get This Notice by E-Mail. The client has the right to get a copy of this notice by e-mail. Even if the client has agreed to receive notice via e-mail, they also have the right to request a paper copy.
V. HOW TO COMPLAIN ABOUT PRIVACY PRACTICES
If the client believes that DPS may have violated their privacy rights, or disagrees with a decision made about access to PHI, the client may file a complaint with the person listed in Section VI below. DPS will take no retaliatory action against the client if a complaint is filed about the privacy practices.
VI. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT DENALI PSYCHOLOGICAL SERVICE’S PRIVACY PRACTICES
If the client has questions about this notice or complaints about DPS’s privacy practices or would like to know how to file a complaint, they can contact the department of consumer affairs’ Board of Psychology. The Board receives and responds to questions and complaints regarding the practice of psychology. If you have questions or complaints you may contact the Board at www.psychology.ca.gov, by emailing bopmail@dca.ca.gov, by calling 1-866-503-3221 or by writing to the following address: Board of Psychology, 1625 North Market Blvd, Suite N-215, Sacramento, CA, 95834.
VII. EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on June 1, 2023.