Cary Frank Schwimmer, Psy.D. CA PY 27145      

Notice of Privacy Practices

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

Your therapist is legally required to protect the privacy of your Protected Health Information (PHI), information that can be used to identify you regarding your past, present, or future health or condition, provision of health care to you, or payment of this health care. Your therapist must provide you with this "Notice of Privacy

Practices" that explains how, when, and why your therapist will "use" and "disclose" your PHI. A "use" of PHI occurs when your therapist shares, examines, utilizes, applies, or analyzes such information within the practice; PHI is "disclosed" when it is released, transferred, has been given to, a third party outside of the practice.

USes and Disclosures Relating to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent:

For treatment: Your therapist can disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are involved in your care.
To obtain payment for treatment: Your therapist can use and disclose your PHI to bill and collect payment for the treatment and services provided to you. Your therapist may also provide your PHI to billing companies, claims processing companies, and others that process health care claims.
For health care operations: Your therapist can disclose your PHI to evaluate the quality of health care services you received or the performance of the health care professionals who provided services to you. Your therapist may also provide your PHI to accountants or attorneys to ensure compliance with applicable laws. • Other disclosures: Your therapist may disclose your PHI if you need emergency treatment, as long as your therapist tries to get your consent after treatment is rendered.

Certain Uses and Disclosures Do Not Require Your Consent:

When disclosure is required by federal, state or local law; by judicial or administrative proceedings; or by law enforcement: For example, your therapist may make a disclosure to applicable officials when a law requires a report of 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, to report information about you to the county coroner. • For health oversight activities: For example, to provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.
For research purposes: In certain circumstances, to provide PHI in order to conduct medical research.
To avoid harm: In order to avoid a serious threat of harm your therapist may disclose PHI to law enforcement personnel or persons able to prevent or lessen such harm.
For specific government functions: Your therapist may disclose PHI of military personnel and veterans in certain situations and for national security purposes, such as protecting the President of the United States or conducting intelligence operations.
For workers' compensation: To comply with workers' compensation laws.
Appointment reminders and health related benefits or services: Your therapist may use PHI to provide appointment reminders or inform you of treatment alternatives or other health care services /benefits offered.

Certain Uses and Disclosures Require You to Have the Opportunity to Object:

                         

Your therapist may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

Other Uses and Disclosures Require Your Prior Written Authorization:

In any other situation not described above, your therapist will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke it in writing to stop any future uses and disclosures of your PHI by your therapist.

Rights You Have Regarding Your PHI

The Right to Request Limits on Uses and Disclosures of Your PHI

You have the right to ask that your therapist limit uses and disclosures of your PHI. However, your therapist is not required to accept the request: If your therapist does accept it, s/he will abide by it except in emergency situations. You may not limit uses and disclosures your therapist is legally required or allowed to make. The Right to Choose How Your Therapist Sends PHI to You

You have the right to ask that your therapist send information to you to at an alternate address or by alternate means (e.g., e-mail instead of regular mail). Your therapist must agree if the PHI can easily be provided to you in the format you requested.

The Right to See and Receive Copies of Your PHI

In most cases, you have the right to see or receive copies of your PHI. Your request must be in writing. Your therapist will respond within 30 days of receiving the written request. If the request is denied, your therapist will explain why, in writing, and tell you how to have the denial reviewed. If you request copies of your PHI, you will be charged not more than $.25 for each page. Your therapist may provide you with a summary or explanation of the PHI as long as you agree to that and to the cost in advance.

The Right to a List of Disclosures Your Therapist Has Made

You have the right to a list of instances in which your therapist has disclosed your PHI. The list will exclude uses or disclosures to which you have already consented, uses and disclosures made for .national security purposes, to law enforcement personnel, or disclosures made before April 15, 2003. Your therapist will respond to your requestwithin60 day& The list will include disclosures made in the last six years unless you request a shorter time. The list will include the date of the disclosure; to who PHI was disclosed; a description of information disclosed; and the reason for the disclosure. The list will be provided at no charge, but for more than one request per year, you will be charged a reasonable, cost-based fee. The Right to Correct or Update Your PHI

If you believe that there is a mistake in your PHI or that important information is missing, you have the right to request a correction or add the missing information. You must provide the request in writing. Your therapist will respond within 60 days of receiving your request to correct or update. Your therapist may deny your request in writing if the PHI is correct and complete; not created by your therapist; not allowed by law to be disclosed; or not part of the records. The written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file such a statement, you have the right to request that your request and the denial be attached to all future disclosures of your PHI. If your therapist approves your request, the change to your PHI will be made, you will be told that the change has been made, and others that need to know about the change to your PHI will be told. The Right to Get This Notice by E-Mail

You have the right to get a copy of this notice by e-mail. Even if you have agreed to receive notice via e-mail, you also have the right to request a paper copy of it.

How to Complain About Your Therapist's Privacy Practices

If you think your therapist has violated your privacy rights or if you disagree with a decision your therapist has made about access to your PHI, you may file a complaint with the person listed below or send a written complaint to the Secretary of the Department of Health and Human Services. Your therapist will take no retaliatory action against you if you file a complaint about your therapist's privacy practices.

For Information About This Notice Or To Complain About Your Therapist's Privacy Practices

If you have any questions or complaints about this notice or your therapist's privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact:

Psychological Treatment Notice of Privacy Practices