I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
Suzanne LeSure, Ph.D. and Associates may use your PHI (protected health information) for treatment, payment and health care operations purposes with your consent. We may use your PHI within the practice for organizing and analyzing data for operations. While the law also allows disclosure to coordinate care with another health care provider, our policy is to always ask for your specific authorization before coordinating care with a health care professional outside of our office. Please be aware that our office uses fax, electronic communication and cell phones, which may be considered less secure than some other forms of written communication.
II. Uses and Disclosures Requiring Authorization
You will always be asked to sign a specific authorization before PHI is disclosed for purposes outside of treatment, payment and health care operations. You may revoke all such authorizations at any time with a written request. The authorization cannot be revoked to the extent that it has already been relied on.
III. Uses and Disclosures without Consent or Authorization
The law requires that mental health professionals report child abuse or elder abuse. Mental health professionals may also disclose PHI if you pose a clear and substantial risk of imminent serious harm to yourself or others. If you have the intent and ability to carry out imminent harm to a specific victim, mental health professionals must take steps to hospitalize or arrange appropriate treatment for you and notify law enforcement and/or your intended victim(s). Your information is protected from court proceedings unless you have been court ordered to be evaluated or treated or you have filed a claim for Worker’s Compensation. We will always ask you for written authorization, even in cases where you are court ordered.
IV. Patient’s Rights
• You have the right to request restrictions on certain uses and disclosures of PHI.
• You have the right to request and receive confidential information by alternative means. (For example, you may request that correspondence be sent to another address).
• You have the right to inspect and copy your PHI and your therapist’s psychotherapy notes. We require that you meet with a mental health professional to do this. The professional will discuss the details of the process.
• You have the right to request an amendment of your PHI.
• You have the right to request an accounting of all disclosures of your PHI.
Dr. LeSure has the duty to maintain the privacy of your PHI and to provide you with this written notice. If these policies are changed, you will receive a written notification that the policy has been changed.
V. Questions and Complaints
Questions, disagreements or other concerns about records, PHI or clinical concerns should be communicated to Dr. LeSure in writing to Suzanne LeSure, Ph.D. at 4475 Valley Forge Drive in Cleveland, Ohio. You may also send a written complaint to the Secretary of the US Department of Health and Human Services. You will never be retaliated against for exercising your right to complain.