Privacy policy

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

PLEASE REVIEW THIS NOTICE CAREFULLY.

Your health record contains personal information about you and your health. This information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to as Protected Health Information (“PHI”). It also describes your rights regarding how you may gain access to and control your PHI.

I am required by law to maintain the privacy of PHI and to provide you with notice of my legal duties and privacy practices with respect to PHI. I am required to abide by the terms of this Notice of Privacy Practices. I reserve the right to change the terms of the Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that I maintain at that time. I will provide you with a copy of the revised Notice of Privacy Practices by sending a copy to you in the mail upon request or by providing one to you at your next appointment.

HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

For Treatment: Your PHI may be used and disclosed by me for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members. I may disclose PHI to any other consultant only with authorization.

For Payment: I may use and disclose PHI so that I can receive payment for the treatment services provided to you. This will only be done with your authorization. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If you use health insurance or managed care to pay for any part of fees for treatment, I may be required to provide that company information about you and your treatment (e.g. diagnosis, my fee(s), date that treatment began, and a treatment plan or summary of treatment). If it becomes necessary to use collection processes due to lack of payment for services, I will only disclose the minimum amount of PHI necessary for purposes of collection.

For Health Care Operations: I may use or disclose, as needed, your PHI in order to support my business activities including, but not limited to, quality assessment activities, reminding you of your appointments, and conducting or arranging for other business activities. For example, I may share your PHI with third parties that perform various business activities (e.g., billing or typing services) provided I have a written contract with the business. Documents pertaining to treatment provided and other necessary documentation are stored primarily in an electronic health records system. For training or teaching purposes PHI will be disclosed only with your authorization.

STORAGE OF CLIENT INFORMATION

Services rendered by Eric Fox, LCSW are routinely stored digitally through a HIPAA compliant platforms. Paper documentation of client information is stored in a location behind lock and key to which Eric Fox, LCSW maintains sole access.

YOUR RIGHTS REGARDING YOUR PHI

• Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures that I make of your PHI. I may charge you a reasonable fee if you request more than one accounting in any 12-month period.

• Right to Request Restrictions: You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. I am not required to agree to your request.

• Right to Request Confidential Communication: You have the right to request that I communicate with you about health matters in a certain way or at a certain location. I will accommodate reasonable requests. I may require information regarding how payment will be handled or specification of an alternative address or other method of contact as a condition for accommodating your request.

• Breach Notification: If there is a breach of unsecured PHI concerning you, I may be required to notify you of this breach, including what happened and what you can do to protect yourself.

• Electronic Transaction Standards

• Right to a Copy of this Notice

COMPLAINTS

If you believe I have violated your privacy rights, you have the right to file a complaint with me in writing at: 220 Monmouth Rd., Oakhurst NJ 07755. You may also send a written complaint to the Secretary of Health and Human Services at 200 Independence Avenue, S.W., Washington, D.C. 20201, or by calling (202) 619-0257. I will not retaliate against you for filing a complaint.

The effective date of this Notice is September 1st, 2017, Updated December 25th, 2020