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 THIS NOTICE CAREFULLY. 

Notice effective 4.14.2003

Your health record contains personal information about you and your health.  The 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).  This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable law and professional codes of ethics.  It also describes your rights regarding how you may gain access to and control your PHI.

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

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

   Uses and Disclosures Requiring Your Consent

For treatment:  Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your treatment and related services.  This includes consultation with EAP treatment team members.

For payment: We may use and disclose PHI so that we can receive payment for the services provided to you.  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.

For Health Care Operations.  We may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, we may share your PHI with third parties that perform various business activities (e.g., subcontracted counselors, accounting services, etc.) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI.    

Uses and Disclosures Requiring Your Authorization

 For uses and disclosures beyond treatment and operations purposes we are required to have your written authorization, unless the use or disclosure falls within one of the exceptions described below. Authorizations can be revoked at any time except to the extent that we have already acted in reliance on your authorization. For example, you may authorize us to share your PHI with another treatment provider to whom we have referred you.

 Uses and Disclosures Not Requiring Consent or Authorization

 When required by law

·         Mandatory reporting of suspected child or elder abuse or neglect.

·         Required by a court order.

·         Necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.  If information is disclosed to prevent or lessen a serious threat, it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

For Health Oversight Activities

We must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule.

Uses and Disclosures Requiring You to Have an Opportunity to Object

We may share PHI with family, friends or other persons directly involved in your care if we inform you about the disclosure in advance and you do not object.  We may only share the information related directly to their involvement in your care.  In an emergency where you cannot be given your opportunity to object, disclosure may be made if it is consistent with any prior expressed wishes and is determined to be in your best interest.  You must be informed and given an opportunity to object to further disclosures as soon as possible.  For example, parents of a minor have certain rights to PHI.  Also we may have to locate family members to inform them of the location of a client who was hospitalized in an emergency

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding PHI we maintain about you.  To exercise any of these rights, please submit your request in writing to our Privacy Officer at EAP Consultants, Inc., 6237-B Presidential Ct., Ft. Myers, FL  33919. Phone: 239.433.1211.

Right to a Copy of this Notice.  You have the right to a copy of this notice.

Right of Access to Inspect and Copy.  You have the right, which may be restricted only in exceptional circumstances, to inspect and copy PHI that may be used to make decisions about your care.  Your right to inspect and copy PHI will be restricted only in those situations where there is compelling evidence that access would cause serious harm to you.  We may charge a reasonable, cost-based fee for copies. 

Right to Amend.  If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information although we are not required to agree to the amendment.  

Right to an Accounting of Disclosures.  You have the right to request an accounting of certain of the disclosures that we make of your PHI.  We 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.  We are not required to agree to your request. 

Right to Request Confidential Communication.

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location in order to preserve your confidentiality. Please note that we cannot guarantee confidentiality of email to our office or staff.

If you believe we have violated your privacy rights, you have the right to file a complaint in writing with our Privacy Officer at 6237-B Presidential Ct., Ft. Myers, FL  33919 or with the Secretary of Health and Human Services at 200 Independence Avenue, S.W.  Washington, D.C. 20201 or by calling (202) 619-0257.  We will not retaliate against you for filing a complaint.