Replenish Her Privacy Practices Policy

Please correct the errors described below.




I. Preamble:

The Licensed Professional Counselors Licensing law provides extremely strong privileged communication protections for conversations between your therapist and you in the context of your established professional relationship with your therapist. There is a difference between privileged conversations and documentation in your mental health records. Records are kept documenting your care as required by law, professional standards, and other review procedures. HIPAA very clearly defines what kind of information is to be included in your “designated medical record” as well as some material, known as “Psychotherapy Notes” which is not accessible to insurance companies and other third party reviewers and in some cases, not to the patient himself/herself.

HIPAA provides privacy protections about your personal health information, which is called “protected health information” which could personally identify you. PHI consists of three components: treatment, payment and health care operations.

TREATMENT refers to activities in which I provide, coordinate or manage your mental health care or other services related to your mental health care. Examples include a therapy session, talking to your physician about medications or other medical conditions, or talking with your child’s teacher about observable behaviors in the classroom.

PAYMENT refers to the reimbursement I receive for providing your mental health care. If you have insurance coverage, filing with your insurance for payment of therapy sessions is an example of this type of sharing of PHI information.

HEALTH CARE OPERATIONS are activities related to the business and quality performance of my therapy practice. Insurance companies can request documentation reviews to assure my work with you is “medically necessary.”

USE applies only to activities within my office such as sharing, employing, applying, utilizing, examining and analyzing information that identifies you.

DISCLOSURE applies to activities outside of my office such as releasing, transferring, or providing access to information about you to other parties.

II. Uses and Disclosures of Protected Health Information Requiring Authorization

Tennessee requires authorization and consent for treatment, payment and healthcare operations. When beginning therapy with me, you will sign this general consent to care and authorization to conduct payment and health care operations, authorizing me to provide treatment and to conduct administrative steps associated with your care. I may use or disclose PHI for purposes outside of treatment, payment and health care operations only when you sign an additional authorization for release of information. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures that you identify in writing. I will also need to obtain an authorization before releasing your psychotherapy notes. “Psychotherapy notes” are notes I have made about our conversations during a private, group, joint, or family counseling session, which I have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI.

You may, in writing, revoke all such authorizations to disclose protected health information at any time provided each revocation is in writing. You cannot revoke an authorization for an activity already done that you instructed me to do or if the authorization was obtained as a condition for obtaining insurance and Tennessee law provides the insurer the right to contest the claim under the policy.

III. Uses and Disclosures with Neither Consent or Authorization

I may use or disclose PHI without your consent or authorization in the following circumstances:

Child Abuse: If I have reasonable cause to believe or suspect abuse of a child or children, I am required by law to report this abuse to authorities.

Elder or Domestic Abuse: If I have reasonable cause to believe that an older adult is in need of protective services (regarding abuse, neglect, exploitation or abandonment), I must report this to the local protective services agency.

Health Oversight Activities: If the licensing board of professional counselors in TN were to audit activities in my practice, I would be required to release information for quality review purposes.

Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is for me to directly appear to report on the therapy I have provided, or the records I maintain documenting these therapy meetings are requested, such information is privileged under state law and I will not release the information without your written consent or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.

Serious Threat to Health or Safety: There are two types of threats to safety: threats toward you or threats toward others. If you express a serious threat to yourself, or intent to kill or seriously injure an identified person, and I determine that you are likely to carry out the threat, I must take reasonable measures to prevent harm. Reasonable measures may include directly advising the potential victim of the threat or intent.

Worker’s Compensation: If you file a worker’s compensation claim, I will be required to file periodic reports with your employer which shall include, where pertinent, history diagnosis, treatment and prognosis.

IV. Clients Rights and Therapist’s Duties:

Client’s Rights: 

Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, I am not required to agree to a restriction you request.

Right to Receive Confidential Communications by Alternative Means and at Alternative Locations: You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you should provide permission for me to leave a voice message at your home or provide an alternative way to reach you if you are worried about sharing your PHI with those at your home residence. Additionally, if you do not want your bills sent to your home address, you can provide an alternative billing address.

Right to Inspect and Copy: You have the right to inspect and/or copy your protected health information in my mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. I may deny your access to PHI under certain circumstances, but in some cases, you may have this decision reviewed. On your request, I will discuss with you the details of the request and the denial process.

Right to Amend: You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. I may deny your request. At your request, I will discuss with you the details of the amendment process.

Right to an Accounting: You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization (as described in Section III of this notice). At your request, I will discuss with you the details of the accounting process.

Right to a Paper Copy: You have the right to obtain a paper copy of the notice from me upon request, even if you have agreed to receive the notice electronically.

Right to Revoke Authorization: You have the right to revoke your authorization of protected health information except to the extent that action has already been taken based on that authorization.

Therapist’s Duties:

  1. I am required by law to maintain the privacy of PHI and to provide you with a notice of my legal duties and privacy practices with respect to PHI.

  2. I reserve the right to change the privacy policies and practices described in this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect.

  3. If I revise my policies and procedures, I will present you with a revised copy when you present for a session.

V. Questions and Complaints:

Christine Finnegan is the appointed “privacy officer” for Replenish Her per HIPAA regulations. If you have any concerns of any sort that your counselor may have somehow compromised your privacy rights, please do not hesitate to speak with her immediately about this matter. You will always find her willing to talk with you about preserving the privacy of your protected mental health information. You may also send a written complaint to the Secretary of the U. S. Department of Health and Human Services.

VII: Effective Date, Restrictions and Changes to Privacy Policy

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