Privacy Notice
1. 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.
2. How we may use and disclose your health information. We use health information about you for your treatment, to get paid for treatment, for administrative purposes, and to evaluate the quality of care that you receive. For example, your health information may be shared with other providers, to whom you are referred, your insurance company for billing purposes, and the courts and probation departments to verify treatment compliance and progress. Information may be shared by paper, mail, fax, or other methods. We may use or disclose your health information without your authorization for several reasons which are listed in the Adult Consent for Treatment form. But beyond those situations, we will ask for your written authorization before using or disclosing your health information. If you sign an authorization to release medical information, you can later revoke it to stop any further uses or disclosures.
3. Your Rights. In most cases, you have the right to look at or get a copy of you health information that we use to make decisions about you. We cannot release raw testing data to someone other than a Qualified Mental Health Provider who is able to interpret psychological testing data. If a Court orders and pays for treatment then they own the right to the release of the record. If you request copies, we may charge you a cost-based fee. You also have the right to request a list of certain types of disclosures of your information that we have made. If you believe your health information is incorrect or information is missing, you have the right to request that we correct the existing information or add the missing information.
4. Our legal duty. We are required by law to protect the privacy of your health information, provide this notice about our privacy practices, follow the privacy practices that are described in this notice, and seek your acknowledgement of receipt of this notice. We may change our notice and post the new notice in the waiting area. You can also request a copy of our notice at any time. For more information on our privacy policies, contact the person listed below.
5. Privacy Complaints. If you are concerned that we have violated your privacy
Rights, our privacy policies, or if you disagree with a decision we made about access to your health information, you may contact the person listed below. You may also send a written complaint to the U.S. Department of Health and Human Services. The person listed below can provide you with the appropriate address on request.
6. Additional Information. A more detailed description of the HIPPA information is available in the waiting room or at www.transitionscounselingcenter.com under the following headings: Before you first visit, intake forms, HIPPA.
7. If you have any questions or complaints, please contact:
Donica Jones: Privacy Office Contact
11999 Katy Freeway, Suite #460
Houston, Texas 77079
Phone number 281-597-9291
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