Austin Psychologist: Claudia Byrne, Ph.D.

Confidentiality

Your privacy is protected by the Health Insurance Portability and Accountability Act

NOTICE OF PRIVACY PRACTICES FOR PERSONAL HEALTH INFORMATION
THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Summary

This Notice describes how your personal health information (PHI) is protected, and how Dr. Byrne may use and disclose this information. PHI includes personally identifiable information that relates to your past, present, or future health, treatment, or payment for health care services. Dr. Byrne’s employees and professional staff are required to comply with this privacy policy, and have access to this information only when there is an appropriate reason to do so, such as to confer with other health care providers or to submit claims for these services.

Under the Health Insurance Portability and Accountability Act (HIPAA), you are afforded privacy rights regarding the use and disclosure of your health information. These include:

a right to be informed of the potential uses and disclosures of your protected health information, and to limit those uses and disclosures of this protected health information;
a right to receive this written notice that explains how we may use and disclose your protected health information, your rights under HIPAA’s privacy rule, and Dr. Byrne’s responsibilities as a covered entity under HIPAA;
a right to a paper copy of this notice, or to have your legally designated representative receive a copy of this notice; you are asked to acknowledge receipt of this notice;
a right to amend your record, to restrict what information from your record is disclosed to others, and to receive an accounting of disclosures of this information that were made without your authorization, other than for treatment, payment or health care operations;
a right to have your complaints about my policies and procedures recorded in these records.
As a health care provider, Dr. Byrne is making a good faith effort to see that you or your representative have received and acknowledged this notice of privacy practices. If you are seen for emergency treatment, you will receive this notice as soon as practically possible afterward.

I. Disclosures for Treatment, Payment, and Health Care Operations

Dr. Byrne may use or disclose your protected health information (PHI), for certain treatment, payment, and health care operations purposes without your authorization. To help clarify these terms, here are some definitions:

PHI refers to information in your health record that could identify you.
Treatment is when Dr. Byrne or another healthcare provider diagnoses or treats you. An example of treatment would be when Dr. Byrne consults with another health care provider, such as your family physician or another psychologist, regarding your treatment.
Payment is when Dr. Byrne obtains reimbursement for your healthcare. Examples of payment are when Dr. Byrne discloses your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.
Health Care Operations is when Dr. Byrne discloses your PHI to your health care service plan (for example your health insurer), or to your other health care providers contracting with your plan, for administering the plan, such as case management and care coordination.
Use applies only to activities within Dr. Byrne’s office, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
Disclosure applies to activities outside of Dr. Byrne’s office, such as releasing, transferring, or providing access to information about you to other parties.
Authorization means written permission for specific uses or disclosures. All authorizations to disclose must be on a specific, legally required form.

II. Uses and Disclosures Requiring Authorization

Dr. Byrne may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. In those instances when Dr. Byrne is asked for information for purposes outside of treatment and payment operations, Dr. Byrne will obtain an authorization from you before releasing this information.

You may revoke or modify all such authorizations of PHI at any time, provided each revocation is in writing; however, the revocation or modification is not effective until Dr. Byrne receives it. You may not revoke an authorization to the extent that (1) Dr. Byrne has relied on that information; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.

III. Uses and Disclosures with Neither Consent nor Authorization

Dr. Byrne may use or disclose PHI without your consent or authorization in the following circumstances:

Child Abuse: Whenever Dr. Byrne, in her professional capacity, has knowledge of or observes a child Dr. Byrne knows or reasonably suspects, has been the victim of child abuse or neglect, Dr. Byrne must immediately report such to a police department or sheriff’s department, county probation department, or county or state welfare department.
Adult and Domestic Abuse: If Dr. Byrne, in her professional capacity, has observed or has knowledge of an incident that reasonably appears to be physical abuse, abandonment, abduction, isolation, financial abuse or neglect of an elder or dependent adult, or if Dr. Byrne is told by an elder or dependent adult that he or she has experienced these, or if Dr. Byrne reasonably suspects such, she must report the known or suspected abuse immediately to the local ombudsman or the local law enforcement agency.
Health Oversight: If a complaint is filed against Dr. Byrne with the State Board that licenses her profession, the Board has the authority to subpoena confidential mental health information from Dr. Byrne relevant to that complaint.
Serious Threat to Health or Safety: If you communicate to Dr. Byrne a serious threat of physical violence against an identifiable victim, Dr. Byrne must make reasonable efforts to prevent harm, which may include communicating that information to the potential victim, and the police. If Dr. Byrne has reasonable cause to believe that you are in such a condition, as to be dangerous to yourself or others, Dr. Byrne may release relevant information as necessary to prevent the threatened danger.
Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made about the professional services that Dr. Byrne has provided you, Dr. Byrne must not release your information without:
1. your written authorization or the authorization of your attorney or personal representative; or
2. a court order
The privilege does not apply when you are being evaluated for a third party or where the evaluation is court-ordered. Dr. Byrne will inform you in advance if this is the case.

IV. Patient’s Rights and Provider’s Duties

Patient’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, Dr. Byrne is 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 may not want a family member to know that you are seeing Dr. Byrne and may request that she not telephone your residence).
Right to Inspect and Copy You have the right to inspect or obtain a copy (or both) of PHI in Dr. Byrne’s mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. Dr. Byrne may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. On your request, Dr. Byrne will discuss with you the details of the request and 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. Dr. Byrne may deny your request. On your request, Dr. Byrne 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). On your request, Dr. Byrne 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 Dr. Byrne upon request, even if you have agreed to receive the notice electronically.

Duties of Provider:

Dr. Byrne is required by law to maintain the privacy of PHI and to provide you with a notice of her legal duties and privacy practices with respect to PHI.
Dr. Byrne reserves the right to change the privacy policies and practices described in this notice. Unless Dr. Byrne notifies you of such changes, however, she is required to abide by the terms currently in effect.
If Dr. Byrne revises her policies and procedures, Dr. Byrne will provide you with a written copy of the revised policies and procedures at the earliest possible opportunity following this revision, in person or by mail.

V. Complaints

If you are concerned that Dr. Byrne has violated your privacy rights, or you disagree with a decision Dr. Byrne made about access to your records, you may contact the Compliance Officer for further information.

For complaints, contact Dr. Byrne at (512) 306-8790, or:
Claudia Byrne, Ph.D.
3101 Bee Caves Road, #210, Austin, TX 78746
You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. Dr. Byrne will provide the appropriate address upon request.

VI. Effective Date, Restrictions, and Changes to Privacy Policy

This notice went into effect April 14, 2003. Dr. Byrne reserves the right to change the terms of this notice and to make the new notice provisions effective for all PHI that Dr. Byrne maintains. Dr. Byrne will provide you with a revised notice by mail, at the earliest opportunity following the revision.