Notice of Privacy policy and Practices
NOTICE OF PRIVACY PRACTICES
This notice of privacy practices explains how your health information is protected, used, and disclosed in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and relevant Colorado state laws. It also outlines your rights regarding your health information and how you may access or control it. Our commitment, Inner Alchemy Therapeutics LLC ( Inner Alchemy Therapeutics LLC,(the “Company”, “we”, “us”, or “our”), is to ensure your information is keep secure and confidential while delivering quality care. Please review this notice carefully and provide electronic acknowledgment and signature.
OUR PLEDGE REGARDING HEALTH INFORMATION:
WE understand that health information about you and your health care is personal and Inner Alchemy Therapeutics LLC is committed to protecting your privacy.
We are required by law to:
Protect your privacy: Ensure that protected health information (PHI) identifying you remains private in accordance with HIPAA and Colorado privacy laws.
Provide Notice of My duties: Give you this notice outlining my legal duties and privacy practices regarding your PHI
Adhere to This Notice: Follow the terms of the notice while it is in effect.
We reserve the right to revise this notice. Changes will apply to all health information and the updated notice will be available upon request and posted to my website.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
This section describes the different ways we may use and disclose your health information. Each category provides examples to help clarify permitted uses and disclosures, though not every specific use or disclosure will be listed. All allowable uses and disclosures will fall within these general categories.
For treatment, payment, or Health Care Operations: Federal privacy regulations under HIPAA permit healthcare providers with a direct treatment relationship to use or disclose a client’s protected health information (PHI) without written authorization, for purposes related to treatment, payment, and health care operations.
Treatment: Inner Alchemy Therapeutics LLC may use or disclose your PHI to coordinate and manage care, including consultation with other healthcare providers or referrals. For example, If consulting with other healthcare providers or referrals about your condition to aid in diagnosis or treatment, your PHI may be disclosed to facilitate that conversation. Note that discloses for treatment are not restricted by the “minimum necessary” standard, as therapists require comprehensive information to deliver quality care. Treatment may involve coordinating with third parties, consultation between providers, and referrals.
Lawsuits and Legal Disputes: If you are involved in a legal proceeding, you may disclose PHI as required by law or in response to a court or administrative order. I may also release PHI in response to a subpoena, discovery request, or another lawful process, provided that efforts have been made to inform you of the request or to obtain a protective order to safeguard your information.
CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
Some uses and disclosures of your health information cannot be made without your explicit authorization. These include:
Psychotherapy Notes. I maintain “psychotherapy notes” as that term is defined in 45 CFR § 164.501. Any use or disclosure of such notes requires your written authorization except in the following situations:
a. For our use in treating you.
b. For our use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
c. For our use in defending myself in legal proceedings instituted by you. d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
e. Required by law and the use or disclosure is limited to the requirements of such law.
f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
g. Required by a coroner who is performing duties authorized by law.
h. Required to help avert a serious threat to the health and safety of others.
Marketing Purposes: Inner Alchemy Therapeutics LLC will not disclose your protected health information (PHI) for marketing purposes.
Sale of PHI: Inner Alchemy Therapeutics LLC will not sell your PHI as part of any business operations
CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:
Under certain circumstances, we may use or disclose your protected health information (PHI) without your written authorization, as permitted or required by law. These include:
Legal Requirements: When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
For public health activities: We may disclose your PHI for public health purposes, such as reporting suspected child, elder, or dependent adult abuse, or taking action to prevent or reduce a serious threat to the health or safety of yourself or anyone else.
For health oversight activities authorized by law including audits, inspections, and investigations.
For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so whenever possible.
For law enforcement purposes, including reporting crimes occurring on my premises or disclosed.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes: We may use or disclose your PHI for research purposes, such as studies comparing therapeutic outcomes for similar conditions, provided all legal conditions for privacy are met
Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; and/or, helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes. Although our preference is to obtain an Authorization from you when possible, we may provide your PHI in order to comply with workers’ compensation laws.
Appointment reminders and health-related benefits or services. We may use and disclose your PHI to contact you to remind you that you have an appointment with me via phone, email, or text message. We may also use and disclose your PHI to tell you about treatment alternatives, or other services or benefits that we offer. We may also use and disclose your PHI to provide referrals for alternative services.
CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:
In certain situations, we may disclose your protected health information (PHI) to individuals involved in your care such as family members, friends, or others you indicate are involved in your care or the payment of your healthcare. You have the right to reject disclosures, either in part or in full. If an emergency arises and we are unable to obtain your consent in advance, we may provide the necessary information and seek your consent retroactively.
YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
The Right to Request Limits on Uses and Disclosures of Your PHI: You have the right to request that I limit the use or disclosure of your protected Health Information (PHI) for treatment, payment, or healthcare operations. While we will consider your request, we are not obligated to agree and may deny your request if we believe it could affect your care.
The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full: You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
The Right to Choose How We Send PHI to You: You have the right to ask us to contact you in a specific way (for example, home or office phone, email, text message, etc.) or to send mail to a different address, and we will agree to all reasonable requests.
The Right to See and Get Copies of Your PHI: Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost-based fee for doing so.
The Right to Get a List of the Disclosures I Have Made: You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge you a reasonable cost-based fee for each additional request.
The Right to Correct or Update Your PHI: If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that we correct the existing information or add the missing information. We may say “no” to your request, but will tell you why in writing within 60 days of receiving your request.
The Right to Get a Paper or Electronic Copy of this Notice: You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
Acknowledgment of Receipt of Privacy Notice
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information (PHI).