This notice is required by law to be given to you.
This notice describes how health information may be used and disclosed and how you can get access to this information. Please review it carefully.
Protected Health Information (PHI) is medical information that identifies you or may provide a basis for identifying you, including demographic information. Your PHI relates to your past, present, or future physical or mental health condition and related health care services. Frederick Psychiatry LLC is required by law to keep records of the care which is provided to you.
A Medical Record is defined as a record of clinical services provided and details of information discussed during a session. This may be in electronic or paper form. Billing records are separate from the medical record.
Release of certain medical information is permitted for purposes such as case consultation, lab investigation, coordination of care, and sometimes billing or insurance purposes. It is not considered PHI if none of that information can identify you.
This notice applies to all of the records of your care generated by this practice. This notice will tell you about the ways in which we may use and disclose health information about you. It also describes your rights to the health information we keep about you and describes certain obligations we have regarding the use and disclosure of your health information.
We can change the terms of this Notice, and such changes will apply to all information we have about you. The new Notice will be available upon request, in our office, and on our website.
The following categories describe different ways that we use and disclose health information. For each category, we will explain what we mean and give examples. Not every use or disclosure will be listed, but all uses and disclosures will fall within one of these categories.
Disclosures for treatment purposes are not limited to the minimum necessary standard, as other health care providers may need access to the full record to provide quality care. "Treatment" includes, among other things, coordination of care, consultations between providers, and referrals.
Subject to certain legal limitations, we may use and disclose your PHI without your authorization for the following purposes:
By providing your mobile phone number, you consent to receive SMS/text messages from Frederick Psychiatry LLC for purposes including, but not limited to:
Message frequency will vary depending on your appointment schedule and other services. Standard message and data rates may apply. You can opt out of SMS messages at any time by replying STOP, and you may text HELP for assistance.
Your phone number and any data related to SMS communications are stored securely and are used only for clinical or administrative communication in accordance with applicable HIPAA laws.
You have the right to:
This notice goes into effect on the date you sign this document and remains in effect until revised.
Acknowledgement 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. By signing or checking the box on your intake form, you acknowledge:
