Practice-Related Notice of Privacy Policy

Last updated May 2023

Notice of Clinicians' Policies and Practices to Protect the Privacy of Your 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.

 

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

Lisa Robinson, PhD may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. To help clarify these terms, here are some definitions:

  • "PHI" refers to information in your health record that could identify you.

  • "Treatment Payment and Health Care Operations"

    •         Treatment is when your clinician provides, coordinates or manages your mental health care and other services related to your mental health care. An example of treatment would be when your clinician consults with another health care provider, such as your family physician or another Clinician.

    •         Payment is when Lisa Robinson, PhD obtains reimbursement for your healthcare. Examples of payment are when information is disclosed to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.

    •         Health Care Operations are activities that relate to the performance and operation of my practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.

  • "Use" applies only to activities, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.

  • "Disclosure" applies to activities, such as releasing, transferring, or providing access to information about you to other parties.

 

Some examples in which disclosure requires only that you provide written, advance consent include the following:

  • Consultations with other health professionals about a case to assist in providing high-quality treatment. During a consultation, every effort is made to avoid revealing the identity of clients and the other professional is only told the minimum necessary to understand the situation and provide feedback. The other professionals are also legally bound to keep the information confidential. 

  • Extended leave coverage to provide backup for emergencies during Dr. Robinson’s absence. 

  • Other professionals and staff who work at Red Dun Ranch may, at times, need protected information for clinical or administrative purposes, such as scheduling.  All of these people are bound by the same confidentiality requirements under HIPAA.

  • Contracted service providers have access to certain PHI as part of the service procedures.  Dr. Robinson’s contracts currently include those with therapyappointment.com (online practice management system) and Office Ally (electronic insurance claim submission).  As required by HIPAA, a formal business associate contract with these businesses exists in which they promise to maintain the confidentiality of this data except as specifically allowed in the contract or otherwise required by law. You may obtain a blank copy of this contract.

  • Disclosures required by health insurers or to collect overdue fees as discussed in the Agreement.

II.         Uses and Disclosures Requiring Authorization  

Lisa Robinson, PhD may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An "authorization" is written permission above and beyond the general consent that permits only specific disclosures. In those instances when your clinician is asked for information for purposes outside of treatment, payment and health care operations, an authorization will be obtained from you before releasing this information, including releasing of your psychotherapy notes. "Psychotherapy notes" are notes your clinician has made about your conversation during a private, group, joint or family counseling session which are kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI.  Lisa Robinson, PhD will also obtain an authorization from you before using or disclosing (1) PHI in a way that is not described in this Notice; (2) PHI for marketing purposes (e.g., communications to you about new services at Red Dun Ranch).

You may revoke all such authorities (of PHI or psychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) your clinician has relied on that authorization: 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

Lisa Robinson, PhD may use or disclose PHI without your consent or authorization (and in some situations may be legally obligated to disclose PHI in an attempt to protect others from harm) in the following circumstances:

  • Child Abuse: If there is cause to believe that a minor has been or may be, abused or neglected (including physical injury, substantial threat of harm, mental or emotional injury, or any kind of sexual contact or conduct), or that a child is a victim of a sexual offense (i.e., homosexual conduct, public lewdness, indecent exposure, indecency with a child, and improper photography or visual recording) a report must be made within 48 hours to the Texas Department of Protective and Regulatory Services, the Texas Youth Commission, or to any local or state law enforcement agency.  Once such report is filed, additional information may be required.

  • Adult and Domestic Abuse: If there is any cause to believe that an elderly or disabled/vulnerable person is in a state of abuse, neglect, or exploitation, your clinician must immediately report such to the Department of Protective and Regulatory Services or if the alleged abuse, neglect or exploitation occurred in a facility operated, licensed, certified or registered by a state agency (other than the Texas Department of Mental Health and Mental Retardation), to said state agency.  Once such report is filed, additional information may be required.  A psychologist who makes a disclosure regarding adult or domestic abuse must promptly inform the patient that such a report has been or will be made except if: (1) the psychologist in the exercise of his or her professional judgment believes informing the patient would place the patient at risk of serious harm; or (2) the psychologist would be informing a personal representative and the psychologist reasonably believes the personal representative is responsible for the abuse, neglect or other injury and that informing the personal representative would not be in the patient's best interest as determined by the psychologist in the exercise of professional judgment.

  • Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under the state law, and will not be released without written authorization from you or your personal or legally appointed representative, 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.  If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.

  • Serious Threat to Health or Safety: If a psychologist determines that there is a probability that a patient will inflict imminent physical injury on another, or that the patient will inflict imminent physical, mental or emotional harm upon him/herself or others, the provider may be required to take protective action by disclosing relevant confidential mental health information to medical or law enforcement personnel or by securing hospitalization of the patient.

  • Worker's Compensation: If you file a worker's compensation claim, records relating to your diagnosis and treatment for which compensation is being sought may be disclosed to your employer's insurance carrier upon appropriate request without your authorization to determine the amount of payment or entitlement to payment.

  • Sexual misconduct:  When sexual misconduct by another mental health professional has been disclosed, a provider is required to report such misconduct to the appropriate licensing board.

  • Complaints/Lawsuits:  If a patient files a complaint or lawsuit against a psychologist (e.g., Licensing Board complaints, lawsuits, any other legal action against a professional license), the professional may disclose relevant information regarding that patient in order to defend him/herself. If a complaint is filed against a provider with the Texas State Board, they have the authority to subpoena confidential mental health information relevant to the complaint.  The State Board of Examiners of Psychologists shall, on its own motion or on the written request of a party to a contested case pending before the Board, issue a subpoena to require the attendance of a witness or the production of books, records, papers or other objects that may be proper for the purposes of the proceeding, if good cause is shown and on deposit of sums with the Board's Executive Director that will reasonably ensure payment of the estimated expenses of the witness or deponent.

  • When the use and disclosure without your consent or authorization is allowed under other sections of Section 164.512 of the Privacy Rule and the state’s confidentiality law: This includes certain narrowly-defined disclosures to law enforcement agencies, to a health oversight agency (such as HHS or a state department of health), to a coroner or medical examiner, for public health purposes relating to disease or FDA-regulated products, or for specialized government functions such as fitness for military duties, eligibility for VA benefits, and national security and intelligence.

  • Insurance and third party payers:  If you are using insurance or another third party payer, certain information must be shared with them including but not necessarily limited to your diagnosis and the times of your visits.  If there is a managed care company, they may require additional information, such as your symptoms and your progress.  Once released to insurance/third-party payers, the information often stored in national computer databases. 

If any of these situations arise, every effort will be made to fully discuss it with you before any action is taken, and disclosures will be limited to what is necessary.  While this written summary of exceptions to confidentiality are the most common and should prove helpful in informing you about potential problems, there may be additional disclosures of PHI that are required or permitted by law without your consent or authorization.  It is important that you and Lisa Robinson, PhD discuss any questions or concerns you may have now or in the future.  The laws governing confidentiality can be quite complex.  In situations where specific advice is required, formal legal advice may be needed.

 

IV.        Patient's Rights and Clinician's Duties

Patient's Rights:

  • Right to Request Restrictions - You have the right to request restrictions on certain uses and disclosures of PHI about you.  However, Lisa Robinson, PhD 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 communication of PHI by alternative means and at alternative locations.  For example, you may not want a family member to know that you are being seen by me.  Upon your request, all correspondence can be sent to another alternative address.

  • Right to Inspect and Copy - You have the right to inspect or obtain a copy (or both) of PHI and psychotherapy notes in my mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. Lisa Robinson, PhD may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. Upon your request, your clinician will discuss with you the details of the request.

  • Right to Amend - You have the right to request an amendment of PHI for as long as the PHI is maintained in the record.  Your request may be denied.  Upon your request, your clinician 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).  Upon your request, your clinician 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 upon request, even if you have agreed to receive the notice electronically.

  • Right to Restrict Disclosures When You Have Paid for Your Care Out-of-Pocket - You have the right to restrict certain disclosures of PHI to a health plan when you pay out-of-pocket in full for my services.

  • Right to Be Notified if There is a Breach of Your Unsecured PHI - You have a right to be notified if: (a) there is a breach (a use or disclosure of your PHI in violation of the HIPAA Privacy Rule) involving your PHI; (b) that PHI has not been encrypted to government standards; and (c) my risk assessment fails to determine that there is a low probability that your PHI has been compromised.

 

Clinician’s Duties:

  • Your clinician is required by law to maintain the privacy and security of PHI and to provide you with a notice of their legal duties and privacy practices with respect to PHI.

  • Your clinician reserves the right to change the privacy policies and practices described in this notice. However, your clinician is required to abide by the terms currently in effect, unless you are notified of such changes.

  • If the policies and procedures are revised, your clinician will give you a notice of the change and a copy of the new revised policies and procedures either in person (if possible) or by US mail.

 

V.         Questions & Complaints

If you have questions about this notice, disagree with a decision Lisa Robinson, PhD has made about access to your records, or have other concerns about your privacy rights, you may contact Lisa Robinson, PhD at 713-922-5339.  If you believe that your privacy rights have been violated and wish to file a complaint you may send a written complaint to Robinson Psychological Services, PLLC at PO Box 1458, Skyland, NC 28776.

You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services.  Your clinician can provide you with the appropriate address upon request.

 

Lisa Robinson, Ph.D. (TX #32216) offers psychological services and is licensed by the Texas State Board of Examiners of Psychologists, who may be contacted regarding questions and complaints about the practice of psychology at: Texas State Board of Examiners of Psychologists, 333 Guadalupe, Tower 2, Room 450, Austin, Texas 78701. (512) 305-7700 or (800) 821-3205

Lisa Robinson, Ph.D. (NC #6155) offers psychological services and is licensed by the North Carolina Psychology Bard, who may be contacted regarding questions and complaints about the practice of psychology at: NORTH CAROLINA PSYCHOLOGY BOARD, 895 State Farm Road, Suite 101, Boone, NC 28607. (828) 262-2258. http://www.ncpsychologyboard.org/complaints/.

You have specific rights under the Privacy Rule and no retaliation will be utilized against you for exercising your right to file a complaint.

 

VI.        Effective Date, Restrictions and Changes to Privacy Policy 

This notice went into effect on September 1, 2013 and was updated again on May 24, 2023.

Lisa Robinson, PhD will limit the uses or disclosures that will be made according to the patient services agreement.

Lisa Robinson, PhD reserves the right to change this notice and to make the new notice provisions effective for all PHI that is maintained.  Lisa Robinson, PhD will provide you with a revised notice either in person (if possible) or by US mail upon request.