The Washington DC Center for Neurocognitive Excellence LLC 1627 K St NW Suite 500 Washington DC 20006 (202) 998-2343
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.
II. IT IS THE LEGAL DUTY OF THE WASHINGTON DC CENTER FOR NEUROCOGNITIVE EXCELLENCE LLC TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI). By law The Washington DC Center for Neurocognitive Excellence LLC (hereafter DCNE) is required to insure that your Personal Health Information (PHI) is kept private. The PHI constitutes information created or noted by DCNE that can be used to identify you. It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. DCNE is required to provide you with this Notice about DCNE’s privacy procedures. This Notice must explain when, why, and how DCNE would use and/or disclose your PHI. Use of PHI means when DCNE shares, applies, utilizes, examines, or analyzes information within the practice; PHI is disclosed when DCNE releases, transfers, gives, or otherwise reveals it to a third party outside the practice. With some exceptions, DCNE may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, DCNE is legally required to follow the privacy practices described in this Notice. Please note that DCNE reserves the right to change the terms of this Notice and DCNE privacy policies at any time as permitted by law. Any changes will apply to PHI already on file with DCNE. Before DCNE makes any important changes to policies, DCNE will immediately change this Notice and post a new copy of it in the office and on the website. You may also request a copy of this Notice from DCNE, or you can view a copy of it at the office.
III. HOW DCNE WILL USE AND DISCLOSE YOUR PHI. DCNE will use and disclose your PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find the different categories of DCNE’s uses and disclosures, with some examples.
A. Uses and Disclosures Related to Treatment, Payment, or Healthcare Operations Do Not Require Your Prior Written Consent.
1. DCNE may use and disclose your PHI without your consent for the following reasons:
For treatment. DCNE can use your PHI within the practice to provide you with mental health treatment, including discussing or sharing your PHI with DCNE colleagues, trainees, and interns. DCNE may disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are otherwise involved in your care. Example: If a psychiatrist is treating you, DCNE may disclose your PHI to her/him in order to 6. 2022 HIPAA NOTICE OF PRIVACY PRACTICES coordinate your care.
2. For health care operations. DCNE may disclose your PHI to facilitate the efficient and correct operation of the DCNE practice. Examples: Quality control - DCNE might use your PHI in the evaluation of the quality of health care services that you have received or to evaluate the performance of the health care professionals who provided you with these services. DCNE may also provide your PHI to DCNE’s attorneys, accountants, consultants, and others to make sure that DCNE is in compliance with applicable laws.
3. To obtain payment for treatment. DCNE may use and disclose your PHI to bill and collect payment for the treatment and services DCNE provided you. Example: DCNE might send your PHI to your insurance company or health plan in order to get payment for the health care services that DCNE has provided to you. DCNE could also provide your PHI to business associates, such as billing companies, claims processing companies, and others that process health care claims for the DCNE office.
4. Other disclosures. Examples: Your consent isn't required if you need emergency treatment provided that DCNE attempts to get your consent after treatment is rendered. In the event that DCNE tries to get your consent but you are unable to communicate with DCNE (for example, if you are unconscious or in severe pain) but DCNE thinks that you would consent to such treatment if you could, DCNE may disclose your PHI.
B. Certain Other Uses and Disclosures Do Not Require Your Consent. DCNE may use and/or disclose your PHI without your consent or authorization for the following reasons:
1. When disclosure is required by federal, state, or local law; judicial, board, or administrative proceedings; or, law enforcement. Example: DCNE may make a disclosure to the appropriate officials when a law requires DCNE to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.
2. If disclosure is compelled by a party to a proceeding before a court of an administrative agency pursuant to its lawful authority.
3. If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.
4. If disclosure is compelled by the patient or the patient’s representative pursuant to corresponding federal statutes of regulations, such as the Privacy Rule that requires this Notice.
5. To avoid harm. DCNE may provide PHI to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of a person or the public (i.e., adverse reaction to medications, neurofeedback, or mental health services).
6. If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or the person or property of others, and if DCNE determines that disclosure is necessary to prevent the threatened danger.
7. If disclosure is mandated by the Child Abuse and Neglect Reporting law. For example, if DCNE has a reasonable suspicion of child abuse or neglect.
8. If disclosure is mandated by the Elder/Dependent Adult Abuse Reporting law. For example, if DCNE has a reasonable suspicion of elder abuse or dependent adult abuse.
9. If disclosure is compelled or permitted by the fact that you tell DCNE of a serious/imminent threat of physical violence by you against a reasonably identifiable victim or victims.
10. For public health activities. Example: In the event of your death, if a disclosure is permitted or compelled, DCNE may need to give the local coroner information about you.
11. For health oversight activities. Example: DCNE may be required to provide information to assist the government in the course of an investigation or inspection of a healthcare organization or provider.
12. For specific government functions. Examples: DCNE may disclose PHI of military personnel and veterans under certain circumstances. Also, DCNE may disclose PHI in the interests of national security, such as protecting the President of the United States or assisting with intelligence operations.
13. For research purposes. In certain circumstances, DCNE may conduct research. If any PHI or PII is used, your consent will be requested prior to its use.
14. For emailing purposes. Your information will never be sold or given away. Emailing refers to DCNE emails to you that include educational information about services DCNE provides, education about topics salient to your work with DCNE, DCNE announcements, etc. These emails may be managed by an emailing management service (such as MailChimp or ConvertKit).
15. For Workers' Compensation purposes. DCNE may provide PHI in order to comply with Workers' Compensation laws.
16. Appointment reminders and health related benefits or services. Examples: DCNE may use PHI to provide appointment reminders. DCNE may use PHI to give you information about alternative treatment options, or other health care services or benefits DCNE offers.
17. If an arbitrator or arbitration panel compels disclosure, when arbitration is lawfully requested by either party, pursuant to subpoena duces tectum (e.g., a subpoena for mental health records) or any other provision authorizing disclosure in a proceeding before an arbitrator or arbitration panel.
18. If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law. Example: When compelled by U.S. Secretary of Health and Human Services to investigate or assess DCNE compliance with HIPAA regulations.
19. If disclosure is otherwise specifically required by law.
C. Certain Uses and Disclosures Require You to Have the Opportunity to Object.
1. Disclosures to family, friends, or others. DCNE may provide your PHI to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.
D. Other Uses and Disclosures Require Your Prior Written Authorization. Disclosures to family, friends, or others. DCNE may provide your PHI to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.
IV. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI These are your rights with respect to your PHI:
A. The Right to See and Get Copies of Your PHI. In general, you have the right to see your PHI that is in DCNE possession, or to get copies of it; however, you must request it in writing. If DCNE does not have your PHI, but DCNE knows who does, DCNE will advise you how you can get it. You will receive a response from DCNE within 30 days of DCNE receiving your written request. Under certain circumstances, DCNE may feel DCNE must deny your request, but if DCNE does, DCNE will give you, in writing, the reasons for the denial. DCNE will also explain your right to have DCNE’s denial reviewed. If you ask for copies of your PHI, DCNE will charge you not more than $.25 per page. DCNE may see fit to provide you with a summary or explanation of the PHI, but only if you agree to it, as well as to the cost, in advance.
B. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that DCNE limit how DCNE uses and disclose your PHI. While DCNE will consider your request, DCNE is not legally bound to agree. If DCNE does agree to your request, DCNE will put those limits in writing and abide by them except in emergency situations. You do not have the right to limit the uses and disclosures that DCNE am legally required or permitted to make.
C. The Right to Choose How DCNE Sends Your PHI to You. It is your right to ask that your PHI be sent to you at an alternate address (e.g. sending information to your work address rather than your home address) or by an alternate method (for example, via email instead of by regular mail). DCNE is obliged to agree to your request providing that DCNE can give you the PHI, in the format you requested, without undue inconvenience. DCNE may not require an explanation from you as to the basis of your request as a condition of providing communications on a confidential basis. You will also be responsible for the fee associated with sending your PHI should it be sent in a manner that requires a fee (e.g. overnight or 2 day mail, etc.).
D. The Right to Get a List of the Disclosures DCNE has Made. You are entitled to a list of disclosures of your PHI that DCNE has made. The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before January 30, 2015. After January 30, 2015, disclosure records will be held for three years or the amount of time required by law. DCNE will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list DCNE gives you will include disclosures made in the previous year unless you indicate a specific time period not to exceed three years. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. DCNE will provide the list to you at no cost, unless you make more than one request in the same year, in which case DCNE will charge you a reasonable sum based on a set fee for each additional request.
E. The Right to Amend Your PHI If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that DCNE correct the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of DCNE’s receipt of your request. DCNE may deny your request, in writing, if DCNE finds that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of DCNE records, or (d) written by someone other than DCNE. DCNE's denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and DCNE’s denial be attached to any future disclosures of your PHI. If DCNE approves your request, DCNE will make the change(s) to your PHI. Additionally, DCNE will tell you that the changes have been made, and DCNE will advise all others who need to know about the change(s) to your PHI.
F. The Right to Get This Notice by Email. You have the right to get this notice by email. You have the right to request a paper copy of it, as well.
V. HOW TO COMPLAIN ABOUT DCNE’s PRIVACY PRACTICES If, in your opinion, DCNE may have violated your privacy rights, or if you object to a decision DCNE made about access to your PHI, you are entitled to file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W. Washington, D.C. 20201. If you file a complaint about DCNE privacy practices, DCNE will take no retaliatory action against you.
VI. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT DCNE’s PRIVACY PRACTICES If you have any questions about this notice or any complaints about DCNE’s privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact DCNE at: The Washington, DC Center for Neurocognitive Excellence LLC, 1627 K ST NW Suite 500, Washington, DC 20006