Notice of Privacy Practices
This notice describes how your health information may be used and disclosed, and how you can access this information. Please review it carefully.
My Pledge Regarding Health Information
I understand that your health information is personal, and I am committed to protecting your privacy. I maintain records of care to ensure quality service and to comply with legal requirements. This notice applies to all health information created or maintained by my practice.
As required by law, I will:
Ensure that protected health information (PHI) identifying you is kept private.
Provide you with this notice outlining my legal duties and privacy practices.
Follow the terms of this notice currently in effect.
Inform you of any updates to this notice, which will apply to all PHI I maintain. Updated versions will be available upon request, in my office, and on my website.
How I May Use and Disclose Your Health Information
Your confidentiality is essential to good care. There are legal exceptions when disclosure is required. Permitted uses and disclosures include:
Treatment, Payment, and Operations: I may use or disclose your PHI without written authorization to provide treatment, obtain payment, or manage operations. I may consult with other professionals for support without revealing your identity. These professionals are also bound by confidentiality.
Insurance: If you seek reimbursement from an insurer, I may need your authorization to release clinical details (e.g., diagnosis, treatment plan). I’ll notify you of any requests, which you may choose to decline.
Legal Requests: I may disclose health information in response to court orders, subpoenas, or other legal processes, following all applicable safeguards.
Uses and Disclosures Requiring Your Authorization
Psychotherapy Notes: These will not be shared without your written permission, unless required for treatment, supervision, legal defense, compliance review, or to prevent serious harm.
Marketing & Sale of PHI: I will never use your PHI for marketing or sell it.
Uses and Disclosures Not Requiring Your Authorization
With certain limitations, I may use or disclose PHI without your permission for:
Public health and safety (e.g., abuse reporting, health threats)
Oversight activities (e.g., audits, investigations)
Legal proceedings (e.g., court orders)
Law enforcement purposes
Coroners or medical examiners
Approved research
Workers’ compensation claims
Appointment reminders or service-related communication
Note: If you pay by credit card, “HANMER LCSW” will appear on your billing statement.
Disclosures with the Right to Object
I may share your information with family, close friends, or others involved in your care or payment, unless you object. In emergencies, this consent may be obtained after the fact.
Your Rights Regarding Your Health Information
You have the right to:
Request Limits: Ask me not to use or disclose certain information. I may decline if it affects your care.
Request Restrictions for Self-Paid Services: If you pay in full out-of-pocket, you may request that related information not be shared with your health plan.
Confidential Communication: Request to be contacted in specific ways or at certain locations.
Access Your Record: Request a copy or summary of your record (excluding psychotherapy notes), within 30 days. A reasonable fee may apply.
Receive a Disclosure List: Get a record of certain disclosures (not related to treatment) made in the last six years.
Request Corrections: Ask to amend your PHI. If I deny your request, I’ll provide a written explanation.
Request This Notice: Ask for a copy of this notice at any time.
Legal Protections Under HIPAA
Under HIPAA, I am required to safeguard your PHI and provide you with this notice. If you’ve paid out-of-pocket for services in full, I will honor your request to restrict disclosure of that information to your health plan, unless otherwise required by law.
This notice is effective as of July 1, 2025, and I intend to comply with its terms. I reserve the right to update it and apply those changes to all PHI I maintain.
Questions or Complaints
If you believe your privacy rights have been violated, you may contact me directly or file a complaint with the U.S. Department of Health and Human Services. You will not face retaliation for filing a complaint.
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