NOTICE OF POLICIES AND PRACTICES UTILIZED BY THE
CLINICAL PSYCHOLOGY CENTER
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.

The Clinical Psychology Center (CPC) may use or disclose your protected health information (PHI), for treatment, payment, and health care operations with your consent.  To help you clarify these terms, here are some definitions:



• PHI refers to infromation in your clinical record that could identify you.

• Treatment occurs when the CPC provides, coordinates, or manages your health care or other services related to your health care.  An example of treatment would be when your therapist at the CPC consults with another health care provider, such as your family physician or another psychologist.

• Payment is when the CPC obtains reimbursement for your health care.  Examples of payment are when the CPC discloses your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.  However, note that at this time the CPC does not accept insurance.

• Health care operations are activities that relate to the performance and operation of the CPC.  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 within the CPC, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.

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

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