Notice of Privacy Policy (HIPAA)

INCLUSIVE JOURNEYS PSYCHOTHERAPY LCSW PLLC

1178 BROADWAY, FL 3, STE 4201,
NEW YORK, NY 10001-5404

(212) 994 – 4905

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on February 1, 2025.

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. OUR PLEDGE REGARDING HEALTH INFORMATION:

At Inclusive Journeys Psychotherapy LCSW PLLC (“the Practice”), we understand that your health information is personal. We are committed to protecting your privacy and safeguarding your protected health information (PHI). This notice applies to all of the records of your care generated by the Practice, whether provided directly by Yulissa S. Vera, LCSW, or by any clinician under the Practice.

This notice explains how we may use and disclose your health information, your rights concerning that information, and our obligations to protect it. We are required by law to:

- Ensure that your PHI is kept private.

- Provide you with this Notice of our legal duties and privacy practices concerning your health information.

- Follow the terms of this Notice that is currently in effect.

- Update this Notice as needed, with changes applying to all information we maintain. The updated Notice will be available upon request on our website (inclusivejourneysny.com).

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

We may use and disclose your health information in the following ways:

For Treatment Payment or Health Care Operations:

Federal regulations allow health care providers who have direct treatment relationship with the client to use or disclose PHI without written authorization, for treatment, payment and health care operations. This includes coordination between providers, consultation with other health professionals, and referrals to other clinicians.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because clinicians and other health care providers need access to the full record and/or full and complete information in order to provide quality care. For example, if your clinician consults with another provider regarding your care, they may share necessary information to ensure the best possible treatment We may use your information to bill and receive payment from insurance companies or other entities. This also includes administrative tasks, quality assurance, and staff training to improve services.

Lawsuits and Disputes:

If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order, but only after efforts have been made to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

We will not use or disclose your PHI without your written consent for the following:

1. Psychotherapy Notes: We do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your explicit authorization unless the use or disclosure is:
  - - Used by your clinician for treatment purposes.
  - - For use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
  - - For use in defending the Practice in legal proceedings instituted by you.
  - - For use by the Secretary of Health and Human Services to investigate the Practice’s compliance with HIPAA.
  - - Required by law and the use or disclosure is limited to the requirements of such law.
  - - Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
  - - Required by a coroner who is performing duties authorized by law.
    - Required to help avert a serious threat to the health and safety of others.
2. Marketing Purposes: We do not use PHI for marketing purposes.
3. Sale of PHI: We do not sell your PHI under any circumstances.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:

Subject to certain limitations in the law, we may disclose your PHI without your authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
3. For health oversight activities, including audits and investigations.
4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.
5. For law enforcement purposes, including reporting crimes occurring on my premises.
6. To coroners or medical examiners, when such individuals are performing duties authorized by law.
7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
9. For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, we may provide your PHI in order to comply with workers’ compensation laws.
10. Appointment reminders and health-related benefits or services. We may use and disclose your PHI to contact you to remind you that you have an appointment. We may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that we offer.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:

Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to request restrictions on how we use or disclose your PHI. While we will consider your request, we are not legally required to agree to your request if we believe it would affect your health care.
2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
3. The Right to Choose How We Send PHI to You. You have the right to ask the Practice to contact you in a specific way (for example, email, text, phone call) or to send mail, if needed, to a different address, and we will agree to all reasonable requests.
4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost-based fee if printed copies are requested.
5. The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided the Practice with an authorization. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge you a reasonable cost-based fee for each additional request.
6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that the Practice corrects the existing information or add the missing information. We may deny the request, but you’ll receive an explanation in writing within 60 days.
7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.