Dear Client,
Compassionate Recovery Care (hereinafter referred to as CRC) takes great care to protect your privacy. Below, you will find a government-mandated notice delineating your rights as a client. Your signature will indicate that you have received this notice. Any questions about this notice can be directed to the President of CRC, Roger Sherman, MD at (615) 674-0909.
Notice of 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
CRC may use or disclose your protected health information (PHI), for treatment, payment, and health care operations including purposes with your written authorization. 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
o Treatment is when a CRC doctor or provider provides, coordinates, or manages your health care and other services related to your health care. An example of treatment would be when your therapist consults with another health care provider, such as your family physician or another mental health provider;
o Payment is when CRC obtains reimbursement for your healthcare. Examples of payment are when CRC or biller discloses your PHI to your health insurer to obtain reimbursement for your health care to determine eligibility or coverage.
o Health Care Operations are activities that relate to the performance and operations of CRC’s 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 within CRC’s office, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
• Disclosure applies to activities outside of CRC’s office, such as releasing, transferring, or providing access to information about you to other parties.
• Authorization is your written permission to disclose confidential mental health information. All authorizations to disclose must be on a specific legally required form.