Pathway Provider Services, P.C.
Health Insurance Portability and Accountability Act (HIPAA) Notice
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.
Uses of Information and How Disclosed
Information given to Pathway Provider Services, P.C. and its staff may be used for treatment, including for: 1) identifying treatment goals agreed upon by both client and staff; 2) setting a plan of treatment for pursuing those goals; and 3) monitoring effectiveness of the treatment plan. An example of each of these would be: the client tells or writes information to staff, and staff and client discuss this.
Information given to Pathway and its staff may be used as Pathway and/or its agents seek payment for services, including: 1) mailing invoices to a client at the address given by the client; 2) submitting client information to insurance providers, if the client requests this, such as social security number, date of birth, address, mental health diagnosis, insurance policy number, and dates of service—on occasion, insurance companies require additional information, including session notes and assessments; 3) writing, phoning, or e-mailing the client’s pastor/church or other payor, if the client requests this, and identifying the client, to seek payment for services; and 4) giving client information such as social security number, date of birth, address, and dates of service to a collections agency if the client makes no payment arrangements after at least four months of unpaid billings.
Information given to Pathway and its staff may be used by Pathway and/or its agents for health care operations, in that staff will track appointment times and will write in a client chart summaries of things talked about with clients or others who are involved in a client’s treatment at Pathway. Staff may phone for the client if appointment times need to be rescheduled, and may send correspondence to clients and former clients by U.S. Mail.
Information will be disclosed generally by United States Mail or by talking on the phone, when disclosure is appropriate. However, with a few exceptions (see below), information about a client will not be disclosed to anyone outside of Pathway without the client’s authorization. The client may revoke such authorization at any time; revoking requires two actions by the client: 1) informing staff; and 2) ensuring that this request has been received by staff, by for instance asking staff to state understanding that authorization is revoked.
Without the client’s authorization, information about him or her will not be disclosed to anyone, with the following exceptions: 1) if staff determines that the client or someone else is at risk of eminent physical harm; 2) if staff determines that a child, (meaning anyone under 18 years old) might have been or possibly is being physically harmed, neglected or endangered; 3) if staff determines that a senior (meaning anyone 60 years old or older) might have been or possibly is being physically harmed, neglected or endangered; 4) if there is a medical emergency; 5) if ordered by a court of law; and 6) any other exceptions required by law. In such situations, staff will provide information deemed useful to ensure safety or to abide by applicable law and may take steps to ensure safety, including for example calling police or arranging a hospital visit.
A Pathway client has the right to: 1) request restrictions on certain uses and disclosures of protected health information, although Pathway is not required to agree to the request; 2) receive confidential communications of the client’s protected health information; 3) inspect and copy protected health information; 4) request to amend protected health information; 5) receive an accounting of disclosures of protected health information; and 6) receive a copy of this notice upon request.
Responsibilities of Pathway Provider Services, P.C.
Pathway is required by law to: 1) maintain the privacy of protected health information and to provide clients with notice of this responsibility, as above; and 2) follow the terms of this notice if transmitting client information electronically; and 3) offer clients a revised copy of this notice if Pathway revises this notice in the future.
If you believe your privacy rights have not been upheld, you may inform Pathway Provider Services and its staff at 708-445-9330. The best approach for addressing such complaints would be to discuss it with your Pathway counselor, as this may elicit the information of what really happened. If after doing this you are not satisfied, you could reach the HIPAA Hotline at 866-627-7748 or www.cms.hhs.gov/hipaa. You would not be retaliated against for filing a complaint.
This notice is effective April 14, 2003, revised October 6, 2014.