HIPAA Privacy Policy.

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 read it carefully. In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) regarding procedures protecting client’s rights related to health records, including mental health. HIPAA has three parts. The “privacy rule” focuses on when and to whom confidential patient information can be disclosed. The “transaction rule” addresses technical aspects of the electronic process and requires use of standardized formats whenever health care transactions, such as claims, are sent or received electronically. The “security rule” seeks to assure the security of confidential electronic patient information. For mental health professionals, this refers to access to offices, access to files and computers, as well as the processes used to keep electronic information secure. Protected Health Information (PHI) under HIPAA refers to any information that identifies the client. 

1. As related to Sycamore and Sage, this information includes Diagnostic Interviews, Pretreatment Assessments, Family Assessments, Therapy Summaries, Treatment Plans/Updates, Discharge Summaries, Consultation Notes, Emails, Claim Forms, Insurance EOBs, Client Intake Forms, and Correspondence with persons/agencies with written client consent. Records received from other persons/agencies also become part of the patient’s PHI. PHI will only be released by consent of the client or the client’s guardian. In situations where the client is a ward of the state of Nebraska, the caseworker is presumed to be the legal guardian. Information provided to Sycamore and Sage by the caseworker becomes the patient’s PHI and can be forwarded by Sycamore and Sage to agencies needing the material for treatment decisions (e.g., Nebraska Heritage Health).

2. Sycamore and Sage is a trade name registered in the state of Nebraska for advertising by Wolf Chalenburg, LLC. In order to provide the best possible care for clients, it is sometimes helpful to consult another mental health professional. When this is done, Ms. Chalenburg and/or Ms. Wolf will discuss the case without using names and in a manner protecting the identity of the client. A note of the consultation will become PHI and placed in the client’s file. 

3. Sycamore and Sage will only release a client’s PHI with a signed release from the client or client’s guardian (in the case of a minor). Only information specifically identified on the signed release will be sent from this office. A copy of the signed release becomes part of the patient’s file and PHI. The release allows the client to restrict the information disclosed by identifying it on the form. Sycamore and Sage has no control over information once it is released. If the client uses commercial insurance to managed care benefits to pay for services, it is Sycamore and Sage’s policy to release the least amount of information possible that will allow claims to be paid. Information typically includes dates of service, length and type of treatment provided, address, social security number, and diagnosis. If companies request more information, Sycamore and Sage will consult with the client before sending information.

4. Sycamore and Sage may need to disclose PHI without your consent in certain circumstances. In cases of suspected child abuse, staff is required by law to make a report. In cases where the client threatens to seriously harm self or others, staff is obligated to take steps to keep the client and others identified by threat safe. In some court proceedings, staff may be required to present PHI via a court order or subpoena.

5. Sycamore and Sage may use a billing agency that has access to demographic and diagnostic information necessary for processing claims with insurance companies. A clearing house may be used for handling claims submitted electronically. Secretarial help may be used. Sycamore and Sage may use an agency to scan and store patient data electronically. Sycamore and Sage may use an agency to shred old files. Sycamore and Sage may also use a company/individual to clean Sycamore and Sage Offices. All employees and contractors used by Sycamore and Sage have signed a Business Associate Agreement consenting to abide by Sycamore and Sage’s confidentiality procedures. Sycamore and Sage would be happy to provide you with a copy of this Business Associate Agreement upon request.

6. Sycamore and Sage maintains responsibility for amending policies and procedures related to client records as laws change. If a client has a complaint about his/her health record, they may contact Elizabeth Chalenburg, LIMHP or Kayleigh Wolf, LIMHP. Ms. Chalenburg and/or Ms. Wolf will sanction employees or contractors who do not follow his procedures related to PHI, including discussion of infractions at the least, requiring further training, or termination of services as the last resort.

7. Sycamore and Sage will honor client requests to have copies of their health records but they are encouraged to sit down with Ms. Chalenburg and/or Ms. Wolf, as some information in the file needs interpretation and can be misunderstood if taken out of context. Requested copies of client health records will be provided within 30 days. A reasonable fee may be imposed.

8. Clients of Sycamore and Sage have the right to request that information in their file be amended or changed if they feel it is incorrect. Ms. Chalenburg and/or Ms. Wolf will discuss the request with the client and make changes if the information provided by the client was misinterpreted or the client has data to suggest that a wrong assumption was made by Ms. Chalenburg and/or Ms. Wolf. Changes will not be made when comments made by Ms. Chalenburg and/or Ms. Wolf are based on observations or clinical opinion. If a request for an amendment to PHI is denied, Ms. Chalenburg and/or Ms. Wolf will document the reason in writing and place it in the patient’s file and also give a copy of the denial to the client/guardian.

9. Sycamore and Sage will provide an accounting at the client’s request of any information that is sent out regarding their record and which individuals have had access to their medical file. This accounting can be viewed by the client upon request. 

10. The client has the right to receive PHI by alternative means and at alternative locations. For example, you may want statements sent to a certain address to keep others in your family from knowing you are in treatment.

11. Personal computers of Ms. Chalenburg and Ms. Wolf are password-protected. Storage devices with patient data on them are stored in locked enclosures. Digital client data is backed up immediately whenever data has been added or updated. This backup is encrypted and transmitted to a server. The data can only be decrypted by Ms. Chalenburg/Ms. Wolf by accessing it from a password-protected or biometrically-protected computer.

12. Sycamore and Sage’s paper medical files are locked in file cabinets and these cabinets are in a room that is locked when the premises are vacant.

13. The client has the right to complain if he/she feels that his/her rights have been violated using the contact information on page one. Sycamore and Sage and associates will not retaliate for filing a complaint.

14. The client will be notified promptly if a breach occurs that may have compromised the privacy or security of PHI.