HIPAA Policies Outline

I have constructed a HIPAA (Health Insurance Portability and Accountability Act) policy which you may have a copy of upon request.

This policy covers:

Current status. I do not electronically bill at this time.
Paper transactions. I follow the “minimum necessary standard”. This means I provide your insurer the minimum information necessary to process and manage your case. Psychotherapy notes (the detailed records of therapy sessions) receive special protected status under Federal Privacy Rules. This means for example your insurance company has a right to a diagnosis and a procedure code but not to the detailed life information that supports this diagnosis.
Clients may have access to their files unless there is a reason allowed by law not to.
Clients may consider amending their information.
Disclosure of information must be accompanied by a signed release except in specific situations, i.e., duty to warn, basic information for billing, and information for administrative review.
Authorization to disclose information has a specific format and allows the client to set specific limits on disclosure.
Administrative requirements. I am a sole proprietor and thus responsible for the administration of my policy.

I have read Alan Asher, M.C.’s HIPAA policy outline and understand that I may have a complete copy of the policy upon request.

If I have a complaint about the privacy of my records, I may file this with Alan Asher M.C. and/or send a written complaint to the U.S. Department of Health and Human Services.

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Client signature Date

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Client signature Date

Please print and Sign form