Chicvara & Associates

Confidentiality & Privacy Policy

 

Confidentiality

Your privacy is important to us!

 

Clinical services are strictly confidential.  No information is released without the written consent of the patient (or the patient’s parent/guardian in the case of minors), except in cases where the patient is an immediate risk to him or herself or others, or is the victim of child abuse or elder abuse.  There are other limits to confidentiality which will be explained in detail during the first visit.

 

 

HIPAA

The Health Insurance Portability and Accountability Act HIPAA was enacted by congress in 1996 to protect your personal health information.  It is a set of regulations about how healthcare information is stored, shared, and how disclosures are made.  It is intended to protect your private medical information.  The State of Illinois and the American Psychological Associations Code of Ethics for Psychologists have long established standards which in most cases meet and in some cases exceed HIPAA standards.  This office has and will continue to comply with all ethical and legal guidelines in the State of Illinois that apply to mental health counseling. 

 

 

Your Personal Information

The only information that we will obtain about you personally is the information that you explicitly and voluntarily supply to us.  Information identifiable to you personally (such as name and address) will not be disclosed to anyone unless you have given us written permission to do so.  We will not give, sell or transfer any personal information to a third party without your expressed permission unless we are required to do so by applicable law or a court.  We do not accept liability for unintentional disclosure. 

 

 

Additional Information for Patients

1.    In accordance with HIPPA, your information may only be released with your consent. 

2.    Your demographic information as well as diagnosis is used in secure electronic billing.  Billing staff is informed of dates of service, diagnostic code, your demographic information, and health insurance information.  

3.    All sessions will become part of your clinical record.  Communication between doctor and patient is privileged.  Your psychologist will keep confidential anything you say, with the following exceptions: 

• You authorize them to tell someone else, as in the case with insurance reimbursement, or consultation with another professional 

• He or she is ordered by the court to disclose your information

• He or she determines that you are a danger to yourself or to others 

• If during session he or she become aware that there is physical abuse, sexual abuse, or neglect to a child or an older adult, he or she is required to report to Illinois Department of Child & Family Services 

• He or she must also disclose to the proper authorities if there has been sexual abuse perpetrated by a minister or therapist, or if there has been a life threatening felony unreported.  

• Patient files are kept in dual locked storage.  Records are maintained for a period of seven years for adults an seven years beyond the age of 18 for minors.  All electronic data is password protected.

4.    In the event any unpaid balance for services of your patient account have not been taken care of  within 90 days, and no payment plan or alternate arrangement has been agreed upon, demographic information, date of service, service provided, charges paid and unpaid will be turned to a professional collection service, or reported to credit agencies.

5.    When requesting additional authorizations from your insurance company your doctor will be required in most cases to support the request with clinical information. 

6.    To ensure quality of care, insurance companies may from time to time audit the practice.  In the event of this, an agent of the insurance company may request access a patient chart to ensure that essential paperwork is enclosed.