Centro Castillo para Bienestar Personal y Familiar

Privacy Act


Privacy Statement


 

Notice of Privacy Practices

In compliance with the Health Information Portability and Accountability Act (HIPAA) this notice describes how psychological and medical information about you can be used and disclosed and how your rights are protected.

 

The practice's commitment to your privacy:

 

The practice is mandated by law and it is fully dedicated to maintaining the privacy of your personal health information.  If you have any questions about this policy or your rights contact: Paula C. Castillo, Psy.D.,

(773) 622-6218, 6250 W. North Ave, Chicago, IL 60639.

 

In order to effectively provide you care, there are times when we will need to share your medical information with others beyond our practices.  These situations include:

 

Treatment: We may use or disclose medical information about you to provide, coordinate, or manage your care or any related services, including sharing information with others outside our practices that we are consulting with or referring you to.

 

Payment: Information will be used to obtain payment for the treatment and services provided.  This will include contacting your health insurance company for prior approval of planned treatment or for billing purposes.

 

Healthcare Operations: We may use information about you to coordinate our business activities.  This may include setting up your appointments, reviewing your care, training staff.

 

After you read this policy in the office during your first visit, you will be asked to sign a separate consent form giving authorization to use and share your information as necessary.  If you do not provide consent, then we are not able to provide you treatment at this time.

 

Should a provider be asked to disclose your private information for any other purpose, then the matter will be discussed with you, and if you consent, you will be asked to sign a Release of Information Form.

 

The practice's main priority is to maintain the privacy of your personal health information; however, there are some circumstances that by law a provider may be required to use or share the information even if you do not provide consent.  They are:

 

1.    When there is a serious threat to your health or physical safety or that of another individual or public. 

 

2.    If during discussions it is revealed that a child, elderly person, or anyone dependent on the care of another person is being abused in any way (sexual, physical, medical neglect) by anyone (yourself or otherwise) then, as a mandated reporter, I must contact the abuse hotline and place a report.

 

3.    In some lawsuits, legal or court proceedings.

 

4.    If Workers' Compensation and/or similar benefit programs require me to do so.

 

 

Your rights regarding your health information:

 

Contacting you: You can make specific requests as to how you would like us to communicate with you regarding your treatment and/or related issues.  For example, you can ask to be called at home and not at work, in order to schedule or cancel an appointment.  We will try our best to do as you ask.

 

Copy of Record: You have the right to look at the health information we have on record for you, such as your medical and billing records.  You can get a copy of these records for a minimal administrative fee.  For clinical reasons, it may not be in your best interest to read the clinical progress notes a provider maintains regarding your treatment and thus the you should openly discuss these concerns prior to you viewing any medical files that we have.

 

Amending your Record: If you believe the information in your records is incorrect or incomplete, you can ask to make some changes to your health information records. Amending your record can only be done after you have submitted a written request outlining the reasons you believe the information is incorrect or incomplete. If your request is denied, you have a right to file a statement disagreeing with the decision.  The written requests will then become part of your clinical record.

 

Release of Records: You may consent in writing for the release or your records (whole or partial records) for any purpose you chose.  You may revoke this consent at anytime. We can not be held responsible for what others do with the information that you have consented us to provide them.

 

Restriction of Record Release: You have the right to ask to limit what we tell certain individuals involved in your care or in the payment for your care, such as family members and friends.  While we do not have to agree to your request, if we do agree, we will keep our agreement unless it is against the law, in case of an emergency, or when the information is necessary to treat you. We will be clear to identify to you when these specific situations arise.

 

Changes in Policy: You have the right to a copy of the NPP.  The practice reserves the right to change its privacy policy based in the needs of the practice and changes in state and federal law.

 

Questions & Complaints: You have the right to file a complaint if you believe your privacy rights have been violated.  You can file a complaint directly with Paula C. Castillo, Psy.D. and also with the Secretary of the Department of Health and Human Services.  All complaints must be in writing.  Filing a complaint will not negatively impact the health care that we provide to you.

 

 


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