The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that is designed to protect the privacy of patient information, provide for the electronic and physical security of health and patient medical information, and simplify billing and other electronic transactions by standardizing codes and procedures.

What this means in English is that the Federal government now requires Phoenix Psychological and Counseling Associates, Inc. to obtain your signature indicating that we have provided you with a Privacy Notice. This also means that we are required to explain to you how your health care and other personal information may be used.

Our staff is well-trained in maintaining your confidentiality and Phoenix Psychological and Counseling Associates, Inc. is fully compliant with HIPAA.  Below is Phoenix' statement of our Privacy Practices:




Phoenix Psychological & Counseling Associates, Inc. is committed to protecting the privacy of your “protected health information,” or PHI. We are required by applicable federal and state laws to maintain this privacy and are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your PHI.


Uses and Disclosures of Protected Health Information 

Except in limited situations, Phoenix Psychological & Counseling Associates, Inc.’s policy does not permit the sharing of PHI.  We use and disclose PHI about you for treatment, payment, and health care operations, for compliance with the Health Insurance Portability and Accountability (HIPAA) Administrative Simplification Rules, and in certain extenuating circumstances.



PHI: Protected Health Information:  Your individually identifiable health information, including: diagnosis, symptoms, treatment plans, appointment times, and summaries of sessions, as well as demographic information such as name, address, phone number, among other things.

Treatment:  Includes: providing health care to a client, coordinating and/or managing a client’s care with a third party, consulting with another provider, and referring a client to another provider.

Payment:  Includes: determining eligibility for benefits, billing and claims management, health care data processing, and other activities with another entity which is also subject to federal privacy laws.  For example, your insurance and/or managed care provider, or a government entity, such as worker’s compensation, Medicaid, Medicare, or other similar program.

Health Care Operations: Includes: quality assessment; case management and care coordination; peer review, accreditation and licensing; conducting or arranging for medical review, legal services, and auditing functions; customer services; business management; and other activities.



Upon your explicit authorization, either verbally or in writing. you or your personal representative (for example, parents, power of attorney, etc.), may give us authorization to use or share your PHI to anyone for any purpose.  If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect.  When you provide us with an authorization for another party to receive information about you, we have the right to review, approve and/or reject your authorization request as per our internal procedures. In addition, you must provide us with an authorization for us to request PHI about you from another party.

Family, Friends, and Others: Only upon your explicit authorization, either verbally or in writing, may we share your PHI to a family member, friend, or personal representative, to the extent necessary to help with your health care or with obtaining payment for your health care.  However, if you are incapacitated, and the situation indicates that disclosure would be in your best interest (for example, to an emergency medical service provider), we may share your PHI to a family member, friend or other person to the extent necessary to help with your care.

Research and Marketing:  We do NOT use or disclose PHI information for research or marketing purposes.

Other Limitations on Disclosure:

Generally, we do not disclose PHI to third parties, except in extenuating circumstances, such as:

Public Health and Safety:  We may disclose your PHI to the extent necessary to avert a serious and imminent threat to your health or safety or the health or safety of others.  We will disclose your PHI to a government agency authorized to oversee the health care system or government programs or its contractors, and to public health authorities for public health purposes.  If you are a minor, we will disclose your PHI to the appropriate authorities if we believe that you are a possible victim of abuse, neglect, domestic violence or other crime.

Required by Law:  We will disclose your PHI when we are required to do so by law.  For example, we must disclose your PHI to the proper authorities for purposes of determining whether we are in compliance with federal privacy laws.

Process and Proceedings:  We must disclose your PHI in response to a court order. However, we must obtain a written authorization in order to disclose your PHI in response to an administrative order, subpoena, discovery request, warrant, officials, or other lawful process.

Law Enforcement:  We will not disclose information to a law enforcement official concerning the PHI of a suspect, fugitive, material witness, crime victim or missing person, except in those instances referred to elsewhere in this Notice (for example, by court order, in cases of possible harm to self or others, etc.).

Military and National Security:  We will not disclose to military authorities the PHI of Armed Forces personnel except in emergency situations where authorized federal officials require PHI for lawful intelligence, counterintelligence, and other national security activities, and they have produced a court order.  In all non-emergency matters (for example, job reference/background checks), we must obtain a written authorization from you to release your PHI.

Other Limitations on Disclosure:  We do not disclose to third parties information which would identify a client who has received treatment for substance abuse or HIV, without your, or your personal representative’s, verbal or written express authorization.

Individual Rights

Access: You have the right to look at or get copies of your PHI, with limited exceptions.  If you request copies, we will charge you a reasonable cost-based fee to copy your PHI and postage if you want the copies mailed to you. If you request, we may prepare a summary or an explanation of your PHI for a fee.

Disclosure Accounting:  You have the right to receive a list of instances in which we or our business associates disclosed your PHI for purposes other than treatment, payment, health care operations and certain other activities.  This may include disclosures made within six (6) years prior to your request, excluding anything prior to April 14, 2003.  We will provide you with the date on which we made the disclosure, the name of the person or entity to whom we disclosed your PHI, a description of the PHI we disclosed, the reason for the disclosure, and certain other information.  If you request this list more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.

Restriction Requests:  You have the right to request that we place additional restrictions on our use or disclosure of your PHI.  We are not required to agree to these additional restrictions, but if we do, we will abide by our Agreement (except in an emergency).

Confidential Communication:  You have the right to request that we communicate with you in confidence about your PHI by alternative means or at an alternative location, if you feel endangered.  You must inform us that confidential communication by alternative means or at an alternative location is required to avoid endangering you.  You must make your request in writing, and you must state that the information could endanger you if it is not communicated in confidence by the alternative means or location you want.  We must accommodate your request  if it is reasonable, specifies the alternative means or location, and continues to permit us to perform health care operations, defined above.

Amendment:  You have the right to request that we amend your PHI.  Your request must be in writing, and it should explain why the information should be amended.  We may deny your request if we did not create the information you wanted amended or for certain other reasons. If we deny your request, we will provide you a written explanation.  You may respond with a statement of disagreement to be appended to the information you wanted amended.  If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you name, of the amendment and to include the changes in any future disclosures of that information.


Questions and Complaints

If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made regarding your individual rights, you may file a complaint with our Privacy Officer using the contact information listed at the beginning of this notice.  You may also submit a written complaint to the US Department of Health and Human Services.


For more information:  See Federal Register, 12/28/00 – HIPAA Privacy Rule 45 CFR 160 & 164. (Modifications 8/14/02), speak to your counselor, or call 304-622-6404.