HIPPA POLICY

Privacy Policy for Inner Freedom Psychotherapy, LLC

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Inner Freedom Psychotherapy, LLC (IFP) is committed to protecting your privacy. IFP is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. IFP is required to provide you with this Notice of Privacy Practices, which explains the IFP's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.

Your rights

Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the IFP at the address noted below.

To inspect and copy PHI.

  • Other than psychotherapy notes, you have the right to inspect or obtain an electronic or paper copy of your medical record. IFP will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request. IFP may charge you a reasonable, cost-based fee.

  • IFP may deny your request if it believes the disclosure will endanger your life or another person's life. You may have a right to have this decision reviewed.

To amend PHI.

  • You can ask to correct PHI you believe is incorrect or incomplete. IFP may require you to make your request in writing and provide a reason for the request.

  • IFP may deny your request. IFP will send a written explanation for the denial and allow you to submit a written statement of disagreement.

To request confidential communications.

• You can ask IFP to contact you in a specific way in order to safeguard your confidentiality. IFP will say “yes” to all reasonable requests.

To limit what is used or shared.

  • You can ask IFP not to use or share PHI for treatment, payment, or business operations. IFP is not required to agree if it would affect your care.

  • If you pay for a service or health care item out-of-pocket in full, you can ask IFP not to share PHI with your health insurer. We will say “yes” unless a law requires us to share that information.

  • You can ask IFP not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.

To obtain a list of those with whom your PHI has been shared.

  • • You can ask for a list, called an accounting, of the times your health information has been shared. The list will be limited to six years prior to the date you ask, and it can be limited to less than 6 years at your request. IFP will include who we shared your PHI with and why. IFP will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.

To receive a copy of this Notice.

  • You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.

  • To choose someone to act for you.

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights.

  • To file a complaint if you feel your rights are violated.

  • You can file a complaint by contacting IFP using the following information:

Inner Freedom Psychotherapy, LLC
3201 Pioneers Blvd., Suite 300, Lincoln, NE 68502
Dr. Omar Bravo
402-317-5412

  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

  • IFP will not retaliate against you for filing a complaint.

To opt out of receiving fundraising communications.

  • IFP may contact you for fundraising efforts, but you can ask not to be contacted again.

OUR USES AND DISCLOSURES

1. Routine Uses and Disclosures of PHI

IFP is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. IFP typically uses or shares your health information in the following ways:

To treat you.

  • IFP can use and share PHI with other professionals who are treating you.

  • Example: Your primary care doctor asks about your mental health treatment.

To run the health care operations.

  • IFP can use and share PHI to run the business, improve your care, and contact you.

  • Example: IFP uses PHI to send you appointment reminders if you choose.

To bill for your services.

  • IFP can use and share PHI to bill and get payment from health plans or other entities.

  • Example: IFP gives PHI to your health insurance plan so it will pay for your services.

2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object

IFP may use or disclose PHI without your authorization or an opportunity for you to object, including:

To help with public health and safety issues

  • Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.

  • Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.

  • Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.

  • Serious threat to health or safety: To prevent a serious and imminent threat.

  • Abuse or Neglect: To report abuse, neglect, or domestic violence.

To comply with law, law enforcement, or other government requests

  • Required by law: If required by federal, state or local law.

  • Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.

  • Law enforcement: For law enforcement purposes or with a law enforcement official.

  • Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.

  • National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons or foreign heads of state, for purpose of determining your own security clearance and other national security activities authorized by law.

  • Workers' Compensation: To comply with workers' compensation laws or support claims.

To comply with other requests

  • Coroners, medical examiner, or Funeral Directors: To perform their legally authorized duties.

  • Organ Donation: For organ donation or transplantation.

  • Research: For research that has been approved by an institutional review board.

  • Inmates: IFP created or received your PHI in the course of providing care.

  • Business Associates: To organizations that perform functions, activities or services on our behalf.

3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object

Unless you object, IFP may disclose PHI:

  • To your family, friends, or others if PHI directly relates to that person's involvement in your care.

  • In a disaster relief situation.

  • If it is in your best interest because you are unable to state your preference, such as if you are unconscious. IFP may also share your information when needed to lessen a serious and imminent threat to health or safety.

4. Uses and Disclosures of PHI Based Upon Your Written Authorization

IFP must obtain your written authorization to use and/or disclose PHI for the following purposes:

  • Marketing, sale of PHI, and psychotherapy notes.

  • You may revoke your authorization, at any time, by contacting IFP in writing, using the information above. IFP will not use or share PHI other than as described in this Notice unless you give your permission in writing.

OUR RESPONSIBILITIES

  • IFP is required by law to maintain the privacy and security of PHI.

  • IFP is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, IFP will abide by the more stringent law.

  • IFP reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by IFP. Should IFP make changes, you may obtain a revised Notice by requesting a copy from IFP, using the information above, or by viewing a copy on the website https://www.innerfreedompsych.com/.

  • IFP will inform you if PHI is compromised in a breach.

  • IFP will not use or share your information other than as described here unless you tell us we can in writing.

This Notice is effective on 11/1/2023.