Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, when we are asked for information for purposes outside of treatment, payment or health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes we have made about our conversation during a private, group, joint, or family counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 12 contracts
Samples: Psychologist Client Services Agreement, Therapist Client Services Agreement, Psychologist Client Services Agreement
Uses and Disclosures Requiring Authorization. We I may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are I am asked for information for purposes outside of treatment, payment or and health care operations, we I will obtain an authorization from you before releasing this information. We I will also need to obtain an authorization before releasing your Psychotherapy Notespsychotherapy notes. “Psychotherapy Notesnotes” are notes we I have made about our conversation during a private, group, joint, or family counseling session, which we I have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 7 contracts
Samples: Services Agreement, www.berrett.com, seattlechildpsych.com
Uses and Disclosures Requiring Authorization. We I may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are I am asked for information for purposes outside of treatment, payment or health care operations, we I will obtain an authorization from you before releasing this information. We I will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes we I have made about our conversation during a private, group, joint, or family counseling session, which we I have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 3 contracts
Samples: Client Therapist Agreement, Client Service Agreement, stacyfroelichlcsw.files.wordpress.com
Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, when we are asked for information for purposes outside of treatment, payment payment, or health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes we have made about our conversation during a private, group, joint, or family counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 2 contracts
Samples: Therapist Client Services Agreement, Therapist Client Services Agreement
Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are asked for information for purposes outside of treatment, payment or and health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notespsychotherapy notes. “Psychotherapy Notesnotes” are notes we have made about our conversation during a private, group, joint, or family counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we We have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 2 contracts
Samples: www.clearwaterpdx.com, www.clearwaterpdx.com
Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “"authorization” " is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are asked for information for purposes outside of treatment, payment or and health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your psychotherapy notes. "Psychotherapy Notes. “Psychotherapy Notes” notes" are notes we have made about our conversation during a private, group, joint, or family counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. I will obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 2 contracts
Samples: Service Agreement, Service Agreement
Uses and Disclosures Requiring Authorization. We I may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “"authorization” " is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are I am asked for information for purposes outside of treatment, payment or and health care operations, we I will obtain an authorization from you before releasing this information. We I will also need to obtain an authorization before releasing your psychotherapy notes. "Psychotherapy Notes. “Psychotherapy Notes” notes" are notes we I have made about our conversation during a private, group, joint, or family counseling session, which we I have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. Initials (of Individual, couple or family) 11 You may not revoke an authorization to the extent that (1) we 1)1 have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We I will also obtain an authorization from you before using or disclosing disclosing: · PHI in a way that is not described in this Notice.. · Psychotherapy notes · PHI for marketing purposes, such as sending a list or newsletter of helpful services to my clients
Appears in 1 contract
Samples: Psychotherapy Services Agreement
Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific specific disclosures. In those instances, when we are asked for information for purposes outside of treatment, payment or health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes we have made about our conversation during a private, group, joint, or family counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 1 contract
Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are asked for information for purposes outside of treatment, payment or and health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notespsychotherapy notes. “Psychotherapy Notesnotes” are notes we have made about our conversation during a private, group, joint, or family counseling session, which we have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 1 contract
Samples: Group Therapy Client Agreement
Uses and Disclosures Requiring Authorization. We I may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, when we are I am asked for information for purposes outside of treatment, payment or and health care operations, we I will obtain an authorization from for you before releasing this information. We I will also need to obtain an authorization before releasing your Psychotherapy Notespsychotherapy notes. “Psychotherapy Notesnotes” are notes we I have made about our conversation during a private, group, joint, joint or family counseling session, which we have I kept separate from the rest of your medical record. These notes are given a greater great degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 1 contract
Samples: twelchpsychologist.com
Uses and Disclosures Requiring Authorization. We I may use or disclose PHI for purposes outside of treatment, payment, or and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are I am asked for information for purposes outside of treatment, payment or payment, and health care operations, we I will obtain an any authorization form from you before releasing this the information. We I will also need to obtain an authorization before releasing your Psychotherapy Notespsychotherapy notes. “Psychotherapy Notesnotes” are notes we which have been made about our conversation during a private, group, joint, or family counseling session, which we have were kept separate from the rest of your medical record. These notes are given a greater great degree of protection than that PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notespsychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is not described in this Notice.
Appears in 1 contract
Samples: Patient Services Agreement
Uses and Disclosures Requiring Authorization. We may use or disclose PHI for purposes outside of treatment, payment, or and health care operations only when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, instances when we are asked for information for purposes outside of treatment, payment or and health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your Psychotherapy Notespsychotherapy notes. “Psychotherapy Notesnotes” are notes we have made about our conversation conversations during a private, group, joint, or family counseling session, which we have been kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notes) psychotherapy notes at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) we have previously relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy. We will also obtain an authorization from you before using or disclosing PHI in a way that is Other uses and disclosures not described in this Noticethe Privacy Notices will be made only with authorization from the individual. Patients have the right to restrict certain disclosures of PHI to health plans/insurance companies if the patient pays out of pocket in full for the health care service. Affected patients have the right to be notified following a breach of unsecured protected health information.
Appears in 1 contract