Treatment

Constructive Psychiatry uses your health information to evaluate your health, diagnose medical conditions, and provide treatment. Your information is only shared with professionals who directly influence your care. You have the right to provide written authorization using our designated form when you want your information shared with another healthcare professional of your choosing.

Payment

Your health insurance company, or another payer, may require us to provide your health information to secure payment. You have the right to pay for your care directly and restrict this disclosure. Please request in writing to change your status to private pay if you want to choose this option. If you fail to pay your bill, you authorize us to use the necessary information within legal parameters to collect payment.

Law Enforcement

Your health information may be disclosed as required by law to government officials and/or law enforcement. Some laws require disclosure and Constructive Psychiatry will comply with all official government and/or law enforcement requests. You will be notified if we must share your health information for this purpose.

Public Health Reporting

Some public health agencies may legally require us to disclose your information to protect the general public. Some communicable diseases must be reported to state and federal agencies. You will be notified if we must share your health information for this purpose.

Other Uses

Your information will be used to contact you about appointments and/or your care using HIPAA-complaint technologies, including secure messaging in the client portal, Google Hangouts, text, or HIPAA-compliant email. Your information may also be known by students or trainees in the process of learning. By consenting to care with Constructive Psychiatry, you agree that we may use the necessary methods to contact you. Please be aware that you may be required to provide a password that only you know to identify yourself when you communicate with a representative of Constructive Psychiatry.

Right to Revise Privacy Practices

As permitted by law, we reserve the right to amend or modify our privacy policies and practices. Local, state, or federal laws may require us to change our privacy practices. If you would like a copy of our policies and associated updates, you may request it anytime.

Requests to Inspect Protected Health Information

You have the right under most circumstances to inspect or copy your protected health information upon written request using our designated form. Your information will be released to you unless there are legal or medical reasons that require us to deny your request.

Individual Rights

• You have certain rights under federal privacy standards. These include the following.

• The right to request restrictions on the use and disclosure of your protected health information.

• The right to receive confidential communications concerning your medical condition and treatment.

• The right to inspect and copy your protected health information.

• The right to amend an accounting of how and to whom your protected health information has been disclosed.

• The right to receive a printed copy of this notice.

Complaints

If you would like to submit a comment or complaint about our privacy practices, you may send us a letter outlining your comments or complaint to the following address. If you believe your privacy rights have been violated, please send a letter with detailed information to the same address. Your comments or complaints will not result in retaliation.

If you have questions about our privacy practices or would like to make a special request regarding our privacy practices, please write to us. You will receive a written response to your letter within 30 days of receipt. These privacy practices are effective on the revision date of this Patient Handbook.

Comments and Complaints:

Constructive Psychiatry

68 Harrison Ave STE 605 PMB 620124

Boston, MA 02111

Patients Under 18 Years of Age

Constructive Psychiatry accepts patients starting at age 4 as allowed by state and federal laws. If a patient is under 18 years of age, parental consent, or legal guardian consent, is required prior to the first treatment appointment. By consenting to treatment, a parent or guardian of the patient validates that he or she will be the only person with access to the patient portal and that he or she is the only person who will have access to consent and acknowledgment forms to be electronically signed. In addition, a parent or guardian must be physically present with the child or adolescent for each treatment session.

Confidentiality

There is no guarantee of confidentiality under the following conditions:

• If we suspect you/your child are/is in imminent danger of harm to self or others, or a child or elderly person is being abused or neglected (as I am a mandated reporter)

• If a court orders a release of information

• If you initiate a malpractice lawsuit or a billing dispute with a financial institution

• If your insurance company requests to review your/your child’s case

• If you pay by credit card, our name will appear on your credit card statement

• If you do not pay your/your child's bill, your/your child's balance due statement (including diagnostic and procedural codes) may be sent to a collections agency or another responsible party

• Between our providers and our administrative staff or colleagues with whom our providers consult professionally