Notice of Privacy Practices

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. THE PRIVACY OF YOUR MEDICAL INFORMATION IS IMPORTANT TO US

Our Legal Duty

Thomas Gill & Associates, Pc, (TGA)

TGA required by federal and state law to maintain the privacy of your medical information. TGA is also required to provide you with this notice about our privacy practices, our legal duties, and your rights concerning your medical information.

This notice takes effect April 14, 2003 and will remain in effect until it is revised and/or updated.

We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted under law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all medical information that we maintain, including medical information we created or received before we made the changes.

When changes are made to the notice, the updated document will be available to you upon request.

TGA provides its Notice of Privacy Practices to every patient with whom it has a direct treatment relationship. The Notice is provided no later than the date of first treatment to patients after April 13, 2003. When a direct treatment patient receives the Notice, TGA asks patients to sign its "Consent for Release and Use of Confidential Information and Receipt of Notice of Privacy Practices" form. You may request a copy of this notice at any time.

Using and Disclosing Your Medical Information

TGA reasonably ensures that the protected health information (PHI) it requests, uses and discloses for any purpose is the minimum amount of PHI necessary for that purpose.

TGA makes reasonable efforts to ensure that PHI is only used by and disclosed to individuals that have a right to protected health information. Toward that end, TGA makes reasonable efforts to verify the identity of those using or receiving PHI.

We must disclose your medical information to you, as described in the Individual Rights section of this notice. We may disclose your medical information to a family member, friend or other person to the extent necessary to help with your health care or with payment for your health care, but only if you agree that we may do so.

We use and disclose medical information about you for treatment, payment, and health care operations. For example:

Treatment could include consulting with or referring your case to another health care provider such as a physician, psychologist, therapist, clinic or hospital. The type of health information that could be used or disclosed includes: medical history, diagnoses, medications or care plan pertinent to your care.

Payment means we may use and disclose your medical information to obtain payment for services provided to you.

Health care operations could include activities such as quality improvement activities, audits of billing processes, and reviewing the competence or qualifications of health care professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Uses or Disclosures We May Make Without Your Authorization

Thomas Gill & Associates uses and discloses protected health information to appropriate individuals as required by law.

The practice discloses protected health information regarding victims of abuse, neglect, or domestic violence. The practice discloses information about a minor, disabled adult, nursing home resident, or person over 60 years of age whom the practice reasonably believes to be a victim of abuse or neglect to the approprate authorities as required by law or, if not required by law, if the individual agrees to the disclosure. This includes child abuse and neglect, elder abuse and exploitation, abused and neglected nursing home residents, or disabled adult abuse.

The practice informs the individual of the reporting unless the practice, in the exercise of professional judgment, believes informing a personal reqresentative, and the practice believes the personal representative is responsible for the abuse, neglect or other injury and that information such person would not be in the best interests of the individual as determined by the professional judgment of the practice.

  • We may also use and disclose medical information in the following manner:
  • We may contact you, by phone or by mail, to provide information about treatment alternatives or other health-related services that may be of interest to you.
  • We may disclose your medical information in response to a court or administrative order, or other lawful process, under certain circumstances. Under limited circumstances, such as a court order, warrant or grand jury subpoena, we may disclose your medical information to law enforcement officials.
  • We may disclose your medical information when we are required to do so by federal, state or other applicable law. We may disclose your medical information when authorized by workers' compensation or similar laws.
  • We may disclose protected health information for military and veterans activities, national security and intelligence activities and other activities as required by law.
  • We will not use or disclose your medical information if it is prohibited or materially limited by other applicable law including, but not limited to, the Illinois Nursing Home Care Act, Illinois Medical Practice Act, Illinois Mental Health and Developmental Disabilities Code, Illinois AIDS Confidentiality Act, Illinois Mental Health and Developmental Disabilities Confidentiality Act, and the Federal Drug Abuse, Prevention, Treatment and Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970.

More Stringent Protection For Your Health Information

In certain cases, Illinois law provides more stringent privacy protections of your health information that this Privacy Notice recites.

If you are an unemancipated minor under Illinois law, then Thomas Gill & Associates will not disclose, without your authorization, information related to your care regarding treatment abuse of drugs or alcohol or emotional disturbance to a parent, legal guardian, person standing in loco parentis or a legal custodian who has legal authority to provide permission for your medical or psychiatric care.

Psychotherapy Notes

Psychotherapy notes may be disclosed by your psychiatrist and/or therapist only after you have given written authorization to do so. Limited exceptions exist, e.g. to prevent you from harming yourself or others and to report abuse/neglect. All records kept at Thomas Gill & Associates are considered psychotherapy notes. you cannot be required to authorize the release of your psychotherapy records in order to obtain health-insurance benefits for your treatment, or medical information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). Any agreement we may make to a request for additional restrictions must be in writing signed by a person authorized to make such an agreement on our behalf.

You have the right to request that we communicate with you about your medical information by alternative means or to alternative locations. You must make your request in writing. We will accomodate your request if it is reasonable, specifies the alternative means or location, and provides satisfactory explanation how payments will be handled under the alternative means or location you request.

You have the right to request that we amend your medical information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request if we did not create the information you want amended or for certain other reasons.