5755 Northpoint Parkway
Alpharetta, GA 30022
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Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
If you have any questions about this notice, please contact Kenneth C. Frontman, Ph.D., PC.
WHO WILL FOLLOW THIS NOTICE
This notice describes the practices of Kenneth C. Frontman, Ph.D., PC and his employees, if any. These employees may share mental health information with each other for treatment, payment or health care operations purposes described in this notice. Other clinicians in this building may have different policies or notices regarding their use and disclosure of your mental health information created in that clinician’s office.
MY PLEDGE REGARDING YOUR MENTAL HEALTH INFORMATION
I understand that mental health information about you is personal. I am committed to protecting medical information about you. I create a record of the care and services you receive at this location. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this practice. In order to provide you with the best possible care and treatment all professional staff involved in your treatment and employees involved in the health care operations of the practice may have access to your records. This notice will tell you about the ways in which I may use and disclose medical information about you. I also describe your rights and certain obligations I have regarding the use and disclosure of medical information.
HIPAA-approved communications are insured through sending encrypted e-mail through TherapyAppointment.com. Voice mails left through office phone are also kept private. Other communciations may present a greater risk of losing confidentiality. Sending e-mail through firstname.lastname@example.org or texting is not encrypted nor safegaurded; therefore use with caution. E-mail and text should only be used for conveying simple business information such as checking appointment times, running late, etc. A confidential fax number is offered at 678-592-0510; however, if a wrong number is dialed, security may be compromised. Therapy or crisis counseling are not to be conducted through e-mail, voice, texting, etc.
Professional commmunciations will be responded to within a 24-48 hour period, during business hours. All consultations will be proated at $150.00 per hour. Under certain conditions, teleconferencing will be conducted through V-See or other HIPAA Zoom on a case-by-case basis. Dr Frontman uses only LINKED-IN, a Professional Social Media service. Use of FACEBOOK or other personal Social Media platforms is prohibited.
WHAT IS MEANT BY YOUR MENTAL HEALTH INFORMATION
Each time you visit me or any health care provider, a record of your visit is made. Typically, this record includes your history, symptoms, lab test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a basis for planning your care and treatment and a means of communication among the many health professionals who contribute to your care. The record may also include records I get from others who treated or evaluated you, psychological test scores, school records, billing and insurance information.
HOW THIS INFORMATION WILL BE USED
Your personal health record will be retained by Kenneth C. Frontman, Ph.D., PC for 7 years after your last clinical contact with the practice. After that time has elapsed, the record will be shredded or burned or otherwise destroyed in a way that protects your privacy. Until the records are destroyed they may be used, unless you ask for restrictions on a specific use or disclosure, for treatment, payment, and healthcare operations such as the following purposes:
- Appointment reminders;
- Notification when an appointment is cancelled or rescheduled by Kenneth C. Frontman, Ph.D., PC;
- As may be required by law, such as reporting of child or elder abuse or neglect; notifying authorities of suspected abuse, neglect, or domestic violence;
- To carry out treatment and health care operations functions through medical transcription services;
- To process urine drug screens through an outside laboratory service;
- Mental health oversight activities, e.g., audits, inspections or investigations of administration and management
- To prevent a serious threat to health or safety;
- To conduct surveys after treatment has ended to evaluate program effectiveness.
YOUR AUTHORIZATION IS REQUIRED FOR OTHER DISCLOSURES
Except as described previously, I will not use or disclose information from your record unless you authorize (permit) in writing for Kenneth C. Frontman, Ph.D., PC to do so. You may revoke your permission, which will be effective only after the date of your written revocation.
YOU HAVE RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION (PHI)
You have the following rights regarding your health information, provided that you make a written request to invoke the right on the form provided by Kenneth C. Frontman, Ph.D., PC.
Right to request restriction. You may request limitations on your mental health information I may disclose, but I am not required to agree to your request. If I agree, I will comply with your request unless the information is needed to provide you with emergency treatment.
Right to confidential communications. You may request communications in a certain way or at a certain location, but you must specify how or where you wish to be contacted.
Right to inspect and copy. You have the right to inspect and copy your mental health information regarding decisions about your care; however, psychotherapy notes may not be inspected and copied. I may charge a fee for copying, mailing, and supplies. Under limited circumstances, your request may be denied; you may request review of the denial by another licensed mental health professional chosen by Kenneth C. Frontman, Ph.D., PC and he will comply with the outcome of the review.
Right to request clarify record. If you believe that the information I have about you is incorrect or incomplete, then you may ask to add clarifying information. You may ask for a form for that purpose and the form will require certain specific information. Kenneth C. Frontman, Ph.D., PC is not required to accept the information that you propose.
Right to accounting of disclosures. You may request a list of the disclosures of your mental health information that have been made to persons or entities other than for treatment or health care operations in the last six (6) years, but not prior to March 19, 2008. Right to a copy of this Notice. You may request a paper copy of this Notice at any time.
REQUIREMENTS REGARDING THIS NOTICE
Kenneth C. Frontman, Ph.D., PC is required to provide you with this Notice that governs his privacy practices. Kenneth C. Frontman, Ph.D., PC may change his policies or procedures in regard to privacy practices. If and when changes occur, the changes will be effective for mental health information I have about you as well as any information I receive in the future. Any time you come in to Kenneth C. Frontman, Ph.D., PC for an appointment, you may ask for and receive a copy of the Privacy Notice that is in effect at the time.
If you believe your privacy rights have been violated, you may file a complaint with Kenneth C. Frontman, Ph.D., PC. You will not be penalized or retaliated against in any way for making a complaint.
Call Kenneth C. Frontman, Ph.D., PC, 770-559-9752 and ask to speak to Dr. Frontman if: you have a complaint; you have any questions about this notice; you wish to request restrictions on uses and disclosure for health care treatment or operations; or you wish to obtain any of the forms mentioned to exercise your individual rights described above.