***At this time my practice is full and I am no longer accepting new clients. I do not keep a waitlist but will update this banner when accepting new patients.***
To find a provider that is currently accepting new patients you can use the following search tools:
https://www.psychologytoday.com/us
NOTICE OF PRIVACY PRACTICES
EFFECTIVE DATE OF THIS NOTICE: July 24, 2023
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
MY PLEDGE REGARDING PROTECTED HEALTH INFORMATION:
I, Jeanne-marie Elisabeth Mailloux, am committed to protecting your privacy. I am required by federal law to maintain the privacy of your Protected Health Information “PHI,” which is information that identifies or could be used to identify you. I am required to provide you with this Notice of Privacy Practices (this “Notice”), which explains my legal duties and privacy practices and your rights regarding PHI that I collect and maintain.
MY RESPONSIBILITIES
I am required by law to maintain the privacy and security of PHI.
I am required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
I reserve the right to amend Notice. All changes are applicable to PHI collected and maintained. Should I make changes, you may obtain a revised Notice by requesting a copy from me, using my contact information above.
I will inform you if PHI is compromised in a breach.
*If any terms of this Notice change, such changes will apply to all information I have about you and the new Notice will be provided to you.
YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
The Right to See and Get Copies of Your PHI.
You have the right to get an electronic or paper copy of your medical record and other information that I have about you. I 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, and I may charge a reasonable, cost based fee for doing so.
The Right to Amend Your PHI.
If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I amend the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request. I will allow you to submit a written statement of disagreement.
The Right to Choose How I Communicate and Send PHI to You.
You have the right to ask me to contact you in a specific way or to send mail to a different address, and I will agree to all reasonable requests.
The Right to Request Limits on Uses and Disclosures of Your PHI.
You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if it would affect your health care. You have the right to request restrictions on disclosures of your PHI to health plans if the PHI pertains solely to a service that you have paid for out-of-pocket in full.
The Right to Get a List of the Disclosures I Have Made.
You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.
The Right to Receive a Paper or Electronic Copy of this Notice.
You have the right to receive a paper copy of this Notice, even if you have received this notice electronically.
The Right 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.
The Right to File a Complaint
If you feel your rights have been violated 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/. I will not retaliate against you for filing a complaint.
HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
1. Routine Uses and Disclosures. The following categories describe different ways that I use and disclose health information as permitted by federal law, without your written authorization. I would typically use or share your health information in the following ways:
To treat you.
I can use and share PHI with other professionals who are treating you. Disclosures for treatment purposes are not limited to the minimum necessary standard. Therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.
Example: Your primary care doctor asks about your mental health treatment.
*I will typically request written authorization even though it is not required.
To run the health care operations.
I can use and share PHI to run the business, improve your care, and contact you
Example: Using PHI to communicate with you or remind you of appointments.
To bill for your services
I can use and share PHI to bill and get payment from health plans or other entities
Example: The Practice 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
I may use or disclose PHI without your authorization or an opportunity for you to object for the following purposes:
When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
For health oversight activities, including audits and investigations.
For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.
For law enforcement purposes. For law enforcement to locate and identify you or disclose information about a victim of a crime.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes. Although my preference is to obtain an authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.
Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object. Unless you object, the Practice may disclose PHI:
To your family, friends, or others if PHI directly relates to that person's involvement in your care. If it is in your best interest because you are unable to state your preference.Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
4. Uses and Disclosures of PHI Based Upon Your Written Authorization.
Marketing Purposes and Sale of PHI. As a psychotherapist, I will NOT sell your PHI or
use or disclose your PHI for marketing purposes.
Psychotherapy Notes. I keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is for:
My use in treating you
The purposes listed under item 2 in this Notice.
For my use in defending myself in legal proceedings instituted by you.
For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.