Notice of Privacy Practices

01

Who We Are

Connecticut Psychotherapy (ConnPsy) is a group psychotherapy practice located in Westport, Connecticut. This notice applies to all protected health information (PHI) created, received, or maintained by our practice, including all licensed clinicians and administrative staff operating under our organization.

We are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations to maintain the privacy of your protected health information, and to provide you with this notice of our legal duties and privacy practices.

02

How We Use Your Information

Your protected health information (PHI) includes any information that can identify you and relates to your mental or physical health, the care we provide to you, or payment for that care. We use PHI in three primary ways:

Treatment

We use your PHI to provide, coordinate, and manage your mental health treatment. Your therapist may share relevant clinical information with other treating providers involved in your care when appropriate and with your knowledge.

Payment

We may use or disclose your PHI to obtain payment for services — including submitting claims to your insurance carrier, verifying coverage eligibility, and processing payments.

Healthcare Operations

We may use your PHI for internal operations including quality assessment, clinical training, business planning, and compliance activities.

Psychotherapy Notes

Notes recorded by your therapist during a private session are held to a higher standard of protection under HIPAA. These notes are not used for payment or operational purposes without your explicit written authorization, and are not shared with insurers or third parties except in legally required circumstances.

03

Permitted Uses and Disclosures Without Authorization

In certain circumstances, we are permitted or required by law to use or disclose your PHI without your written authorization. These include:

• As required by law — court orders, lawful subpoenas, or other legal proceedings
• Public health activities — reporting communicable disease to authorized public health authorities
• Mandated abuse or neglect reporting — as required under Connecticut state law
• Serious threat to health or safety — when we reasonably believe disclosure is necessary to prevent imminent harm to you or others
• Workers' compensation — to the extent required by Connecticut workers' compensation laws
• Law enforcement — under specific, limited circumstances defined by applicable law
• Health oversight activities — to licensing boards or oversight agencies for audits or investigations
• Coroners and medical examiners — as necessary following a death

All other uses and disclosures not described in this notice require your written authorization, which you may revoke at any time in writing.

04

Your Privacy Rights

You have the following rights with respect to your protected health information. To exercise any of these rights, submit a written request to our Privacy Officer at the contact information listed at the end of this notice.

05

Our Obligations

Connecticut Psychotherapy is required to:

• Maintain the privacy of your protected health information
• Provide you with this notice of our privacy practices and legal duties
• Abide by the terms of the notice currently in effect
• Notify you in the event of a breach of your unsecured protected health information

We will not use or disclose your PHI in any manner not described in this notice without your written authorization, except as required or permitted by law.

06

Changes to This Notice

We reserve the right to change the terms of this notice and to make any revised notice effective for all PHI we hold, including information received before the revision date. The most current version will always be posted at connpsy.com and in our office. The effective date at the top of this notice reflects the most recent revision.

07

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us directly or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you in any way for filing a complaint.

File with ConnPsy

Submit a written complaint to our Privacy Officer using the contact information below. We will acknowledge and respond in writing.

File with HHS Office for Civil Rights

Online at hhs.gov/ocr/privacy/hipaa/complaints, by calling 1-800-368-1019 (TDD: 1-800-537-7697), or by mail to: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201.