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NOTICE OF PRIVACY PRACTICES

Commitment to your privacy 

 

Aspire Mental Health, LLC is dedicated to maintaining the privacy of your personal health information as part of providing professional care. This office is required by law to keep your information private. These laws are complicated, but I must give you this important information. This page is a shorter version of the full, legally required Notice of Privacy Practices (NPP) that you received along with this, so refer to it for more information.

 

Aspire Mental Health, LLC will use the health information that you provide for your treatment, to arrange for payment for services, and for some other business activities that are called health care operations. After you have read this Notice of Privacy Practices you will be asked to sign a Consent Form to let this office use and share you information in accordance with Pennsylvania and/or federal law, whichever protects you more. 

 

If you or this office want to disclose (send, share, release) your information for any other purposes, you will be asked to sign an

Authorization Form. 

 

Your health information will be kept private, but there are some times when the law may require this office to use or share it without requiring your written consent. For example:

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  • When there is a serious threat to your health and safety or the health and safety of another individual or the public. We will only share information with a person or organization that is able to help prevent or reduce the threat. 
     

  • Some lawsuits and legal or court proceedings. 
     

  • If a law enforcement official requires us to do so.
     

  • For Workers Compensation and similar benefit programs. There are some other rarely occurring situations like these. They are described in the longer version of the NPP.

Your rights regarding your health information

 

  • You can ask this office to communicate with you about your health and related issues in a particular way or at a certain place that is more private for you. For example, you can ask to be called at home and not at work to schedule or cancel an appointment.
     

  • You have the right to ask this office to limit what I tell people involved in your care or the payment of your care, such as family members and friends. While I do not have to agree to your request, if I do agree, I will keep our agreement except if it is against the law, in an emergency, or when the information is necessary to treat you. 
     

  • You have the right to look at your health information such as your medical and billing records. You can get a copy of these records but you may receive a charge. 
     

  • If you believe the information in your records is incorrect or missing important information, you can ask for an amendment to your health information. You have to make this request in writing and send it to Stephanie Arotin, CRNP, PMHNP. You must provide the reasons you want to make the changes. 
     

  • You have the right to a copy of this notice. If the Notice of Privacy Practices is changed, a new version will be available at Aspire Mental Health, LLC. 
     

  • You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with Stephanie Arotin, CRNP, PMHNP, the owner of Aspire Mental Health, LLC, and with the Secretary of the Department of Health and Human Services. All complaints must be in writing. Filing a complaint will not change the health care we provide you in any way. If you have any questions regarding this notice or our health information privacy policies, please contact Stephanie Arotin, CRNP, PMHNP at 724-422-8834.

MEMBERS’ RIGHTS AND RESPONSIBILITIES

Members have the right to:

 

  • Be treated with dignity and respect.
     

  • Fair treatment; regardless of their race, religion, gender, ethnicity, age, disability, or source of payment.
     

  • Their treatment and other member information kept private. Only where permitted by law, may records be released without member permission.
     

  • Easily access timely care in a timely fashion.
     

  • Know about their treatment choices. This is regardless of cost or coverage by the member’s benefit plan.
     

  • Share in developing their plan of care.
     

  • Information in a language they can understand.
     

  • A clear explanation of their condition and treatment options.
     

  • Information about clinical guidelines used in providing and managing their care.
     

  • Ask their provider about their work history and training.
     

  • Give input on the Members’ Rights and Responsibilities policy.
     

  • Know about advocacy and community groups and prevention services.
     

  • Freely file a complaint or appeal and to learn how to do so.
     

  • Know of their rights and responsibilities in the treatment process.
     

  • Receive services that will not jeopardize their employment.
     

  • Request certain preferences in a provider. Have provider decisions about their care made without regard to financial incentives.

 

 

Members have the responsibility to:

 

  • Treat those giving them care with dignity and respect.
     

  • Give providers accurate information they need. This is so providers can deliver the best possible care.
     

  • Ask questions about their care. This is to help them understand their care.
     

  • Follow the treatment plan. The plan of care is to be agreed upon by the member and provider.
     

  • Follow the agreed upon medication plan.
     

  • Tell their provider and primary care physician about medication changes, including medications given to them by others.
     

  • Keep their appointments. Members should call their provider(s) as soon as they know they need to cancel visits.
     

  • Let their provider know when the treatment plan is not working for them.
     

  • Let their provider know about problems with paying fees.
     

  • Openly report concerns about the quality of care they receive.

Policies

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