Notice of Policies and Practices
The information that follows is in compliance with and explains HIPAA regulations.
Policies specific to the practice of Dr. Denise Novaky follows thereafter.
In the normal administration of psychological services, I will need to disclose protected health information (PHI) outside my office
whether through internet, telephone, or mail. PHI refers to the information in your clinical record that identifies you, your diagnosis,
the services supplied to you, and other personal material. I may need to disclose such information in order to obtain payment from
your health care insurance carrier, treatment authorization from a managed care organization hired by your health insurance carrier,
coordination of treatment services with other professionals, or to complete other services important to your care. Your specific
authorization for information release will typically be secured before information is disclosed. That means that you will be told to
whom the information will be released, the purpose for the release, and the specific information to be released, and the length of time
that the authorization will be valid. You may revoke this written authorization, through a written letter to that effect, at any time
except to the extent action has already been taken. If these policies become changed in any way, you will be notified.
There are some instances where written authorization will not be secured prior to disclosure. With your consent to this document,
the law allows your PHI to be used within my office so that business operations can be executed. Your PHI will be used within my office
so that administrative staff can complete billing.
Should you have questions or concerns about the policies stated in this notice or if you believe your privacy rights have been violated,
please discuss the issue with me immediately so that we can solve the problem. Written complaints can also be forwarded to the
Secretary of the Department of Human Services. I can provide you with the appropriate address, upon request.
