Effective Date: August 1, 2026
Our Commitment to Your Privacy
Allen Psychology, LLC is dedicated to maintaining the privacy of your protected health information (PHI), which includes information about your health condition and the care and services you receive from this practice. In conducting business, records will be created regarding you and the treatment and services provided to you. This notice applies to those records.
This notice explains your privacy rights regarding your PHI, our legal duties concerning your PHI, and our privacy practices, both currently and as they may change in the future. It also describes how your PHI may be used and disclosed to third parties.
How We May Use and Disclose Health Information About You
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your care and any related services. This includes coordination and management of your care with other providers, such as your pediatrician, psychiatrist, or a school professional, when you have authorized that communication.
For Payment
We may use and disclose your PHI so that services you receive may be billed and payment collected from you or, where applicable, an insurance carrier for reimbursement purposes. This practice operates on a self-pay basis and does not bill insurance directly, but a superbill containing PHI (such as diagnosis and procedure codes) may be provided to you at your request so that you may seek reimbursement from your insurer.
For Health Care Operations
We may use and disclose your PHI for our own operations to facilitate the functioning of the practice and as necessary to provide quality care to all patients. Health care operations include quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities.
Other Uses and Disclosures That Do Not Require Your Authorization
We may use or disclose your PHI without your written authorization in the following circumstances, as permitted or required by law:
- As Required by Law: We will disclose PHI when required to do so by federal, state, or local law.
- Public Health Activities: We may disclose PHI for public health activities, such as reporting to a public health authority to prevent or control disease, injury, or disability.
- Health Oversight Activities: We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
- Judicial and Administrative Proceedings: We may disclose PHI in the course of a judicial or administrative proceeding in response to a court order, subpoena, or other lawful process.
- Law Enforcement: We may disclose PHI to a law enforcement official for certain law enforcement purposes, as permitted or required by law.
- To Avert a Serious Threat to Health or Safety: We may disclose PHI when necessary to prevent a serious threat to your health or safety, or the health or safety of the public or another person.
- Mandatory Reporting: As required by state law, we must report suspected abuse or neglect of a child, elder, or dependent adult to the appropriate authorities.
- Workers’ Compensation: We may disclose PHI as authorized by, and to the extent necessary to comply with, workers’ compensation laws.
- Military and National Security: We may disclose PHI of members of the armed forces as required by military command authorities, or for national security purposes, in accordance with applicable law.
Uses and Disclosures Requiring Your Written Authorization
Other than as described above, we will not use or disclose your PHI without your written authorization. This includes, in most circumstances, psychotherapy notes, which are given additional protection under HIPAA and generally require a separate, specific authorization for release. You may revoke a prior authorization, in writing, at any time, except to the extent that we have already taken action in reliance on it.
Your Rights Regarding Your Health Information
- Right to Inspect and Copy: You have the right to inspect and obtain a copy of PHI that may be used to make decisions about your care, with certain exceptions such as psychotherapy notes.
- Right to Amend: You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. This request must be made in writing and must include a reason for the request.
- Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures of your PHI made by this practice, other than disclosures made for treatment, payment, health care operations, or disclosures you have separately authorized.
- Right to Request Restrictions: You have the right to request a restriction on certain uses or disclosures of your PHI. We are not required to agree to every requested restriction, except in certain circumstances involving disclosures to a health plan when you have paid out of pocket in full.
- Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location, such as contacting you only at a specific phone number or address.
- Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of this notice at any time, even if you have agreed to receive it electronically.
- Right to Be Notified of a Breach: You have the right to be notified in the event that we, or a business associate, discover a breach of your unsecured PHI.
To exercise any of these rights, please submit a written request to the contact listed at the end of this notice.
Our Responsibilities
- We are required by law to maintain the privacy of your PHI and to provide you with this notice describing our legal duties and privacy practices.
- We are required to abide by the terms of this notice currently in effect.
- We reserve the right to change the terms of this notice and to make new provisions effective for all PHI we maintain, including PHI created or received before the change. If we change this notice, we will make the revised notice available upon request and, where required, post it prominently.
- We will not use or disclose your PHI without your written authorization, except as described in this notice.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with this practice or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with this practice, contact the individual listed below. All complaints must be submitted in writing. You will not be penalized, and your care will not be affected, for filing a complaint.
To file a complaint with the Department of Health and Human Services, Office for Civil Rights, visit hhs.gov/ocr/privacy/hipaa/complaints or call 1-800-368-1019.
Contact Information
Questions about this notice, or requests to exercise any of the rights described above, should be directed to Korrie Allen, PsyD, ABSNP, Allen Psychology, LLC, 9715 Medical Center Drive, Suite 535, Rockville, MD 20850, korrie.allen@allenpsych.com.
