Affiliated with AdventHealth and Littleton Adventist Hospital

Privacy Practices

Horizon Neuropsychological Services

Effective Date: August 26, 2020

Horizon Neuropsychological Services

Effective Date:
August 26, 2020



During the process of providing services to you, the provider will obtain, record, and use mental health and medical information about you that is Protected Health Information. Ordinarily, that information is confidential and will not be used or disclosed, except in the specific regulatory exceptions described below:

What is “medical information?”
The term “medical information” is synonymous with the terms “personal health information” and “protected health information” for purposes of this Notice. It essentially means any individually identifiable health information (either directly or indirectly identifiable), whether oral or recorded in any form or medium, that is created or received by a health care provider (me), health plan, or other and relates to the past, present or future physical or mental health or condition of an individual (you); and the provision of health care (e.g. mental health) to an individual (you); or the past, present or future payment for the provision of health care to an individual (you).

I. Uses and Disclosures of Protected Information

      1. General Uses and Disclosures Not Requiring the Individual’s Consent. Practitioner will use and disclose Protected Health Information in the following ways.
        1. Treatment. Treatment refers to the provision, coordination or management of health care, including mental health care, and related services by one or more health care providers. For example, your provider may use your information to plan your course of treatment and consult with professional colleagues to ensure appropriate methods are being used to assist you.
        2. Payment. Payment refers to the activities undertaken by a health care provider, including a mental health provider, to obtain or provide reimbursement for the provision of health care. Your provider will use your information to develop accounts receivable information, bill you, and with your consent, provide information to your insurance company or other third-party payers for services provided. The information provided to insurers and other third-party payers may include information that identifies you, as well as your diagnosis, type of service, date of service, provider name/identifier, and other information about your condition and treatment. If you are covered by Medicaid, information will be provided to the State of Colorado’s Medicaid program, including, but not limited to, your treatment, condition, diagnosis, and services received.
        3. Health Care Operations. Health Care Operations refers to activities undertaken by Horizon Neuropsychological Services that are regular functions of the management and administrative activities. For example, Horizon Neuropsychological Services may use or disclose your health information in monitoring service quality, staff training and evaluation, medical reviews, obtaining legal services, auditing functions, compliance programs, business planning and accreditation, certification, licensing, and credentialing activities.
        4. Contacting the Individual. Horizon Neuropsychological Services may contact you to remind you of appointments and to tell you about treatments and other services that may be of benefit to you.
        5. Required by Law. Horizon Neuropsychological Services will disclose Protected Health Information when required by law or necessary for health care oversight. This includes, but is not limited to when (a) reporting child abuse or neglect; (b) a court-ordered release of information; (c) there is a legal duty to warn or take action regarding imminent danger to others; (d) the individual is a danger to self or others or gravely disabled; (e) a coroner is investigating the individual’s death; or (f) to health oversight agencies for oversight activities authorized by law and necessary for the oversight of the health care system, government health care benefit programs or regulatory compliance.
        6. Worker’s Compensation. We may disclose your PHI to comply with applicable laws surrounding worker’s compensation or other similar programs where applicable.
        7. Crimes on the Premises or Observed by the Provider. Crimes that are observed by Horizon Neuropsychological Services staff, crimes that are directed towards Horizon Neuropsychological Services staff, or crimes that occur on the premises will be reported to law enforcement.
        8. Business Associates. Some of the functions of your provider may be provided by contracts with business associates. For example, some of the billing, legal, auditing, and practice management services may be provided by contracting with outside entities to perform those services. In those situations, Protected Health Information will be provided to those contractors as is needed to perform their contracted tasks. Business Associates are required to enter into an agreement maintaining the Protected Health Information privacy of the Protected Health Information released to them.
        9. Research. Horizon Neuropsychological Services may use or disclose Protected Health Information for research purposes if the relevant limitations of the Federal HIPAA Privacy Rule are followed. 45 C.F.R. § 164.512(i).
        10. Involuntary Treatment. Information regarding individuals who are being treated involuntarily, pursuant to law, will be shared with other treatment providers, legal entities, third-party payers, and others, as necessary to provide the care and management coordination needed.
        11. Family Members. Except for certain minors, incompetent individuals, or involuntarily treated individuals, Protected Health Information cannot be provided to family members without the individual’s consent. In situations where family members are present during a discussion with the individual, and it can be reasonably inferred from the circumstances that the individual does not object, information may be disclosed in the course of that discussion. There also may be limited circumstances where discussion with your family members is deemed necessary and in your best interest and we may do that if necessary. However, if the individual objects, Protected Health Information will not be disclosed.
        12. Emergencies. In life-threatening emergencies, Horizon Neuropsychological Services will disclose information necessary to avoid serious harm or death.
      2. Statements That Certain Uses and Disclosures Require Authorization. Horizon Neuropsychological Services must obtain your Authorization or Consent to Release Information in order to use or disclose your Protected Health Information as follows: (1) for marketing purposes; (2) to sell your Protected Health Information to a third party; and (3) most uses and disclosures of your psychotherapy notes.
      3. Individual Authorization or Release of Information. Your provider may not use or disclose Protected Health Information in any other way than set forth in this notice without a signed authorization. When you sign an Authorization or Consent to Release Information, it may later be revoked, provided that the revocation is in writing. The revocation will apply except to the extent Horizon Neuropsychological Services has already taken action in reliance thereon.

II. Your Rights as an Individual

      1. Access to Protected Health Information. You have a right to inspect and obtain a copy of the protected health information Horizon Neuropsychological Services has regarding you, in the designated record set, by making a specific request in writing. If records are used or maintained as electronic health record, you have a right to receive a copy of the protected health information maintained in the electronic health record in an electronic format. This right to inspect and copy is not absolute- in other words, I am permitted to deny access for specified reasons. For instance, you do not have this right of access with respect to my “psychotherapy notes.” The term “psychotherapy notes” means notes recorded (in any medium) by a health care provider who is mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical (includes mental health) record. The term excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date. There are other limitations to this right, which will be provided to you at the time of your request, if any such limitation applies. To make a request, ask your provider.
      2. Amendment of your Record. You have the right to request that your provider amend your protected health information in his/her records by making a request to do so in writing that provides a reason to support the requested amendment. Your provider is not required to amend the record if it is determined that the record is accurate and complete. There are other exceptions, which will be provided to you at the time of your request, if relevant, along with the appeal process available to you. To make a request, ask your provider.
      3. Accounting of Disclosures. You have the right to receive an accounting of certain disclosures Horizon Neuropsychological Services has made regarding your protected health information. However, that accounting does not include disclosures that were made for the purpose of treatment, payment or health care operations. In addition, the accounting does not include disclosures made to you, disclosures made pursuant to a signed Authorization, or disclosures made prior to April 14, 2003. There are other exceptions that will be provided to you, should you request an accounting. To make a request, ask your provider.
      4. Additional Restrictions. You have the right to request additional restrictions on the use or disclosure of your protected health information. Unless you pay for your services out of pocket, your provider does not have to agree to that request, and there are certain limits to any restriction, which will be provided to you at the time of your request. If you pay for a service out of pocket, you are permitted to demand that information regarding the service not be disclosed to your health plan or insurance. To make a request, ask your provider. If a request is granted, Horizon Neuropsychological Services will maintain a written record of the agreed-upon restriction.
      5. Alternative Means of Receiving Confidential Communications. You have the right to request that you receive confidential communications of protected health information from your provider by alternative means or at alternative locations. There are limitations to the granting of such requests, which will be provided to you at the time of the request process. To make a request, ask your provider.
      6. Marketing. Horizon Neuropsychological Services engages in marketing and will obtain your authorization before we use your Protected Health Information to contact you with your marketing communications.
      7. Breach Notification. In the event of any breach of your unsecured Protected Health Information, Horizon Neuropsychological Services will notify you of such breach within sixty (60) days of the date your provider learns of the breach.
      8. Copy of this Notice. You have a right to obtain another copy of this notice upon request.

III. Additional Information

      1. Privacy Laws. Horizon Neuropsychological Services is required by State and Federal law to maintain the privacy of protected health information. In addition, Horizon Neuropsychological Services is required by law to provide individuals with notice of its legal duties and privacy practices with respect to protected health information. That is the purpose of this Notice.
      2. Terms of the Notice and Changes to the Notice. Horizon Neuropsychological Services is required to abide by the terms of this Notice, or any amended Notice that may follow. Horizon Neuropsychological Services reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all protected health information that it maintains. When the Notice is revised, the revised Notice will be posted in Horizon Neuropsychological Services, LLC’s office(s) and will be available upon request.
      3. Complaints Regarding Privacy Rights. If you believe your privacy rights may have been violated either by your provider or by those who are employed by Horizon Neuropsychological Services, LLC, you may file a complaint with your provider by providing a writing that specifies the manner in which you believe the violation occurred, the approximate date of such occurrence, and any details that you believe will be helpful. You also have the right to complain to the United States Secretary of Health and Human Services by sending your complaint to:

        Regional Manager, Office for Civil Rights
        U.S. Department of Health and Human Services
        999 18th Street, Suite 417 Denver, Colorado 80294
        Phone: (800) 368-1019; Fax: (303) 844-2025; TDD: (800) 537-7697

      4. Contact Information. If you have questions about this Notice or desire additional information about your privacy rights, please contact our Privacy Officer at:

        Dr. Meghan T. Lee
        Horizon Neuropsychological Services
        7720 S. Broadway Suite 300 Littleton, CO 80202
        Phone: (720) 242-7533;

      5. Effective Date. This Notice is effective August 26, 2020.