Notice of Privacy Practices | Ryan J. Glode, LMHC

NOTICE OF PRIVACY PRACTICES

Ryan J. Glode, LMHC, LLC
331 Broadway, Suite 104
Providence, RI 02909
Phone: 401-285-0958
Email: ryan@ryanjglodelmhc.com
Website: ryanjglodelmhc.com

Effective Date: January 1, 2027

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY COMMITMENT TO YOUR PRIVACY

I am committed to protecting the privacy and security of your health information. In providing psychotherapy services, I create and maintain records related to your evaluation, treatment, and care. These records may contain protected health information (PHI), including information about your mental health, treatment, and payment for services.

This Notice of Privacy Practices explains how I may use and disclose your PHI, your rights regarding that information, and my legal responsibilities under the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state laws.

I am required by law to:

Maintain the privacy and security of your PHI.
Provide you with this Notice of Privacy Practices.
Follow the terms of the Notice currently in effect.
Notify you following a breach of unsecured PHI when notification is required by law.
Comply with applicable federal and state confidentiality requirements, including laws that provide additional protections for mental health information.

Additional State Confidentiality Protections: I provide psychotherapy services in Rhode Island and Massachusetts. Mental health treatment records and communications may be subject to additional confidentiality protections under Rhode Island and Massachusetts law. I will comply with applicable federal and state confidentiality requirements, including any state laws that provide greater privacy protections than HIPAA. Uses and disclosures of your health information, including those for treatment, payment, healthcare operations, professional consultation, and legal proceedings, remain subject to any additional consent requirements or restrictions imposed by applicable law.

II. HOW I MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

I may use or disclose your PHI for treatment, payment, and healthcare operations as permitted by applicable law. Certain uses and disclosures may be subject to additional restrictions under federal or state confidentiality laws.

Treatment: I may use your PHI to provide psychotherapy, develop treatment plans, evaluate progress, coordinate care, and consult with other qualified healthcare professionals. For example, I may communicate with another treating provider when legally permitted and clinically appropriate.

Payment: I may use or disclose PHI to obtain payment for services, including submitting insurance claims, verifying benefits, and processing billing information. For example, an insurance company may require information about your diagnosis, dates of service, or treatment to process a claim.

Healthcare Operations: I may use or disclose PHI as permitted by law to manage and administer my practice, maintain records, conduct quality improvement activities, and comply with professional and regulatory requirements.

Appointment Reminders and Treatment-Related Communications: I may use your contact information to provide appointment reminders, communicate about scheduling, and inform you about treatment alternatives or other healthcare services that may be relevant to your care.

III. USES AND DISCLOSURES THAT MAY BE PERMITTED OR REQUIRED BY LAW

In addition to treatment, payment, and healthcare operations, I may use or disclose PHI without your written authorization in certain circumstances permitted or required by applicable law.

These may include:

Risk of Harm: To prevent or lessen a serious threat to health or safety when disclosure is legally permitted or required.
Abuse or Neglect: To report suspected child abuse or neglect, or abuse, neglect, or exploitation of older or vulnerable adults, when applicable reporting requirements are met.
Public Health Activities: To comply with legally authorized public health reporting or other public health requirements.
Health Oversight Activities: To comply with authorized audits, investigations, inspections, or other regulatory activities.
Judicial and Administrative Proceedings: I may disclose health information in response to a court order, subpoena, or other legal process only when disclosure is permitted or required under applicable federal and state law. Mental health treatment records and confidential communications may be protected by additional legal privileges. A subpoena alone does not necessarily authorize or require disclosure, and I will evaluate applicable confidentiality requirements before releasing information.
Law Enforcement: To respond to certain legally authorized law enforcement requests, subject to applicable confidentiality protections.
Medical Examiners and Coroners: To provide information when necessary for duties authorized by law.
Research: To participate in research activities only when applicable privacy requirements and legal safeguards are satisfied.
Workers' Compensation: To comply with applicable workers' compensation laws.
Specialized Government Functions: To comply with certain legally authorized government activities, such as military, national security, or correctional institution functions.
Other Legal Requirements: To make disclosures otherwise required by federal or state law.

These examples do not mean that information will automatically be disclosed whenever requested. All disclosures are subject to applicable legal requirements, including any heightened confidentiality protections.

Potential Redisclosure: Information disclosed as permitted or required by law may be subject to further disclosure by the recipient and may no longer be protected by HIPAA. Additional federal or state confidentiality laws may continue to restrict certain uses or disclosures.

IV. USES AND DISCLOSURES REQUIRING WRITTEN AUTHORIZATION

Except as otherwise described in this Notice or permitted or required by applicable law, I will use or disclose your protected health information only with your written authorization.

Written authorization is generally required for:

Uses or disclosures of PHI for marketing purposes, subject to applicable exceptions.
Disclosures that constitute a sale of PHI.
Most uses or disclosures of separately maintained psychotherapy notes, if such notes exist.
Other uses or disclosures requiring authorization under applicable law.

Psychotherapy Notes: Psychotherapy notes, as defined under HIPAA, are notes maintained separately from the regular clinical record that document or analyze the contents of psychotherapy sessions. If I maintain such notes, most uses or disclosures will require your written authorization. Limited exceptions may apply, including my own use of the notes for treatment, qualifying training or supervision activities within my practice, and other uses or disclosures specifically permitted or required by law.

Regular clinical progress notes are part of your treatment record and do not qualify as psychotherapy notes solely because they document psychotherapy services.

I do not sell your PHI or use it for marketing unrelated products or services.

If you provide written authorization for a disclosure, you may revoke that authorization in writing at any time, except to the extent that action has already been taken in reliance on it or another legal exception applies.

V. DISCLOSURES TO FAMILY MEMBERS AND OTHERS INVOLVED IN YOUR CARE

In certain circumstances, I may share relevant PHI with a family member, close friend, or another person involved in your care or payment for your care, consistent with your preferences and applicable law.

When appropriate, you will have an opportunity to agree to or object to such disclosures. If you are unable to express your preferences, limited information may be shared when legally permitted and determined to be in your best interest.

Additional confidentiality considerations apply when treating minors. Parents or legal guardians may have certain rights to information, subject to applicable laws governing minor consent, confidentiality, and access to treatment records.

VI. ADDITIONAL PROTECTIONS FOR SUBSTANCE USE DISORDER RECORDS

Certain substance use disorder treatment records are subject to additional confidentiality protections under federal law, including 42 CFR Part 2.

If I receive or maintain records protected by Part 2, I will use and disclose them only as permitted by applicable law and any required patient consent. When a patient has provided valid consent for treatment, payment, and healthcare operations, certain subsequent uses and disclosures may be permitted under HIPAA, subject to applicable restrictions.

Part 2-protected records, and testimony describing their contents, generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or an appropriate court order issued after notice and an opportunity to be heard, as provided by applicable law. A court order authorizing disclosure must be accompanied by a subpoena or other legally sufficient requirement compelling disclosure.

These additional protections apply when records are subject to Part 2, regardless of whether substance use disorder treatment is the primary focus of services provided by my practice.

VII. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights regarding your PHI, subject to applicable legal requirements.

1. Right to Access Your Records

You have the right to inspect and obtain an electronic or paper copy of your health information maintained in your designated record set, subject to limited legal exceptions.

I will respond to requests within the time required by law, generally within 30 days, unless a permitted extension applies. Reasonable, cost-based fees may apply when authorized by law.

2. Right to Request an Amendment

If you believe that information in your record is inaccurate or incomplete, you may request an amendment.

I may deny a request under certain legally permitted circumstances. I will respond to your request within 60 days, unless a legally permitted extension applies. If your request is denied, you will receive a written explanation and information about your rights.

3. Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your PHI for treatment, payment, or healthcare operations. I am generally not required to agree to these requests.

However, when you pay out of pocket in full for a healthcare service, you may request that information relating solely to that service not be disclosed to your health plan for payment or healthcare operations. I am required to honor that restriction unless disclosure is required by law.

4. Right to Request Confidential Communications

You may request that I communicate with you about your health information in a particular manner or at a specific location to protect your privacy.

I will accommodate reasonable requests. You may submit your request directly to me using the contact information provided in this Notice.

5. Right to an Accounting of Disclosures

You may request an accounting of certain disclosures of your PHI made during the six years preceding your request, or a shorter period if requested.

Certain disclosures, including many disclosures for treatment, payment, and healthcare operations, are excluded from this accounting.

I will respond to your request within 60 days, unless a legally permitted extension applies. One accounting within a 12-month period will be provided without charge. A reasonable, cost-based fee may apply to additional requests, as permitted by law.

6. Right to Receive a Copy of This Notice

You may request a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.

7. Right to Designate a Personal Representative

A person legally authorized to act on your behalf may exercise certain privacy rights and make decisions regarding your health information, subject to applicable legal requirements.

I may request documentation establishing that person's authority before disclosing information or permitting the exercise of these rights.

8. Right to File a Complaint

You have the right to file a complaint if you believe your privacy rights have been violated.

You may submit a complaint directly to me using the contact information provided in this Notice. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
Phone: 1-877-696-6775
Website: https://www.hhs.gov/hipaa/filing-a-complaint/

You may also file a complaint regarding professional conduct or licensing matters with the appropriate licensing authority in Rhode Island or Massachusetts.

You will not be retaliated against for filing a complaint or exercising your privacy rights.

VIII. MY RESPONSIBILITIES

I am responsible for maintaining the privacy and security of your PHI and complying with applicable confidentiality laws.

I will:

Use and disclose your information only as permitted or required by applicable law or with your authorization.
Apply appropriate administrative, technical, and physical safeguards to protect your information.
Notify you of breaches of unsecured PHI when required by law.
Respect applicable restrictions on the use and disclosure of your information.
Follow the privacy practices described in the Notice currently in effect.

If you have questions about your privacy rights or the handling of your health information, you may contact me directly.

IX. CHANGES TO THIS NOTICE

I reserve the right to revise this Notice of Privacy Practices as permitted by law. Any revised Notice may apply to PHI already maintained by my practice, as well as information received in the future.

If this Notice is revised, the updated version will be made available upon request and posted at my office and on my practice website, as applicable, no later than its effective date.

X. PRIVACY CONTACT

Ryan J. Glode, M.A., LMHC
331 Broadway, Suite 104
Providence, RI 02909
Phone: 401-285-0958
Email: ryan@ryanjglodelmhc.com

Please direct questions, requests concerning your privacy rights, or complaints regarding privacy practices to the contact information above.