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Interesting clause in HIPPA

I had to go get a hand x-ray this morning. I hadn't been to the imaging place this year, so they needed me to fill out the paperwork again. As I was reading the paperwork, I noticed that in the HIPPA paperwork, it described the fact that I'm entitled to copies of my medical records, etc. Standard stuff that I already knew, and you all probably already know.

But what I found interesting was the clause that listed the things we can't get copies of. One is any notes or paperwork created with the intent of using it in court - makes sense. No one wants to give the other side ammo.

But it also says you're not entitled to any pyschotherapy notes. That's the one I don't understand. If you're seeing a therapist, you know you have issues, and the therapist is going to tell you what they think and what their diagnosis is, if there is one. So, why couldn't we have copies of those?

Obviously I'm missing something here. But to me, a therapist hiding things from you would inhibit your progress and prevent you from getting healthy and/or stable. So, it seems anything in their notes would be something you already know.

So, can anyone tell me what I'm missing here? (And no, I've never been to a therapist, so if I'm wrong about anything I said, please feel free to [politely] correct me.)

Answer Question

Asked by wendythewriter at 12:29 PM on Dec. 3, 2012 in Health

Level 33 (61,976 Credits)
Answers (7)
  • Maybe you can't since they are "copies" & need to be made by a third party (Secretary, Receptionist etc. ) who is not entitled by law to see that Personal information about a Patient.

    Answer by ILovemyPaulie at 12:34 PM on Dec. 3, 2012

  • So, it's been a while since I took my HIPAA classes but, if I recall correctly, some facilities do not consider your psychotherapy notes part of your primary medical chart/record and, as such, are not subject to HIPAA requirements for PHI release to the patient.

    Having said that, HIPAA provides sort of "ground level" guidelines but your healthcare provider office can make additional requirements as long as they are within the HIPAA scope.

    I hope that makes sense :(

    Answer by Mrs_Prissy at 12:41 PM on Dec. 3, 2012

  • It does make sense. All I really remembered of HIPPA was basically that they couldn't give my info out to just anyone and that I could get copies of my records. So it just kind of struck me as odd, but both the answers you ladies have given me so far would make sense.

    Comment by wendythewriter (original poster) at 12:45 PM on Dec. 3, 2012

  • According to HIPAA, psychotherapy notes are considered separate from regular PHI, and have further protection because they belong to the clinician. However, the psychotherapy notes have to fall under certain guidelines.

    Some facilities have used their own versions of HIPAA forms and so the psychotherapy part of it is sometimes taken out if it doesn't apply to that facility's specialty. However, many facilities who have gone to EMR recently have begun using more standardized forms and that could be why you are just now noticing it.

    Answer by anime_mom619 at 1:13 PM on Dec. 3, 2012

  • I should also add that the psychotherapy part of it pertains more to other providers obtaining your therapy notes than anything else. The idea is to protect that very private information and prevent other healthcare practitioners from refusing to see you based on your psych history. If a person really wanted their psychotherapy notes, they could likely work it out with the therapist to obtain them.

    Answer by anime_mom619 at 1:32 PM on Dec. 3, 2012

  • Psych notes are protected seperately for a variety of reasons. 1. some psych patients truly dont need access to all of their notes. That should be left to the provider's discretion. Someone being treated for depression is likely ok to read all their notes... a paranoid schizophrenic with homicidal tendencies... not so much. Or someone diagnosed with dissociative identity disorder. There is no way they could handle reading their chart notes. 2. HIPPA does that to protect the patient from certain insurance issues. Some psych disorders are Axis II disorders and not paid by insurance companies. However, if a doctor starts treating you for this issue, or any co-occuring issues, then they are ethically mandated to keep treating you even if they wont be paid by your insurance co. So, some docs want to see your charts ahead of time to see if you have any of these diagnosis, and refuse you if you do...

    Answer by Nimue930 at 3:17 PM on Dec. 3, 2012

  • anime and Nimue - those are things I never even considered. Because of the wording of it, I was thinking of it in terms of *I* can't get them, and wondering why *I* can't have copies of notes that are about me (if I was in therapy). But the idea that it's to prevent another doctor from refusing to treat you - that makes a lot of sense. And I hadn't really thought about the more serious disorders - I wasn't thinking that there are some cases where it could be harmful for someone to read all the notes.

    Thanks, ladies!

    Comment by wendythewriter (original poster) at 5:22 PM on Dec. 3, 2012

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