The Doctor-Patient Relationship
The information on www.livemoresimply.com is for general information or educational purposes only and can in no way substitute for clinical and/or healthcare services. Visiting this website or contacting me by email, text or telephone, does not constitute or establish a professional or therapeutic relationship. A relationship between doctor and a patient can only be established in person, in my office and after you have completed all the necessary documents and met with me in person to discuss your condition and testing and/or treatment alternatives. Neither are Meet & Greets clinical sessions. I cannot provide any clinical advise or consultation in an email or during a Meet & Greet.

If You Are Experiencing An Emergency.
I am not medically trained and the limitations of my licensing require me to inform you that in an emergency — medical, psychiatric, psychological, safety, health, welfare and/or others — you must contact 911. 911 will advise you to stay put or to go directly to a hospital emergency room or psychiatric hospital. After you call 911, you should also consider contacting your medical doctors and/or the proper government authority.

If You Need Medication, You Must Contact A Medical Doctor
I am not licensed or qualified to prescribe medication. I feel comfortable making suggestions to a patient’s psychiatrist or family doctor with the patient’s permission, and I will always take an active interest is what medications you take and at what dose. My treatment will not be complete without doing this. You need to clear any changes in your meds, however, with your medical doctors in advance. This is especially true in considering whether to stop medication abruptly, or whether to decrease or increase a dosage, as opposed to phasing out a medication, or to changing a dosage slowly over time. Abrupt changes to meds can be very dangerous and I strongly advise patients to never stop taking their medication as directed until discussing the implications with their physician in person. Until then, it is very important that patients remain on whatever medications currently prescribed.

Email and Texting Policy
I cannot offer the same degree of confidentiality for email as I for other forms of communication. When you email from a given account, I will assume that it is acceptable to return email to you at that same email address. While I will do my best to honor requests to return email to a different email address than the address from which your mail was sent, I do not have a system in place that can guarantee an error will not be made. Consequently, it’s best to refrain from emailing me from accounts you do not wish me to return mail to. Alternatively, you can avoid embarrassing situations by setting your email program to list the address you want your mail returned to as the address that will be accessed when I press the reply button. Because email accounts require a third party to maintain, I cannot guarantee the confidentiality and privacy protection provided by the vendors involved. While I endeavor to protect my computers from hackers, viruses, worms and other threats to the security of your correspondence, I regret that I cannot fully assure their protection. I understand that by initiating email correspondence and/or by providing you with my email address, I am agreeing to use email as an acceptable form of communication for confidential information. I can not protect your confidentiality when you text me.

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

I. Uses and Disclosures for Treatment, Payment, and Health Care Operations

I may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. To help clarify these terms, here are some definitions:

• “PHI” refers to information in your health record that could identify you.
• “Treatment, Payment and Health Care Operations”

– Treatment is when I provide, coordinate or manage your health care and other services related to your health care. An example of treatment would be when I consult with another health care provider, such as your family physician or another psychologist.

– Payment is when I obtain reimbursement for your healthcare. Examples of payment are when I disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.

– Health Care Operations are activities that relate to the performance and operation of my practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.

• “Use” applies only to activities within my [office, clinic, practice group, etc.] such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
• “Disclosure” applies to activities outside of my [office, clinic, practice group, etc.], such as releasing, transferring, or providing access to information about you to other parties.

II. Uses and Disclosures Requiring Authorization

I may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances when I am asked for information for purposes outside of treatment, payment and health care operations, I will obtain an authorization from you before releasing this information. I will also need to obtain an authorization before releasing your psychotherapy notes. “Psychotherapy notes” are notes I have made about our conversation during a private, group, joint, or family counseling session, which I have kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI.

You may revoke all such authorizations (of PHI or psychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.

III. Uses and Disclosures with Neither Consent nor Authorization

I may use or disclose PHI without your consent or authorization in the following circumstances:

§ Child Abuse: If I have reasonable cause to believe that a child has suffered abuse or neglect, I am required by law to report it to the proper law enforcement agency or the Department of Social and Health Services.

§ Health Oversight: If the Texas Examining Board of Psychology subpoenas me as part of its investigations, hearings or proceedings relating to the discipline, issuance or denial of licensure of state licensed psychologists, I must comply with its orders. This could include disclosing your relevant mental health information.

§ Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about the professional services that I have provided to you and the records thereof, such information is privileged under state law, and I will not release information without the written authorization of you or your legal representative, or a subpoena of which you have been properly notified and you have failed to inform me that you are opposing the subpoena, or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.

§ Serious Threat to Health or Safety: I may disclose your confidential mental health information to any person without authorization if I reasonably believe that disclosure will avoid or minimize imminent danger to your health or safety, or the health or safety of any other individual.

§ Worker’s Compensation: If you file a worker’s compensation claim, with certain exceptions, I must make available, at any stage of the proceedings, all mental health information in my possession relevant to that particular injury in the opinion of the Department of Labor and Industries, to your employer, your representative, and the Department of Labor and Industries upon request.

IV. Patient’s Rights and Psychologist’s Duties

Patient’s Rights:

• • Right to Request Restrictions –You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, I am not required to agree to a restriction you request.
  • Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing me. Upon your request, I will send your bills to another address.)
  • Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI and psychotherapy notes in my mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. I may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. On your request, I will discuss with you the details of the request and denial process.
  • Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. I may deny your request. On your request, I will discuss with you the details of the amendment process.
  • Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization (as described in Section III of this Notice). On your request, I will discuss with you the details of the accounting process
  • Right to a Paper Copy – You have the right to obtain a paper copy of the notice from me upon request, even if you have agreed to receive the notice electronically.

Psychologist’s Duties:

• I am required by law to maintain the privacy of PHI and to provide you with a notice of my legal duties and privacy practices with respect to PHI.
• I reserve the right to change the privacy policies and practices described in this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect.
• If I revise my policies and procedures, I will date and post a copy of the revisions to the Professional Policies Page.

V. Questions and Complaints

If you have questions about this notice, disagree with a decision I make about access to your records, or have other concerns about your privacy rights, you may contact me, Stuart N. Robinson, Ph.D. at 888-923-2256.

If you believe that your privacy rights have been violated and wish to file a complaint with me/my office, you may send your written notice of your complaint to me, Stuart N. Robinson, Ph.D., 10260 N. Central Expy, Suite 274, Dallas, TX, 75231.

You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. I will be happy to provide you with the appropriate address upon request.

You have specific rights under the Privacy Rule. I will not retaliate against you for exercising your right to file a complaint.

VI. Effective Date. Restrictions and Changes to Privacy Policy

This notice will go into effect on January 23, 2010.

I reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI that I maintain. Revisions to this notice will be posted to this website at the time of revision. I will be happy to provide you with a written copy of these revisions upon request.

There are 3 things you could lose when you use health insurance…

• You could lose privacy
• You could lose control
• You could lose peace of mind

You could lose privacy
In the past, therapists only needed to provide a diagnostic code to insurance companies. They require a thorough description of your problems, history, family life, work life, and so on. Insurance companies almost always require a psychiatric diagnosis, which then becomes a permanent part of your medical history, accessible along with your non-psychological records, to any physician or hospital you authorize. This information can also be viewed by employees of both the insurance company, managed care company and sometimes by your employers. This all puts your privacy at risk.

You could lose control over your healthcare
Insurance and managed care companies can decide if they think your treatment is “medically necessary.” Even if you or I feel like you need help, they can deny paying for it. Company representatives who do not know either you or me, and who may be working in another state, often with the benefit of little psychological training, are empowered to make decisions about the type and amount of testing and therapy that is appropriate for you; insurance companies rarely cover an unlimited number of sessions, so that you may have to quit therapy or suddenly begin paying a much higher fee, if you wish to continue beyond their willingness to reimburse your costs.

You could lose peace of mind.
Using your insurance company to pay for therapy can cause your premiums to go up after making a claim(s). Life and disability insurance may be affected as well. In addition, future employers may receive background checks that include your history in therapy if you use insurance.

What costs should I expect if I use my insurance?
We have developed this list of specific questions to ask you insurance company so you can get an accurate answer to this question. Insurance companies often directly increase you out of pocket expense by:

• Imposing an annual deductible you must pay before they begin to reimburse
• Increasing the size of your co-payment for each visit.
• Reducing the number of visits allowed per year, or hiding your costs by labeling them “co-insurance” (which means you pay, not them).

The indirect means of reducing benefits paid to you include: requiring “pre-authorization” for every 5 visits, requiring clinical information be supplied to them before they “authorize” continued therapy, making “customer service” difficult to find and time-consuming to use, and refusing to pay for service until you appeal.

What costs can I expect without health insurance?
If you are contemplating long-term, ongoing therapy, your costs might be as high as your monthly car payment for a while. If your therapy turns out to be brief, your out-of- pocket costs actually may be very small. If your in-network benefits are not much different from your out of network benefits, the actual difference between the two may be minimal. The insurance questions listed above should help you figure this out. I will be glad to help you find the best solutions for your personal situation.