DOVETAIL PRIVACY PRACTICES
Revised: May 1, 2008
If you have any questions about his policy or your rights contact the Privacy Officer of Dovetail, Evan Peterson, LCSW, at 888-275-3683 or by mail to: Dovetail, 60 W. Terra Cotta Ave #227, Crystal Lake, Illinois 60014. Please do not use e-mail to send confidential information.
USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
Dovetail Employee Assistance Program (EAP) respects your confidentiality and will only release information about you according to state and federal law. We will only use minimum necessary information to accomplish any task.
Information Within Dovetail. In order to effectively provide services, we will share your information within Dovetail. We will use information to coordinate services, including setting up your appointments and reviewing the work of our counselors. We may contact you to remind you of future appointments and information about referrals and treatment alternatives. We will not leave messages on voicemail without your permission. Dovetail will not send you email unless you specifically request that we send you email to assist you with referrals to Work/Life resources.
Referrals Outside Dovetail. We will use or disclose information when necessary to provide referrals to Work/Life resources not related to health care. With your consent, we will use or disclose information when we make a referral to others who provide services not offered by the EAP and to assist you in finding potential resources and coordinating benefits with your insurance company.
Payments To Dovetail. Dovetail EAP services are paid for by your employer. Dovetail will not contact your insurance company to bill for our services.
Managed Care. If Dovetail provides behavioral health and chemical dependency managed care for your employer, we will receive information about your care from your providers and will share the minimum necessary information to coordinate treatment with your providers and with the third party administrator or insurance company in order for your services to be reimbursed according to your insurance policy.
Information Disclosed By Law. Under state and federal law, information about you may be disclosed without consent in these circumstances:
Emergencies: Sufficient information may be shared to assist you in an emergency, which includes if we believe you are a risk to yourself or others. ILLINOIS CLIENTS ONLY: As of June 1, 2008, if a counselor reasonably believes that you have a condition that poses a clear and present or imminent danger to the patient, any other person or the community, it must be reported in compliance with Illinois Public Act 95-0564.
As Required by Law: We will provide information as legally required by a subpoena, court order, and as mandated by law, including suspected child and elder abuse and neglect, and with a coroner or medical examiner. We are required to disclose information to a health oversight agency for activities authorized by law, such as audits and investigations.
Criminal Activity: If a crime is committed on our premises or against our personnel we may share information with law enforcement to assist them in apprehending the criminal.
PATIENT RIGHTS
Copy of Record. You may inspect the record we have generated about you. We may charge you a reasonable fee for copying and mailing your record.
Release of Records. You may consent in writing to release of your records to others. This may include your employer or others providers you wish to have knowledge of your counseling. You may revoke this consent at any time. You may in a written request to the Vice President of Dovetail ask us not to use or disclose part of your information.
Amending Record. If you believe that something in your record is incorrect or incomplete, you may request we amend it. To do this contact the Vice President of Dovetail and ask for the Request to Amend Health Information form. In certain cases, we may file a response to your statement and add that to your record.
Accounting for Disclosures. You may request an accounting of any disclosures we have made related to your information, except for information we used within Dovetail, with you, information that you gave us specific consent to release, and information we are legally required to release. To receive information regarding disclosures made for a specific time period no longer than six years after January 1, 2003, submit your request in writing to the Vice President of Dovetail. We will notify you if there is a cost for the report.
Questions and Complaints. If you have any questions, wish a copy of this Policy, or have any complaints you may contact the Vice President of Dovetail in writing at our office for further information. You may complain to the Secretary of US Health and Human Services if you believe Dovetail EAP has violated your privacy rights.
Changes To This Policy. Dovetail EAP may change this Privacy Policy in the future based on our needs and changes in state and federal law.
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Web Site Privacy Statement. This web site and all contents are copyright 2005-2008 Dovetail, Inc., all rights reserved, with the exception of the logos provided to us for links, which are used with the gracious permission of the folks who own the logos. This site uses no cookies and we do not track user Internet activity outside of this web site. The supervisor's corner page and others with access restricted to users with passwords are exclusively for the private use of supervisors in our client organizations. Access to these areas is not guaranteed. We log access to restricted areas and reserve the right to grant access or exclude individuals at our discretion.
Web Site Terms of Use. By using this web site, you agree to hold Dovetail, its owners, and staff harmless for any act or omission associated with its use. Dovetail, Inc., provides this web site as a courtesy and makes no warranty as to its accuracy or usefulness in any particular situation. Access to any restricted area of Dovetail's web site is not a right. Access is at the sole discretion of Dovetail, Inc., and may be withdrawn at any time and for any reason. Although we made every effort to use simple and generally compatible code, access to this site and it's features can't be guaranteed for every Internet browser. We made every effort for it to be accurate when we uploaded the content but the Internet is a wild and woolly place and if our stuff gets scrambled or some ne'er-do-well hacks it, we will try to fix it - so please let us know.
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