The information you share with me is confidential with several exceptions (see limits to confidentiality and use of insurance).
For the most part, I cannot speak to anyone about your treatment without written authorization from you. You choose whether you would like me to speak with anyone and the limits of information which I can discuss with an outside party.
In some cases I may recommend a release to include a physician and emergency contact, but ultimately the decision is yours.
Limits to confidentiality:
There are a few instances when I am legally and ethically obliged to break our confidentiality:
- The client expresses a clear and imminent intent to do serious harm to himself/herself or someone else. The State Law of Ohio requires that others be informed if a client threatens to harm herself/himself, or others. If that threat is perceived to be serious, the proper individuals and law enforcement must be contacted. The person against whom the threat has been made may also be contacted to prevent harm.
- There is evidence or reasonable suspicion of abuse/neglect against a minor child, elder person (65 or older), or disabled adult.
- Should I be presented with a court order, I may be required to disclose information in the presence of a judge.
In the event of any of these situations, I will discuss them with you during our session or on the phone before taking any action.
Use of insurance and limits to confidentiality:
Health insurance companies require that a statement of diagnosis of a mental health condition be indicated before they will agree to reimburse for therapy services. If you choose to use your health insurance to pay for psychotherapy, your insurance company will ask me to submit your clinical diagnosis, dates of service, length of sessions, and charges for each session. I am not able to protect confidentiality of this information once it is shared with the insurance company. At your first visit you will be asked to give me a signed permission to provide this information to your insurance company.
Any diagnosis made will become part of your permanent insurance records.
It is important to remember that you always have the right to pay for my services yourself to avoid the release of any information about you. An increasing number of our clients are choosing this option. While insurance can help defray the cost of our services, clients express the following concerns:
- Clinical diagnosis. Insurance companies require there to be a clinical diagnosis in order to reimburse for services. Thus, we will discuss what clinical diagnosis you meet during our initial meeting. If you self-pay, then no diagnosis is filed with an insurance company and there is no record of your treatment unless you choose to share with others.
- Loss of confidentiality. If your insurance is managed care, your therapist may be required contractually to write detailed updates periodically to the managed care company. It is then possible that some of the issues discussed in counseling could be logged into an insurance computer. While managed care companies generally endeavor to keep this information private, insurance companies can share information with each other if you apply for coverage elsewhere.
- Future Insurance Denial/Rating.Clients sometimes find that because of previous psychological/psychiatric diagnoses, that they are either unable to get health, disability, or life insurance coverage in the future, or are required to pay higher premiums. Even if you don’t tell an insurance company on your application that you have had treatment, all medical services are logged with the Medical Information Bureau each time your provider bills an insurance company. If you self-pay, then no diagnosis is filed in insurance computers, and thus there is no record of treatment outside of our office, unless you choose to share this.
- Promotion Difficulties. Before making promotion decisions some companies check the health/insurance records of their employee without the employees’ knowledge or consent.