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Useful Web Links & Policies
LINKS TO OTHER WEBSITES:
Dr. Varady's Wellness Tips
Eating Disorder Referral and Information Center
American Psychological Association Help Center
Mental Health Links, North Carolina Psychological Association
National Institute of Sports Professionals
Motivated Results - nutritional and metabolic assessment
Juice Plus+ Whole Food Nutritional Capsules
My ED Help Website
Something Fishy Eating Disorder Site
US Government Nutrition and Exercise Guidelines
William Alanson White Institute
Wellness Forum
Dr. Varady's Wellness Tips
Eating Disorder Referral and Information Center
American Psychological Association Help Center
Mental Health Links, North Carolina Psychological Association
National Institute of Sports Professionals
Motivated Results - nutritional and metabolic assessment
Juice Plus+ Whole Food Nutritional Capsules
My ED Help Website
Something Fishy Eating Disorder Site
US Government Nutrition and Exercise Guidelines
William Alanson White Institute
Wellness Forum
GENERAL POLICIES:
Full payment is required at the time of service.
Cancellations must be made at least 24 hours in advance to avoid the full-session fee
for late cancellation.
Psychotherapy sessions last 45-50 minutes, initial evaluations last 60 minutes, and
psychological testing sessions are usually longer in duration.
Information discussed in evaluations and psychotherapy sessions is held confidential,
except as limited by law (see policies to protect health information section below).
In the event of a psychiatric emergency and Dr. Varady is unavailable in person or by
phone, clients agree to contact their psychiatrist, their local emergency room, or dial 911.
Full payment is required at the time of service.
Cancellations must be made at least 24 hours in advance to avoid the full-session fee
for late cancellation.
Psychotherapy sessions last 45-50 minutes, initial evaluations last 60 minutes, and
psychological testing sessions are usually longer in duration.
Information discussed in evaluations and psychotherapy sessions is held confidential,
except as limited by law (see policies to protect health information section below).
In the event of a psychiatric emergency and Dr. Varady is unavailable in person or by
phone, clients agree to contact their psychiatrist, their local emergency room, or dial 911.
NOTICE OF PSYCHOLOGISTS’ POLICIES AND PRACTICES TO
PROTECT THE PRIVACY OF YOUR HEALTH INFORMATION
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
Dr. Varady 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:
Treatment is when Dr. Varady provides, coordinates or manages 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 Dr. Varady obtains reimbursement for your health care. Examples of payment are when Dr. Varady
discloses 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 a psychology 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.
II. Uses and Disclosures Requiring Authorization
releasing this information. Dr. Varady will also need to obtain an authorization before releasing your releasing this
information. Dr. Varady will also need to obtain an authorization before releasing your psychotherapy notes.
“Psychotherapy notes” are notes she might make about conversations during a private, group, joint, or family
counseling session, which she would keep separate from the rest of your medical record. These notes are given a
greater degree of protection than PHI.
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) Dr. Varady has 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
IV. Patient's Rights and Psychologist's Duties
Patient’s Rights:
Psychologist’s Duties:
V. Questions and Complaints
If you have questions about this notice, disagree with a decision Dr. Varady makes about access to your records, or
have other concerns about your privacy rights, you may contact Susan Ann Varady, Ph.D. at her office, 704.847.4826.
If you believe that your privacy rights have been violated and wish to file a complaint with Dr. Varady and/or her office,
you may talk with Dr. Varady, or send your written complaint to Dr. Varady at: 9930 Monroe Road, Suite 103,
Matthews, NC 28105.
You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. The
person listed above can provide you with the appropriate address upon request.
You have specific rights under the Privacy Rule. Psychologists 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 01 March 2005. Dr. Varady reserves the right to change the terms of this notice and
to make the new notice provisions effective for all PHI that she maintains. Should she choose to make a change, she
will provide you with a revised notice either in person, or by mail.
PROTECT THE PRIVACY OF YOUR HEALTH INFORMATION
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
Dr. Varady 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 Dr. Varady provides, coordinates or manages 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 Dr. Varady obtains reimbursement for your health care. Examples of payment are when Dr. Varady
discloses 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 a psychology 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
releasing this information. Dr. Varady will also need to obtain an authorization before releasing your releasing this
information. Dr. Varady will also need to obtain an authorization before releasing your psychotherapy notes.
“Psychotherapy notes” are notes she might make about conversations during a private, group, joint, or family
counseling session, which she would keep separate from the rest of your medical record. These notes are given a
greater degree of protection than PHI.
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) Dr. Varady has 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
- Psychologists may use or disclose PHI without your consent or authorization in the following circumstances:
- Child Abuse: If you give Dr. Varady information, which leads her to suspect child abuse, neglect, or death due
to maltreatment, she must report such information to the county Department of Social Services. If asked by
the Director of Social Services to turn over information from your records relevant to a child protective services
investigation, she must do so.
- Adult and Domestic Abuse: If information you give Dr. Varady gives her reasonable cause to believe that a
disabled adult is in need of protective services, she must report this to the Director of Social Services.
- Health Oversight: The North Carolina Psychology Board has the power, when necessary, to subpoena
relevant records should Dr. Varady be the focus of an inquiry.
- Judicial or Administrative Proceedings: If you are involved in a court proceeding, and a request is made for
information about the professional services that Dr. Varady has provided you and/or the records thereof, such
information is privileged under state law, and Dr. Varady must not release this information without your written
authorization, or a court order. This 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: Dr. Varady may disclose your confidential information to protect you or
others from a serious threat of harm by you.
- Worker’s Compensation: If you file a workers’ compensation claim, Dr. Varady is required by law to provide
your mental health information relevant to the claim to your employer and the North Carolina Industrial
Commission.
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, Dr. Varady is 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, Dr. Varady 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 in my mental health
and billing records used to make decisions about you for as long as the PHI is maintained in the record.
Psychologists may deny your access to PHI under certain circumstances, but in some cases, you may have
this decision reviewed. On your request, Dr. Varady 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. Dr. Varady may deny your request. On your request, she 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, Dr. Varady 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 this notice from Dr. Varady upon request,
even if you have agreed to receive the notice electronically
Psychologist’s Duties:
- Dr. Varady is 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. - Dr. Varady reserves the right to change the privacy policies and practices described in this notice. Unless she
notifies you of such changes, however, she is required to abide by the terms currently in effect. - If Dr. Varady revises her policies and procedures, she will either mail a printed copy to you, or provide you with
a printed copy in of the revision in person at our earliest appointment subsequent to the change.
V. Questions and Complaints
If you have questions about this notice, disagree with a decision Dr. Varady makes about access to your records, or
have other concerns about your privacy rights, you may contact Susan Ann Varady, Ph.D. at her office, 704.847.4826.
If you believe that your privacy rights have been violated and wish to file a complaint with Dr. Varady and/or her office,
you may talk with Dr. Varady, or send your written complaint to Dr. Varady at: 9930 Monroe Road, Suite 103,
Matthews, NC 28105.
You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. The
person listed above can provide you with the appropriate address upon request.
You have specific rights under the Privacy Rule. Psychologists 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 01 March 2005. Dr. Varady reserves the right to change the terms of this notice and
to make the new notice provisions effective for all PHI that she maintains. Should she choose to make a change, she
will provide you with a revised notice either in person, or by mail.
