This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Cornerstone Montgomery is required by law to maintain the privacy of Protected Health Information* (“PHI”) and to provide you with notice of our legal duties and privacy practices with respect to PHI.
References to “Cornerstone Montgomery,” “we,” “us,” and “our” include Cornerstone Montgomery, its employees, workforce members and members of affiliated covered entities who are involved in providing and coordinating health care who are all bound to follow the terms of this Notice of Privacy Practices (“Notice”). The members of affiliated covered entities will share PHI with each other for the treatment, payment and health care operations of the affiliated covered entity and as permitted by HIPAA and this Notice. This Notice describes how we may use and disclose PHI about you, as well as how you obtain access to such PHI.
Cornerstone Montgomery, Inc. reserves the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, Cornerstone Montgomery is required by law to comply with this Notice. When any amendments are made, Cornerstone Montgomery will post the updated version at our program offices and on our website.
*Protected Health Information (PHI) means information that may identify you and that relates to your past, present, or future physical or mental health or condition, the provision of health care products and services to you or payment for such services.
It is our policy to reasonably limit disclosures of, and requests for, protected health information for payment and health care operations to the minimum necessary. Cornerstone Montgomery limits which members of our staff may have access to personal health information for treatment, payment, and health care operations, based on those who need access to the information to do their jobs.
The following categories describe different ways that we use and disclose your PHI. We have provided you with examples in certain categories; however, not every permissible use or disclosure will be listed in this Notice.
Note that some types of PHI, such as HIV information, genetic information, alcohol and/or substance abuse records, and mental health records may be subject to special confidentiality protections under applicable state or federal law and we will abide by these special protections.
We will obtain your written authorization before using or disclosing your PHI for purposes other than those described in this Notice or otherwise permitted by law. You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the authorization.
We will obtain your written authorization for the use or disclosure of psychotherapy notes, use or disclosure of PHI for marketing, and for the sale of PHI, except in limited circumstances where applicable law allows such uses or disclosure without your authorization.
Cornerstone Montgomery will disclose your PHI when required to do so by federal, state or local law. Except where prohibited by federal or state laws that require special privacy protections, we may use and disclose your PHI for treatment, payment and health care operations without your prior authorization as follows:
At Cornerstone Montgomery, we take confidentiality very seriously. Cornerstone Montgomery collects your health information and stores it in a paper chart and in a protected electronic health record. This is your medical record. Your medical record (your protected health information) is kept in a secure location and only those employees who need access to your medical record for treatment, payment or health care operations, have access to your medical record unless you sign an authorization.
Cornerstone Montgomery – Medical Records Department
6040 Southport Drive, Bethesda, Maryland 20814
Cornerstone Montgomery must give access to the patient’s medical record within 30 days of the request. In the event that more time is required before the health information is released, Cornerstone Montgomery will give an explanation of the delay within that 30-day time frame, and the patient must be granted access to his medical record within 60 days.
Under certain limited circumstances, Cornerstone Montgomery may deny an individual’s request for access to all or a portion of the PHI requested. In some of these circumstances, an individual has a right to have the denial reviewed by a licensed health care professional designated by Cornerstone Montgomery who did not participate in the original decision to deny. Unreviewable grounds for denial, include, but not limited to:
Reviewable grounds for denial, whereas a licensed health care professional has determined in the exercise of professional
If Cornerstone Montgomery denies access, in whole or in part, to PHI requested by the individual, a denial in writing will be provide to the individual no later than within 30 calendar days of the request (or no later than within 60 calendar days if the individual was notified of an extension). If the denial was based on a reviewable ground for denial and the individual requests review, Cornerstone Montgomery will promptly refer the request to the designated reviewing official. The reviewing official must determine, within a reasonable period of time, whether to reaffirm or reverse the denial. Cornerstone Montgomery will then promptly provide written notice to the individual of the determination of the reviewing official, as well as take other action as necessary to carry out the determination.
*Psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.
Cornerstone Montgomery maintains a commitment to uphold the highest standards in the services and support we provide, as we believe that every client of Cornerstone Montgomery has the right to receive fair and just treatment. If you believe that your protected health information has been released in violation of the law, you have the right to file a complaint. You may file a complaint with our program by contacting or submitting a letter to:
Chief Compliance Officer
2 Taft Court
Rockville, Maryland 20850
(301) 715-3673 ext. 243
If you believe that Cornerstone Montgomery or its business associate violated your health information privacy rights or committed another violation, you may file a complaint with the any authorized agency listed below:
US Department of Health & Human Services
Office for Civil Rights (OCR)
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
Maryland Behavioral Health Administration (BHA)
Office of Health Care Quality (OHCQ)
Spring Grove Center, Bland Bryant Building
55 Wade Avenue, Catonsville, MD 21228
Montgomery County Department of Health and Human Services (DHHS)
Local Behavioral Health Authority (LBHA)
401 Hungerford Drive, First Floor
Rockville, MD 20851
Patients can expect to be free from retaliation and will not be barred from services should they choose to submit a grievance to address their concerns. At any point during the grievance process, the patient maintains the right to utilize counsel or other representation.