Practice of Joseph Pedoto, Ph.D. LLC

30 Holland Circle, Sparta, NJ 07871/605 Bloomfield Avenue, Montclair, NJ 07042

​

THIS NOTICE DESCRIBES HOW MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

 

All information describing your mental health treatment and related health care services (“mental health information”) is personal, and we are committed to protecting the privacy of the personal and mental health information you disclose to us. We are required by law to maintain the confidentiality of information that identifies you and the care you receive. When we disclose information to other persons and companies to perform services for us, we require them to protect your privacy, too. This Notice applies to your psychotherapist, psychiatrist and other health care professionals who provide care to you. We must also provide certain protections for information related to your medical diagnosis and treatment, including HIV/AIDs, and information about alcohol and other substance abuse. We are required to give you this Notice about our privacy practices, your rights and our legal responsibilities.

 

WE MAY USE AND DISCLOSE YOUR MENTAL HEALTH INFORMATION AS FOLLOWS:

For TREATMENT- for example, we may give information about your psychological condition to other health care providers to facilitate your treatment, referrals or consultations.

 

For PAYMENT- For example, we may contact your insurer to verify what benefits you are eligible for, to obtain prior authorization, and to receive payment from your insurance carrier.

To COMPLY WITH INSURANCE COMPANY audits of patient records.

​

For APPOINTMENTS AND SERVICES to remind you of an appointment, or tell you about treatment alternatives or health related benefits or services.

​

WITH YOUR WRITTEN AUTHORIZATION we may use or disclose certain mental health information for purposes not described in this Notice only with your written authorization

 

As REQUIRED BY LAW when required or authorized by other laws, such as the reporting of child abuse, elder abuse or dependent adult abuse.

 

For HEALTH OVERSIGHT ACTIVITIES to governmental, licensing, auditing, and accrediting agencies as authorized or required by law including audits; civil, administrative or criminal investigations; licensure or disciplinary actions; and monitoring of compliance with law.

 

In JUDICIAL PROCEEDINGS in response to court/administrative orders, subpoenas, discovery requests or other legal process.

 

To PUBLIC HEALTH AUTHORITIES to prevent or control communicable disease, injury or disability, or ensure the safety of drugs and medical devices.

 

To LAW ENFORCEMENT for example, to assist in an involuntary hospitalization process.

 

To THE STATE LEGISLATIVE SENATE OR ASSEMBLY RULES COMMITTEES for legislative investigations.

 

For RESEARCH PURPOSES subject to a special review process and the confidentiality requirements of state and federal law.

 

To PREVENT A SERIOUS THREAT TO HEALTH OR SAFETY of an individual. We may notify the person, tell someone who could prevent the harm, or tell law enforcement officials.

 

To PROVIDE TELEHEALTH SERVICES to you via Business Associates who are integral to the provision of secure telehealth services. (Examples would include Doxy.me or Hushmail who provide secure remote video and audio communication and email encryption services, respectively).

​

For CORONORS, MEDICAL EXAMINERS, and FUNERAL DIRECTORS We may release Protected Health Information-PHI. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to enable them to perform their duties.

 

For FUND RAISING- To contact you with information about sponsored activities such as fund raising. If you do not wish to receive this information you may opt out.of receiving such communications. THIS PRACTICE DOES NOT HAVE A FUND RAISING COMPONENT,

 

OTHER USES AND DISCLOSURES OF PHI Your authorization is required, with a few exceptions, for disclosure of psychotherapy notes, use or disclosure of PHI for marketing, and for the sale of PHI. We will also obtain your written authorization before using or disclosing your PHI for purposes other than those provided for in this Notice (or as otherwise permitted or required 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 acted in reliance on the authorization.

SUD TREATMENT INFORFMATION. If we receive or maintain any information about you from a substance use disorder treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the Part 2 Program record for purposes of treatment, payment or health care operations, we may use and disclose your Part 2 Program record for treatment, payment and health care operations purposes as described in this Notice. If we receive or maintain your Part 2 Program record through specific consent you provide to us or another third party, we will use and disclose your Part 2 Program record only as expressly permitted by you in your consent as provided to us. In no event will we use or disclose your Part 2 Program record, or testimony that describes the information contained in your Part 2 Program record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you, unless authorized by your consent or the order of a court after it provides you notice of the court order.

 

REPRODUCTIVE HEALTHCARE PRIVACY-We are prohibited from using or disclosing your protected health  information to identify, investigate, prosecute or impose liability on any person for the mere act of seeking, obtaining, providing or facilitating reproductive health care that is lawful under the circumstances in which it is provided

​

YOUR HEALTH INFORMATION RIGHTS

To Request Restrictions. You have the right to request a restriction or limitation on the mental health information we disclose about you for treatment, payment or health care operations. You must put your request in writing. We are not required to agree with your request. If we do agree with the request, we will comply with your request except to the extent that disclosure has already occurred or if you are in need of emergency treatment and the information is needed to provide the emergency treatment.

 

To Inspect and Request a Copy of Your Mental Health Record except in limited circumstances. A fee will be charged to copy your record. You must put your request for a copy of your records in writing. If you are denied access to your mental health record for certain reasons, we will tell you why and what your rights are to challenge that denial.

 

To Request an Amendment and/or Addendum to your Mental Health Record. If you believe that information is incorrect or incomplete, you may ask us to amend the information or add an addendum (addition to the record) of no longer than 250 words for each inaccuracy. Your request for amendment and/or addendum must be in writing and give a reason for the request. We may deny your request for an amendment if the information was not created by us, is not a part of the information which you would be permitted to inspect and copy, or if the information is already accurate and complete. Even if we accept your request, we do not delete any information already in your records.

 

To Receive An Accounting of Certain Disclosures we have made of your mental health information. You must put your request for an accounting in writing.

 

To Request That We Contact You By Alternate Means (e.g., email versus mail) or at alternate locations. Your request must be in writing, and we must honor reasonable requests.

 

 

CHANGES TO THIS NOTICE. We reserve the right to change our privacy practices and the terms of this Notice at any time provided such changes are permitted by applicable law and to make new Notice provisions effective for all protected health information we maintain.

 

QUESTIONS AND COMPLAINTS- If you want more information about our privacy practices or have questions, please speak to us directly or contact us in writing via email at cbtpsychologist@drjosephpedoto.com.

When using the later method, first request an encrypted email link from us with instructions on encryption. If you are concerned that we may have violated your privacy rights, or if you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us directly or use the above email address to notify us in writing. You also may submit a written complaint to one of the Departments of Health and Human Services listed below.

 

 

PRIVACY OFFICIALS CONTACT INFORMATION

State of New Jersey   
Department of Human Services                          
Attn: Privacy Officer                                         

PO Box 700                                                   

Trenton, NJ 08625                                         
Phone: (609) 292-3557                                     

​

State of New York

Region II Office of Civil Rights

U.S. Department of Health and Human Services

Jacob Javits Federal Building

26 Federal Plaza- Suite 3312

New York, New York 10278

Phone: (212) 264-3313

​

​

By law, Joseph Pedoto, PhD, LLC is required to follow the terms in this privacy notice.. The Notice of Privacy Practices for Joseph Pedoto, PhD, LLC will appear and be prominently and clearly viewable on our website drjosephpedoto.com on the Privacy Notice page (see menu). Copies of the Notice will be supplied on request.

                                 

                                      Effective Date of Notice 2/26/26