Pscyhotherapy notes are defined as being notes kept separate from the patient's chart... that always confuses people. To make it clear:

"Psychotherapy Notes" are only for the therapist's reference. Anything kept with the patient's records are fair game for the patient and are accessible by federal law.



HIPAA also covers any covered entity that uses an electronic medium... so.... this is just about everyone these days. Very few doctors offices or what not will actually mail claims in to be processed, right?
SO... what we have here is an era where HIPAA covers almost everything, as almost everyone these days files electronic claims.

There will come a day soon I think when HIPAA will be overruled by something more powerful in protecting patient rights to privacy and medical records access.