The Notice below describes how medical information about you may be used and disclosed. It also explains how you can get access to this information. Please review this carefully.

WE HAVE A LEGAL DUTY TO PROTECT HEALTH INFORMATION ABOUT YOU

We are required by law to protect the privacy of health information that can identify you. This information is known as “Protected Health Information” or “PHI”.

  1. We must protect PHI that we have created or received about your past, present or future health condition, about health care we provide to you or about payment for your health care.
  2. We must notify you how we protect PHI about you.
  3. We must explain how, when and why we use and disclose PHI about you.
  4. We may only use or disclose PHI as we have described in this Notice.

WE MAY USE AND DISCLOSE “PHI” ABOUT YOU WITHOUT YOUR AUTHORIZATION

  1. We may disclose your PHI to provide, coordinate or manage your health care and related services. For example, we may disclose PHI about you when you need a prescription for orthoses, for a swallow study, for an x-ray or when we refer you to another health care provider.
  2. We may disclose your PHI to bill and collect payment for the treatment and services provided to you. Before you receive services, we may share information with your health plan(s). This allows us to verify coverage under your plan or policy. We may share portions of your medical information with collection agencies, insurance companies, health plans or consumer reporting agencies (e. g., credit bureaus).
  3. We may use your PHI to perform “health care operations”. These “health care operations” allow us to improve the quality of care we provide and reduce health care costs. Examples include:
    1. Reviewing and improving the quality, efficiency and cost of care that we provide to you and our other patients
    2. Reviewing and evaluating the skills, qualifications and performance of our therapists and nurses
    3. Providing training programs for students and trainees
    4. Cooperating with outside organizations that assess the quality of our care or those who certify or license our staff or facilities
    5. Conducting business management and general administrative activities
    6. Resolving grievances within our organization
    7. Reviewing activities in the event that we sell or give control of our business or property to someone else
    8. Complying with this Notice and with applicable laws.
  4. We may disclose PHI when it is:
    1. Required by law, for public health activities or for law enforcement purposes
    2. Related to victims of abuse, neglect or domestic violence
    3. Needed for health oversight activities
    4. Related to decedents to avert a serious threat to health or safety
    5. Related to specialized government functions
    6. Related to correctional institutions and in other law enforcement custodial situations.
  5. We may share PHI about you with a family member, relative, friend or other person identified by you who is directly related to that person’s involvement in your care or payment for your care to notify such individuals of your location, general condition or death.
  6. We may share PHI about you with a public or private agency (for example, American Red Cross) for disaster relief purposes if necessary for the emergency circumstances.
  7. We may use or disclose PHI to contact you so that we can provide a reminder to you about an appointment you have for treatment or medical care.
  8. We may use or disclose PHI to manage or to coordinate your health care with information about treatment, services, products or health care providers. This may include telling you about those treatments, services, products or other health care providers. We may also use or disclose PHI to give you gifts of a small value.
  9. Under any circumstances other than those listed above, we will ask for your written authorization before we use or disclose PHI about you. If you sign a written authorization allowing us to disclose PHI about you in a specific situation, you can later cancel your authorization in writing. If you cancel your authorization in writing, we will not disclose PHI about you after we receive your cancellation, except for disclosures that were being processed before we received your cancellation.

YOU HAVE SEVERAL RIGHTS REGARDING YOUR “PHI”

  1. You have the right to request that we restrict the use and disclosure of PHI about you. We are not required to adhere to your requested restrictions. Even when we have agreed to your request, your restrictions may not be followed in certain situations. These situations include emergency treatment, disclosures to the Secretary of the Department of Health and Human Services and uses and disclosures described in Subsection 4 of the previous section of this Notice. You may request a restriction by notifying THERAPY 2000 in writing.
  2. You have the right to request how and where we contact you about PHI. For example, you may request that we do not contact you at your work. We must accommodate reasonable requests. You must submit those alternative communication requests to us in writing.
  3. You have the right to request seeing and receiving a copy of PHI contained in clinical, billing and other records used to make decisions about you. Your request must be in writing. We may charge you related fees and there are certain situations in which we are not required to comply with your request.
  4. You have the right to request that we make amendments to clinical, billing and other records used to make decisions about you. Your request must be in writing and must explain your reason(s) for the amendment. We may deny your request if:
    1. The information was not created by us (unless you prove the creator of the information is no longer available to amend the record)
    2. The information is not part of the records used to make decisions about you
    3. We believe the information is correct and complete
    4. You do not have the right to see and copy the record.
  5. You have the right to receive a written list of our disclosures of PHI about you. You may ask for disclosures made up to six (6) years before your request (not including disclosures made prior to April 14, 2003). We are required to provide a listing of all disclosures except the following:
    1. For your treatment
    2. For billing and collection of payment for your treatment
    3. For our health care operations
    4. Made to or requested by you, or that you authorized
    5. Occurring as a byproduct of permitted uses and disclosures
    6. Made to individuals involved in your care for directory or notification purposes or for other purposes described in Subsection B5 above
    7. Allowed by law when the use or disclosure relates to certain specialized government functions or relates to correctional institutions and in other law enforcement custodial situations (please see Subsection B4 above)
    8. As part of a limited set of information which does not contain certain information which would identify you. You may request a listing of disclosures by notifying THERAPY 2000 in writing. You have the right to request a paper copy of this Notice at any time.

YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES
If you think we have violated your privacy rights, or you want to complain to us about our privacy practices, follow THERAPY 2000′s Grievance Procedure.