This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Please review it carefully.
Effective: 9-1-19
If you have any questions or requests, please contact Nancy Johnston at (407) 260-0551.
A.) We have a legal duty to protect Health Information about you. We are required to protect the privacy of your health information called "protected health information" or "PHI" for short. We must give you notice of our legal duties and privacy practices concerning PHI:
- We must protect PHI that we have created or received bout you or your child's past, present or future diagnosis, treatment, or payment for services provided.
- We must notify you about how we protect PHI about you or your child.
- We must explain how, when and why we use and/or disclose PHI about you or your child.
- We may only use and/or disclose PHI as we have described in the notice.
- We are required to follow the procedures in this notice. We reserve the right to change the terms of this notice and to make new notice provisions effective for all PHI that we maintain by first:
- Posting the revised notice in our offices
- Making copies of the revised notice available upon written request
B.) We may use and disclose PHI about you without your authorization in the following circumstances:
- For treatment: i.e. Information obtained during an evaluation and therapy may be recorded and used by the therapist to choose the appropriate plan of care for you or your child. Prescriptions will be obtained from your PCP, as well as signatures on evaluations and updated goals, as needed. Pertinent information such as medical information sensory issues, etc. will be documented so that any substitute or additional therapists will be aware of this information.
- For payment: i.e. Information regarding you or your child will be given to the insurance company during the insurance verification process. Claims are sent to the insurance agency and includes identifiers about you or your child which is necessary to process claims for payment. If the account were to go to a collection agency the agency also receives identifying information about you or your child necessary to collect on the account.
- For regular health care operations: These health care operations allow us to improve the quality of care we provide and reduce health care costs, i.e. to review and evaluate the skills and performance of the therapists providing services to you, provide training programs, planning for our organization's future operations.
- In addition, we may use and disclose PHI about you when making recommendations to your primary care physician regarding referrals to other health care providers.
- We may use and disclose PHI under other circumstances without your authorization.
- Examples include but are not limited to: ○
- When required by federal, state, or local law or other judicial or administrative proceeding.
- When necessary for public health activities such as exposure to a communicable disease.
- When it relates to victims of abuse, neglect or domestic violence.
- Avert a serious threat to health or safety.
- Pursuant to a specific authorization.
- To a Business Associate.
- To a personal representative.
- For certain marketing.
- You can object to certain uses and disclosures of your PHI.
- Unless you object we may use or disclose PHI about you or your child in the following circumstances:
- We may share evaluation results, treatment goals and progress made, discharge and payment information etc. to family members, relatives, friends or other persons identified by you in writing.
- (If you would like to object to our use or disclosure of PHI about you in the above circumstances, please call our contact person listed on the cover page of this notice and submit request in writing.)
- We may contact you to provide appointment reminders.
- We may contact you with information about treatment, services, product or other health care providers.
- We may use and/or disclose PHI to manage or coordinate additional services. This may include telling you about additional treatments, services, products or other healthcare providers that would be beneficial to the impairment being address i.e. services through your school district, early intervention program, and computer software program.
- 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 which were being processed before we received your cancellation.
C.) Your Rights Regarding PHI
- You have the right to the following by written request:
- Request a restriction on certain uses and disclosures of you or your child's information.
- Request communications of your health information by alternative means or at alternative locations.
- Inspect and copy your health record. Request amendment of PHI about you.
- A listing of disclosures we have made regarding your therapy.
- A copy of this notice.
D.) You may file a complaint about our privacy practices.
- If you think we have violated your privacy rights, you can contact: Nancy Johnston at (407) 260-0551, 455 W Warren Ave, Suite 200, Longwood or complete a suggestion/comment form in our confidential mailbox located in the office waiting room. You may also send a written complaint to the United States Secretary of the Department of Health and Human Services. There will be no retaliation for filing a complaint.
E.) Effective Date Of This Notice: April 2003
- This Notice of Privacy Practice is effective on April 2003
