Notice of Privacy Practices

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.

 

This Notice provides an overview of the privacy practices of Relief All Day Physical Therapy and Wellness (also referred to in this Notice as “we,” “us,” and/or “our”). The privacy practices described in this Notice will be followed by all Relief All Day and Wellness Physical Therapy healthcare professionals, employees, staff, trainees, students, volunteers, and business associates. If you have any questions about this Notice, please contact Sean Colaco, DPT.

 

This Notice of Privacy Practice describes how the use and disclosure of your protected health information (PHI) may be utilized to carry out our treatment, payment, or health care operations and for other purposes that are permitted or required by the law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you, and that relates to your past, present or future physical or mental health, conditions, and related health care services, as well as, your healthcare insurance benefits, full-face photographs and any comparable images of you, and any unique numbers that may identify you. The privacy of your medical information is important to us. We understand that your medical information is personal, and we are committed to protecting it. The record we create of the care and services you receive is needed so we may provide you with the best quality care and also comply with certain legal requirements.

 

OUR PRIVACY COMMITMENT TO YOU 

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The information we collect about you is private. Only individuals who have both the need and the legal right may view your information. Unless you give us permission in writing, we will only disclose your information for purposes of treatment, payment, business operations, and when we are required by law to do so, or for one of the other reasons listed below. 

• Treatment: We may use or disclose medical information about you to provide and coordinate your health care. For example, after your initial appointment with us, a letter is often sent to your referring physician regarding your treatment. Another letter will be sent after you have been discharged from our care, and with progress notes as needed.

 • Payment: Information may be disclosed so that the care you receive can be properly billed and paid for. For example, we may send your health insurer a bill for our services that includes an explanation of the treatment you received and why. 

• Health Care and Business Operations: We may need to use and disclose information in our business operations. For example, to improve the activities necessary to run the business (training or reviewing the quality of care that you and others receive from us).

 • Exceptions: For certain kinds of records, your permission may be required, even for release of treatment, payment, and business operations. We will provide you with authorization and consent forms for your signature in order for us to release certain information. 

• Phone Messages: We may contact you via phone, answering machine, email, or mail to provide you with authorization, referral, and billing information, including information regarding other services that may be of interest to you. You may request in writing if you do not wish for this information to be left with a person other than yourself via phone. 

• Mailings: We may send birthday cards/postcards (with no mention of your date of birth). We may also mail statements and other documents necessary to conduct business. You may request in writing that all mail be sent confidentially (enclosed in an envelope). As required by Law and for other Government Functions: We will release information when required to do so by law or for other government functions, examples of such releases would be for law enforcement, subpoenas or other court orders, for national security purposes, communicable disease reporting, disaster relief, review of our activities by government agencies, to avert a serious threat to health or safety or in other kinds of emergencies. 

• Public Health and Safety: We may use or disclose information about you as necessary to prevent or reduce a serious threat to the health or safety of another person or the public. For example, we will have to disclose information about certain diseases (and immunizations) to public health officials. 

• Family and Friends: We may disclose your information to family members, friends, or others you identify to the extent it is relevant to their involvement with your care or payment for your care, or to let them know about where you are and your condition. Additionally, if necessary to prevent or lessen a serious or imminent threat to the health and safety of a person or the public, and to people reasonably able to prevent or lessen that threat.

• After Death: We may disclose your information to coroners or medical examiners and funeral homes after you are deceased.

 • With Your Permission: If you provide us permission in writing, we may use and disclose your personal information for the purposes you list. If you give us permission, you have the right to change your mind and revoke it, but this must be in writing. We cannot take back any uses or discloses already made with your permission. Our use and disclosure of your personal health information must comply not only with federal privacy regulations but also with applicable state law. State laws may provide different or additional protections for your personal health information. For example, Michigan provides extra protection for minors; we must adhere to the more stringent state privacy protections. We also follow HITECH and HIPAA Omnibus regulations. While we might implement the use of mobile computing devices, we follow recommended security procedures.

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Individual rights

 The notice contains a statement of your rights with respect to protected health information and a brief description of how you may exercise these rights, as follows:

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You have the right to request restrictions on certain uses and disclosures of protected health information and can get an electronic or paper copy of your medical record. We will provide a copy or a summary of your health information, usually within 30 days of a written request. We may charge a reasonable, cost-based fee.

You have the right to correct your medical record: You can ask us to correct health information about yourself that you believe is incorrect or incomplete. To do so, submit a written request along with proper documentation to support the request.  You’ll be informed within 30 days if your request is denied or unable to be performed.

You have a right to request confidential communications: You can request to be contacted in a specific way (for example, home or office phone) or to send mail to a different reasonable address. 

You have the right to access and ask us to limit what we use or share. You can request that certain health information about treatment, payment, or procedures not be used or shared. We are not required to agree to your request, and the denial reasons might be related to inadvertent negative effects on your care or safety. However, when legally allowed, you can ask us not to share certain information for the purpose of payment or our operations with your health insurer if you pay for a service or health care item out-of-pocket in full. 

You have a right to receive a copy of this Privacy Notice. You can ask for a paper copy of this Notice at any time. 

You have a right to receive information on disclosures of your protected health information made in the six years prior to the date on which the accounting is requested. We will include all the disclosures except for those about treatment, payment, and health care operations, disclosures authorized by you or for legal, law enforcement, correctional institutions, or national security purposes. certain other disclosures (such as any you asked us to make). 

You have a right to choose someone to act for you. If you have a legal guardian or have given someone medical power of attorney, that person can exercise your rights and make choices about your health information.

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Our Responsibility 

We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this Notice and provide you a copy of this Notice. We will not use or share your information other than as described in this Notice unless you tell us we can in writing by completing and signing our HIPAA Authorization Form. If you tell us we can use or share your information other than as described in this Notice, you may change your mind at any time by informing our Privacy Officer of the change in writing. 

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Note on Incidental Disclosures 

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Despite our implementation of reasonable and appropriate safeguards to protect the privacy of your protected health information, your protected health information may be incidentally disclosed in connection with otherwise permissible or required uses or disclosures of your information. For example, other people in the treatment area may observe and/or overhear discussions regarding your protected health information during the course of your treatment session. The HIPAA Privacy Rule permits such incidental disclosures of your protected health information. We can change the terms of this Notice without first notifying you, and the changes will apply to all information we have about you. The new Notice will be available upon request, in our office, and on our website.

 

Get More Information or Complaints

 

We will follow our rules as set forth in this Notice. If you want more information or if you believe your privacy rights have been violated, we want to make it right. We will never penalize you for filing a complaint. To do so, please contact us immediately to discuss with the Owner or Compliance Officer, or file a formal, written complaint within 180 days with:

 

The U.S. Department of Health & Human Services Office of Civil Rights

200 Independence Ave., S.W.

Washington, DC 20201

877.696.6775

You may get your “HIPAA Complaint” form by calling our compliance officer.

 

These privacy practices are in accordance with the original HIPAA enforcement effective April 14, 2003, and undated to the Omnibus Rule effective March 26, 2013, and will remain in effect until we replace them as specified by Federal and/or State Law.

 

This Notice of Privacy Practices applies to Relief All Day Physical Therapy and Wellness

For more information regarding the Notice of Privacy Practices, please see:

www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/Noticepp.html