.jpg)
Privacy Policy
HIPPAA Notice of Privacy Practices
ProTherapy SLP Services, Inc.
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 of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry
out treatment, payment or healthcare operations (TPO) and for other purposes that are permitted or required by 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 relates to your past, present or future physical or
mental health or condition and related health care services.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
Your protected health information may be used and disclosed by Pro Therapy SLP Services, Inc. and others outside of our
office that are involved in your care and treatment for the purposes of providing health care services to you, to pay your
health care bills, to support the operation of Pro Therapy SLP Services, Inc.’s practice and any other use required by law.
Treatment: We will use and disclose your protected health information to provide, coordinate or manage your health care
and any related services. This includes coordination or management of your healthcare with a third party. For example,
your protected health information may be provided to a physician to whom you have been referred to ensure that the
physician has the necessary information to diagnose or treat you.
Payment: Your protected health information will be used, as needed, to obtain payment for your healthcare services. For
example, obtaining approval for treatment may require that your relevant protected health information be disclosed to the
health plan to obtain approval for the treatment.
Healthcare Operations: We may use or disclose, as needed, your protected health care information in order to support the
business activities of your physician’s practice. These activities include, but are not limited to, quality assessment activities,
employee review activities, training of speech pathology students, licensing, marketing and fundraising activities and
conducting or arranging for other business activities. For example we may use a sign in sheet at the registration desk where
you will be asked to sign your name and indicate your therapist. We may also call you by name in the waiting room when
your therapist is ready to see you. We may use or disclose your protected health information, as necessary, to contact you
to remind you of your appointment.
We may use or disclose your protected health information in the following situations without your authorization. These
situations include: as Required By Law, Public Health issues as required by law, Communicable Disease, Health Oversight,
Abuse or Neglect, Food and Drug Administration requirements, Legal Proceedings, Law Enforcement, Research, Criminal
Activity, Military Activity and National Security, Workers’ Compensation, Required Uses and Disclosures. Under the law we
must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to
investigate or determine our compliance with the requirements of section 164.500.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES WILL BE MADE ONLY WITH
YOUR CONSENT, AUTHORIZATION OR OPPORTUNITY TO OBJECT UNLESS REQUIRED BY LAW.
You may revoke this authorization any time in writing, except to the extent that your physician or the physician’s practice
has taken action in reliance on the use or disclosure indicated in the authorization.
YOUR RIGHTS
The following is a statement of your rights with respect to your protected health information.
You have the right to inspect and copy your protected health information. Under federal law, however, you may not inspect or
copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or
administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health
information.
You have the right to request a restriction of your protected health information. This means you may ask us not to use or
disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also
request that any part of your protected health information not be disclosed to family members or friends who may be involved in your
care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction
requested and to whom you want the restriction to apply. In the case of a child custody issue, we will need legal documentation stating
that no information is to be released to the person to whom you want the restriction to apply.
Your physician is not required to agree to a restriction that you may request. If your physician believes it is in your best interest to
permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have
the right to use another Healthcare Professional.
You have the right to request to receive confidential communications from us by alternative means or at an alternative
location. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this
notice alternatively i.e. electronically.
You may have the right to have your physician amend your protected health information. If we deny your request for
amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will
provide you with a copy of any such rebuttal.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.
We reserve the right to change the terms of this notice and will inform you by mail of any changes. You then have the right to object or
withdraw as provided in this notice.
Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us.
You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a
complaint.
This notice was published and becomes effective on/or before July1, 2010.