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NOTICE OFHEALTH INFORMATIONPRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED ANDHOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This information is made available to all patients
Our Mission Regarding Your Health Information
Our mission is to be a good steward of our patients’ health information. We shall strive to maintain theprivacy, security and confidentiality of all personal health information we create or possess. All of ourwork procedures shall be designed and practiced to protect our patients’ personal health information. Ourgoal is to be recognized by our patients, business associates, and the public as a professionalorganization of caring, “privacy-minded” individuals.
Introduction
This Notice is provided to you in accordance with the Privacy Regulations of the Health InsurancePortability and Accountability Act of 1996
(HIPAA)
. The Privacy regulations issued by the Department ofHealth and Human Services require us to inform you of our privacy practices as they relate to your healthinformation.We understand that your medical information is personal to you, and we are committed to protecting thisinformation about you. We create medical records, both paper and electronic, about care we provide foryou. We need this record in order to provide for your health care needs, and to comply with professionaland legal requirements. This record of information is often referred to as your health or medical recordand under HIPAA, is referred to as Protected Health Information
(PHI)
. Your medical record serves as a:
•
Basis for planning your care and treatment
•
Means of communication among the many health professionals who contribute to your care
•
Legal document describing the care you received
•
Means by which you or a third-party payer can verify that services billed were actually provided
•
Tool in educating health professionals
•
Source of data for medical research
•
Source of information for public health officials charged with improving the health of this State andNation
•
Source of data for our planning and marketing
•
Tool with which we can assess and continually work to improve the care we render and theoutcomes we achieve.Understanding what is in your record and how your health information is used helps you ensure itsaccuracy, better understand how, when, and why others may access your PHI, and make more informeddecisions when authorizing disclosures to others.
Health Care Provider Responsibilities
The following section describes the obligations of Performax Physical Therapy regarding the useand disclosure of your medical information.
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The law requires us to:
•
Make sure that your health information is kept private
•
Provide you with this notice explaining our legal duties and privacy practices with respect toinformation we collect and maintain about you
•
Accommodate reasonable requests you may have to communicate health information byalternative means or in alternative locations
•
Notify you if we are unable to agree to your requested restriction
•
Follow the conditions of the Notice that is currently in effect
How we may use and disclose medical information about you:
The following categories that are bulleted are italicized describe different ways that we use, share, anddisclose your PHI with others. Each category of uses or disclosures provides a general explanation andprovides some examples of uses. Not every use or disclosure in a category is either listed or actually inplace. The explanation is provided for your general information only.
We will use your health information for treatment.
For example:
We use medical information about you to provide you with current or prospective physicaltherapy treatment of services. Information provided by you, your referring physician, physical therapist, orother member of your health care team may be documented in your record and used to determine thecourse of treatment that should work best for you. It is usual for us to ask you about how your affectedbody area is feeling. We will especially ask you questions about your pain level, tolerance to treatment,and how your current function affects your daily activities. Your physical therapist may communicate withyour physician either verbally or in writing. We normally provide your physician with a written evaluation ofour initial findings and a summary of your progress in physical therapy. We may also provide asubsequent health care provider with copies of various reports.
We will use your health information for regular health operations.
We use and disclose medical information about you so that we can operate our practice. We use anddisclose medical information about you so that we can run our practice more efficiently and make surethat all of our patients receive quality care. These uses may include reviewing our treatment and servicesto evaluate the performance of our staff, deciding what additional services to offer and where, decidingwhat services are not needed, and whether new treatments are effective.
Treatment Setting:
Physical exercise plays a prominent role in your care at our facility. The gym area ofour facility is a common treatment area used to instruct patients in, and observe, their performance ofprescribed exercises. In this setting it is probable that other patients may learn of your physical ailment.
For Example:
You may be performing an exercise similar to that of another patient. It would be easy foryou to infer that they are being treated for a similar malady. Additionally, others may overhear aconversation between you and your therapist.
Business Associates:
There are some services provided to you, our patient, through contacts withbusiness associates. Examples include outside vendors who provide rental units, on-call or fill-in therapistservices, and other services we may use when providing you access to your medical record. When theseservices are contracted, we may disclose your health information to our business associate so that theycan perform the job we’ve asked them to do and bill you or your third-party payer for services rendered.
However, we do require that our business associates act appropriately to protect your healthinformation
Directory
: Because of the size and scope of our practice, a hospital-like directory of your status andlocation is not used. However, unless you object, we may use or disclose information about yourpresence in our facilities to those who ask for you by name.
For example
: If a person telephones, orpersonally asks to speak to you while you are at our office, or asks if you have arrived or left from yourappointment, we will disclose that information to the person who has inquired about you by name.
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Payment
: We may use and disclose medical information about you for services and procedures so thatthey may be billed and collected from you, an insurance company, or other third party.
For Example:
Weoften need to give your health care information about treatment you received at our practice to obtainpayment or reimbursement for care. We may also tell your health plan and/or referring physician about atreatment you are going to receive to obtain prior approval or to determine whether your plan will coverthe treatment.
Appointment and patient recall reminders:
We may use and disclose medical information about you as areminder that you have an appointment with our practice. This contact may be by phone, in writing,e-mail or otherwise, and may involve leaving such message where it could potentially be “picked up” byothers.
Mailing lists and direct mailings
: We maintain a database of our patients’ mailing addresses. We protectthis database and do not engage in the practice of selling or otherwise distributing our mailing list or yourdemographic data to others. We use this list to include you in our regular mailings, such as birthdaycards, newsletters, and to keep you informed of new services we may offer in the future.
Communication with family and friends:
Health professionals, using their best judgment, may disclose to afamily member, other relative, close personal friend, or any other person you identify, health informationrelevant to that person’s involvement in your care or payment related to your care.
Research:
Our practice does not routinely participate in formal research projects. However, under certaincircumstances we may use and disclose medical information about you for research purposes regardingefficiency or treatment protocols and the like. We will, as required by law, obtain your specificauthorization to release information to a qualified researcher.
Workers Compensation:
We may disclose health information to the extent authorized by and to the extentnecessary to comply with laws relating to workers compensation or other similar programs established bystatute.
Correctional institution:
Should you be an inmate of a correctional institution, we may disclose to theinstitution or agents thereof health information necessary for your health and the health safety of otherindividuals.
Law Enforcement:
We may disclose health information for law enforcement purposes as required byfederal, state, or local law.
Lawsuits and disputes:
If you are involved in a lawsuit or a dispute, we may disclose medical informationabout you in response to a court or administrative order. This is particularly true if you make your healthan issue. We may also disclose medical information about you in response to a subpoena, discoveryrequest, or other lawful process by someone else involved in the dispute. We may also use suchinformation to defend ourselves, or any member of our practice, in any actual or threatened action.
We will notify you if we discover a breach of your PHI
A breach is defined as an
impermissible
use or disclosure under the Privacy Rule that compromises thesecurity or privacy of your PHI and that poses a
significant
risk of financial, reputational, or other harm toyou. If we discover a breach of your PHI, we will notify you in writing describing the nature of the breach,the type of patient information disclosed, steps you can take to protect yourself, and steps our practice istaking to remedy the situation
Patient Rights
The following section describes your rights regarding the use and disclosure of your medicalinformation.
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