Effective Date: September 13, 2006
SPORTS THERAPY AND REHABILITATION, PT, OT, PLLC
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.
Our Pledge Regarding Medical Information
We are committed to protecting medical information about you. This includes all records of your care generated by the office, whether made by your therapist or by office personnel. We are required by law to make sure that medical information that identifies you is kept private.
We are required by law to provide you with this notice of our legal duties and privacy practices with respect to medical information about you. This notice describes your rights and certain obligations we have regarding the use and disclosure of medical information. If you would like more information about this notice you may contact:
- Sports Therapy and Rehabilitation, PT, OT, PLLC
160 East 56th Street New York, NY 10022
Uses And Disclosures
The following categories describe different ways that we may use or disclose your protected health information (PHI). Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories:
Treatment includes the disclosure of health information to other providers who have referred you for services or are involved in your care. This may include doctors, nurses, technicians and other physical therapists. For example, we may feel that a stroke patient we are treating would benefit from an evaluation by a speech-language pathologist to address a swallowing difficulty. The health information we share with the speech-language pathologist would be considered a treatment related disclosure.
Payment includes the disclosure of health information to your insurance company, including Medicare and Medicaid, so payment can be obtained for services rendered. Your insurance company may make a request to review your medical record to determine that your care was necessary.
Business Operations includes the uses and disclosures necessary to run the office and make sure all our patients receive quality care. For example, we may use your medical information to monitor our staff's performance in caring for you and educate them as to how to improve the care they provide to you.
We may share your medical information with our "business associates", such as our billing service and other vendors who perform administrative services for us. We have a written contract with each of these business associates that requires them to protect the confidentiality of your medical information.
Other Special Uses
We may use your PHI for other reasons including: contacting you with an appointment reminder, calling out your name in the waiting room when we are ready to see you, informing you of other health and recreational therapy related services that may be of interest to you, or requesting a contribution to our charitable activities.
Uses and Disclosures Required by Law
The federal health information privacy regulations either permit or require us to use or disclose your PHI in the following ways: we may share some of your PHI with a family member or friend involved in your care if you do not object, we may use your PHI in an emergency situation when you may not be able to express yourself, and we may use or disclose your PHI for research purposes if we are provided with very specific assurances that your privacy will be protected. We may also disclose your PHI when we are required to do so by law, for example by court order or subpoena. Disclosures to health oversight agencies are sometimes required by law to report certain diseases or adverse drug reactions. We may use and disclose health information about you to avert a serious threat to your health or safety or health of the public or others. If you are in the Armed Forces, we may release health information about you when it is determined to be necessary by the appropriate military command authorities. We may release information about you for workers' compensation or other similar programs that provide benefits for work-related injury or illness. Your authorization is required before your PHI may be used or disclosed by us for other purposes.
Your Privacy Rights
You have the following rights regarding medical information we maintain about you:
You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment and how your PHI is used. However, we are not required to agree with your request. If we do agree, we must abide by your request.
You have the right to request confidential communication from us at a location of your choosing. This request must be in writing.
Access to PHI
You have the right to request a copy of your medical record. You must make this request in writing and we may charge a fee to cover the costs of copying and mailing.
You have the right to request an amendment be made to your PHI if you believe it is incorrect or incomplete. This request must be made in writing. If we do not agree with you, we are not required to make the change. You have the right to submit a written statement about why you disagree with our decision that will become part of your record. We may not amend parts of your medical record that we did not create.
Accounting of Disclosures
After April 14, 2003, you have the right to request an accounting of the disclosures made in the previous six years. This request must be made in writing. These disclosures will not include those made for treatment, payment, or business operations or for those which we have obtained authorization.
Changes to this Notice
We reserve the right to amend this notice at any time in the future. After an amendment is made, the revised Notice of Privacy will apply to all protected health information we maintain, regardless of when it was created or received. A copy of our current notice will be posted in our waiting area. You may also view the current notice on our website.
If you feel that your privacy rights have been violated, you have the right to file a written complaint with the office or with the Secretary of the Department of Health and Human Services. To file a complaint with the office, contact Sports Therapy and Rehabilitation, PT, OT, PLLC at the address listed at the beginning of this notice. Your complaint should contain enough specific information so that we may adequately investigate and respond to your concerns. You will not be penalized for filing a complaint.