NOTICE OF PRIVACY PRACTICES
Temecula Valley Therapy Services Effective July 1, 2008 Revised January 1, 2017
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.
We understand the importance of privacy and are committed to maintaining the confidentiality of your medical information. We make a record of the medical care we provide and may receive such records from others. We use these records to provide or enable other health care providers to provide quality medical care, to obtain payment for services provided to you as allowed by your health plan and to enable us to meet our professional and legal obligations to operate this outpatient clinic properly. We are required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information. This notice describes how we may use and disclose your medical information. It also describes your rights and our legal obligations with respect to your medical information.
- THIS NOTICE DESCRIBES OUR PRACTICES AND THAT OF:
- Any health care professional authorized to enter information into your patient record.
- All employees, staff members, independent contractors, volunteers, representatives or agents of our business.
- WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI)
We are legally required to protect the privacy of your health information. We call this information protected health information, or PHI for short, and it includes information that can be used to identify you that we have created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. We must provide you with this notice about our privacy practices that explains how, when, and why we use and disclose your PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose for the use or disclosure. We are legally required to follow the privacy practices that are described in this notice.
American Speech-Language- Hearing Association
41769 Enterprise Circle N, Suite 104, Temecula, CA 92590 951-303-8255 (office) www.temeculatherapy.com
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We reserve the right to change the terms of this notice and our privacy policies at any time. Any changes will apply to the PHI we already have. Before we make important changes to our policies, we will promptly change this notice and post a new notice in clear and prominent locations. The notice will contain on the first page, in the top right-hand corner, the effective date. You can also request a copy of this notice from the contact person listed in Section VI (Privacy Officer), below, at any time.
III. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION. We use and disclose protected health information for many different reasons. For some of these uses or disclosures, we need your specific authorization. Below, we describe the most common categories of our uses and disclosures and give you some examples of each category.
- Uses and Disclosures Relating to Treatment, Payment or Health Care Operations.
We may use and disclose your PHI for the following reasons:
- For treatment. We may disclose your PHI to physicians, nurses, medical students and other health care personnel who provide you with health care services or are involved in you care. For example, if you’re being treated for a speech problem related to an injury, we may disclose your PHI to a physical rehabilitation department in order to coordinate your care. 2. To obtain payment for treatment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to our billing department and your health plan to get paid for the health care services we provided to you. Under certain circumstances, we may also provide your PHI to our business associates, such as billing companies, claims processing companies and others that process our health care claims. 3. For health care operations. We may use and disclose medical information about you for Center operations. For example, we may use you PHI in order to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided health care services to you. Under certain circumstances, we may also provide your PHI to our accountants, attorneys, consultants, and others in order to make sure we are complying with the laws that affect us. 4. For office communications. We may use and disclose PHI to contact you regarding your appointments and/or scheduling changes, insurance, and billing information by email or phone. If you do not answer, we may leave a detailed message for you to return the call at your convenience.
- Certain Uses and Disclosures Do Not Require Your Authorization. We may use and disclose your PHI without your authorization for the following reasons:
- When a disclosure is required by federal, state, or local law, judicial or administrative proceedings or law enforcement. For example, we make disclosures when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect or when ordered in a judicial or administrative proceeding.
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- To avoid harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm. 3. For public health activities. We may, and are sometimes required by law to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child, elder or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medication; and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment, we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm 4. For health oversight activities. For example, we will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization. 5. For research purposes. In certain circumstances, we may provide PHI in order to conduct medical research. We do not disclose the name or address of the patient or family. 6. Marketing We may contact you to give you information about products or services related to your treatment, case management or care coordination, or to direct or recommend other treatments or health-related benefits and services that may be of interest to you via patient literature. We may also encourage you to purchase a product or service when we see you. We will not use or disclose your medical information without your written authorization. 7. Fundraising activities. We may contact you in our efforts to raise funds for our organization. The money raised through these activities is used to expand and support the health care services and educational programs we provide to the community. If you do not wish to be contacted as part of our fundraising efforts, please contact the Privacy Officer. 8. For specific government functions. We may disclose PHI for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody. 9. For workers’ compensation purposes. We may disclose PHI in order to comply with workers’ compensation laws.
- When This Medical Practice May Not Use or Disclose Your Health Information Except as described in this Notice of Privacy Practices, this medical practice will not use or disclose health information which identifies you without your written authorization. If you do authorize this medical practice to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
Your Health Information Rights: 1. Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information, by a written request specifying what information you want to limit and what limitations on our use or disclosure of that information you wish to have imposed. We reserve the right to accept or reject your request, and will notify you of our decision. 2. Right to Request Confidential Communications. You have the right to request that you receive your health information in a specific way or at a specific location. For example, you may ask that we contact you at a specific phone number or send information to your work address. We will comply with all reasonable requests submitted in writing which specify how or where you which to receive these communications.
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- Right to Inspect and Copy. Your have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request detailing what information you want access to and whether you want to inspect it or get a copy of it. We will charge a reasonable fee, as allowed by California law. We may deny your request under limited circumstances. If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed. In the event you request that the denial be reviewed, another licensed health care professional chosen by the Privacy Officer will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review. 4. The Right to an Accounting of Disclosures. You have a right to request a list of disclosures of medical information other than for our own operations or as required by law. Your request must be in writing and specify the time period you request which may not be more than six years or include dates prior to January 1, 2007. The list we will give you will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. We will provide the list to you at no charge, but if you make more than one request in the same year. We may charge you for the costs of providing the list. 5. The Right to Request a Correction or an Update to Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information. You must provide the request and your reason for the request in writing to the Privacy Officer. We will respond within 60 days of receiving your request. We may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed to be disclosed, or (iv) not part of our records. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you do not file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If we approve your request, we will make the change to your PHI, tell you that we have done it, and tell others that need to know about the change to your PHI. 6. The Right to Request a Paper Copy of this Notice. You have the right to request a paper copy of this notice by contacting the Privacy Officer.
- COMPLAINTS If you think that we may have violated your privacy rights, you may file a complaint with the Privacy Officer. All complaints must be in writing. You also may send a written complaint to the U.S. Department of Health and Human Services. Complaints to the Secretary must identify the entity about which the complaint is being made, must describe the situation that gives rise to the complaint, and must be filed within 180 days of the date when the complainant knew, or should have known of the event that gave rise to the complaint. We will take no retaliatory action against you if you file a complaint about our privacy practices.
- HOW TO CONTACT US If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact: Privacy Officer Minjon Ellison / 951-303-8255 Temecula Valley Therapy Services 41769 Enterprise Circle North, Ste. 104 Temecula, CA 92590