NOTICE OF PRIVACY PRACTICES
Effective April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Physical Therapy Connections is dedicated to personally protecting your medical information. The medical record is the physical property of Physical Therapy Connections, and the health information contained in the medical record is yours. We are required by law to maintain the privacy of protected health information and to provide you with this Notice of our legal duties and privacy practices with respect to protected health information.
We are required by law to:
- Keep medical information about your protected health information private.
- Provide you this Notice of our legal duties and privacy practices with respect to medical information about your protected health information.
- Follow the terms of this Notice that is currently in effect.
Changes to this Notice
We reserve the right to change the terms of this Notice, making any revision applicable to all of the health information that we maintain.
If Physical Therapy Connections revises the terms of this Notice, we will post a revised Notice at Physical Therapy Connections locations.
We will also provide paper copies of this Notice upon request. You also will be asked to acknowledge in writing the receipt of this notice.
Who will follow this Notice?
Physical Therapy Connections provides health care to our clients/patients in partnership with physicians and other professionals and organizations. The information in this Notice of Privacy Practices will be followed by:
-Any healthcare professional that treats you at our location.
-All employed associates, staff or volunteers of our organization.
- Any business associate or partner of Physical Therapy Connections with whom we share health information.
Our pledge to you
We understand that medical information about you is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive. We provide quality care and comply with all legal requirements. This Notice applies to all of the records of your care that we maintain, whether created by facility staff, your personal physician or records disclosed to us with your authorization form from other providers.
How your medical information will be used and disclosed
-We may use and disclose verbal and written medical information about you for evaluation and treatment (such as sending medical information about you to a specialist as part of a referral process); to obtain payment for evaluation and treatments (such as sending billing information to your insurance company or Medicare); and for health care operations (such as review for quality assessment and the appropriateness of the care you receive); Coroners, Medical Examiners, and Funeral Directors, Organ Donation and Disease Registries.
-Subject to several requirements, we may use or disclose medical information about you without prior authorization including but not limited to health care operations, medical research projects subject to strict oversight and approvals and with safeguards to protect your privacy, public health purposes, quality assurance activities, licensing, training programs, obtaining legal and financial services, conducting business planning, processing grievances and complaints, creating reports that do not identify you individually, abuse and neglect reporting, health oversight audits or inspections, worker’s compensation or other similar programs.
-We may disclose medical information in specific circumstances when required by law (such as a request from law enforcement for a blood alcohol level), for reports about victims of abuse, neglect, or domestic violence, in limited situations such as when there is a warrant or subpoena or when the information is needed to locate a suspect or stop a crime, and in response to valid judicial or administrative orders.
-We may contact for appointment reminders or to tell you about our recommended possible treatment options, alternatives, health-related benefits or services that may be of interest to you or to support fund-raising efforts.
-You may be asked for your comments on the care you received at Physical Therapy Connections.
-Unless you object, and with the exception of Behavioral Health Patients, Physical Therapy Connections may disclose your medical information to family members, other relatives or close personal friends involved in your medical care.
-Physical Therapy Connections may disclose your medical information to a public or private entity for the purpose of coordinating with that entity to assist in disaster relief efforts.
-Physical Therapy Connections may disclose your medical information to prevent or lessen a serious threat to the health or safety of another person or the public.
Other uses of medical information
In any other situation not covered by this Notice, we will ask for your written authorization before using or disclosing medical information about you. If you choose to authorize use or disclosure, you can later revoke that authorization by notifying us in writing of your decision.
Patient Rights
Your rights regarding your medical information include:
-The right to request restrictions on certain uses and disclosures of your medical information. Physical Therapy Connections is not required to agree to your requested restriction.
-The right to choose how you receive communications from Physical Therapy Connections in a confidential manner (such as sending mail,
e-mail, or phone). You must make any such request in writing.
-The right to inspect and obtain a copy of your medical records. You may be charged a reasonable fee for any copies of your records.
-The right to request an amendment of your medical information. Your request must be in writing and may be denied if the information was not created by Physical Therapy Connections; is not part of the medical information maintained by Physical Therapy Connections; or if it is determined that the information in the record is accurate and complete. If we deny your request you may submit an appeal of the denial in writing to be included in your records.
-The right to receive an accounting of the disclosures of your medical information made by Physical Therapy Connections except for the disclosures made for treatment, payment or healthcare operations and for those specifically authorized by you or designated representatives
or family members, for national security purposes, or to law enforcement personnel.
-The right to receive a paper copy of the Notice.
Complaints
If you are concerned that your privacy rights may have been violated or you disagree with a decision Physical Therapy Connections has made, you may register your complaint with Physical Therapy Connections 58 GlenRoyal Dr, Pueblo, CO 81005-2174 (719) 565-6678 or file a written complaint with the Department of Health and Human Services, Office of Civil Rights, 200 Independence Avenue, S.W. Room 509F, HHH Bldg, Washington, DC 20201.
Please call us at 719.565.6678 with any privacy questions