Ellis Rehabilitation Services, Inc.
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.
A federal regulation, 45 CFR Parts 160 and 164, known
as the "HIPAA Privacy Rule" requires that we provide detailed
notice in writing of our privacy practices. We know that this Notice
is long. The HIPAA Privacy Rule requires us to address many specific
things in this Notice.
1. OUR COMMITMENT TO PROTECTING HEALTH INFORMATION
ABOUT YOU
In this Notice we describe the ways that we may use
and disclose health information about our patients. The HIPAA Privacy
Rule requires that we protect the privacy of health information that
identifies a patient, or where there is a reasonable basis to believe
the information can be used to identify a patient. This information
is called ‘protected health information" or "PHI".
This Notice describes your rights as our patient and our obligations
regarding the use and disclosure of PHI. We are required by law to:
o Maintain the privacy of PHI about you;
o Give you this Notice of our legal duties and privacy practices
with respect to PHI; and
o Comply with the terms of our Notice of Privacy Practices that is
currently in effect.
We reserve the right to make changes to this Notice
and to make such changes effective for all PHI we may already have
about you. If and when this Notice is changed, we will post a copy
in our office in a prominent location. We will also provide you with
a copy of the revised Notice upon your request made to our Privacy
Official.
1. HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION
ABOUT YOU
USES AND DISCLOSURES FOR TREATMENT, PAYMENT, AND HEALTH
CARE OPERATIONS
The following categories describe the different ways
we may use and disclose PHI for treatment, payment, or health care
operations. The examples included with each category do not list
every type of use or disclosure that may fall within that category.
Treatment: We may use and disclose PHI about you to
provide, coordinate or manage your health care and related services.
We may consult with other health care providers regarding your treatment
and coordinate and manage your health care with others. For example,
we may use and disclose PHI when you need a prescription, medical
equipment, orthotic devices, or other health care services. In addition,
we may use and disclose PHI about you when referring you to another
health care provider or to a specialist to whom you have been referred.
We may also disclose PHI about you for the treatment
activities of another health care provider. For example, we may send
a report from us to the physician which referred you.
Payment: We may use and disclose PHI so that we can
bill and collect payment for the treatment and services provided
to you. Before providing treatment or services, we may share details
with your health plan concerning the services you are scheduled to
receive. For example, we may ask for payment approval from your health
plan before we provide care or services. We may use and disclose
PHI to find out if your health plan will cover the cost of care and
services we provide. We may use and disclose PHI to confirm you are
receiving the appropriate amount of care to obtain payment for services.
We may use and disclose PHI for billing, claims management, and collection
activities. We may disclose PHI to insurance companies providing
you with additional coverage. We may disclose limited PHI to consumer
reporting agencies relating to collection of payments owed to us.
We may also disclose PHI to another health care provider
or to a company or health plan required to comply with the HIPAA
Privacy Rule for the payment activities of that health care provider,
company, or health plan. For example, we may allow a health insurance
company to review PHI for the insurance company’s activities
to determine the insurance benefits to be paid for your care.
Health Care Operations: We may use and disclose PHI
in performing business activities which are called health care operations.
Health care operations include doing things that allow us to improve
the quality of care we provide and to reduce health care costs. We
may use and disclose PHI about you in the following health care operations:
* Reviewing and improving the quality, efficiency and
cost of care that we provide to our patients. For example, we may
use PHI about you to develop ways to assist our therapists and staff
in deciding how we can improve the medical treatment we provided
to others.
* Improving health care and lowering costs for groups of people who
have similar health problems and helping to manage and coordinate
the care for these groups of people. We may use PHI to identify groups
of people with similar health problems to give them information,
for instance, about treatment alternatives, and educational classes.
* Reviewing and evaluating the skills, qualifications, and performance
of health care providers taking care of you and other patients.
* Providing training programs for students, trainees, health care
providers, or non-health care professionals (for example, billing
personnel) to help them practice or improve their skills.
* Cooperating with outside organizations that assess the quality
of the care that we provide.
* Cooperating with outside organizations that evaluate, certify,
or license health care providers or staff in a particular field or
specialty. For example, we may use or disclose PHI so that one of
our therapists may become certified as having expertise in a specific
field of therapy.
* Cooperating with various people who review our activities. For
example, PHI may be seen by doctors reviewing the services provided
to you, and by accountants, lawyers, and others who assist us in
complying with the law and managing our business.
* Assisting us in making plans for our practice’s future operations.
* Resolving grievances within our practice.
* Reviewing our activities and using or disclosing PHI in the event
that we sell our practice to someone else or combine with another
practice.
* Business planning and development, such as cost-management analyses.
* Business management and general administrative activities of our
practice, including managing our activities related to complying
with the HIPAA Privacy Rule and other legal requirements.
* Creating de-identified information that is not identifiable to
any individual.
If another health care provider, company, or health
plan that is required to comply with the HIPAA Privacy Rule has or
once had a relationship with you, we may disclose PHI about you for
certain health care operations of that health care provider or company.
For example, such health care operations may include: reviewing and
improving the quality, efficiency and cost of care provided to you;
reviewing and evaluating the skills, qualifications, and performance
of health care providers; providing training programs for students,
trainees, health care providers, or non-health care professionals;
cooperating with outside organizations that evaluate, certify, or
license health care providers or staff in a particular field or specialty;
and assisting with legal compliance activities of that health care
provider or company.
Communication From Our Office: We may contact you to
remind you of appointments and to provide you with information about
treatment alternatives or other health related benefits and services
that may be of interest to you.
OTHER USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR
WRITTEN AUTHORIZATION
Uses and disclosures for which you have the opportunity
to agree or object
We may use and disclose PHI about you in some situations
where you have the opportunity to agree or object to certain uses
and disclosures of PHI about you. If you do not object, then we may
make these types of uses and disclosures of PHI.
* Individuals Involved In Your Care or Payment for
Your Care: We may disclose PHI about you to your family member, close
friend, or any other person identified by you if that information
is directly relevant to the person’s involvement in your care
or payment for your care. If you are present and able to consent
or object (or if you are available in advance), then we may only
use or disclose PHI if you do not object after you have been informed
of your opportunity to object. If you are not present or you are
unable to consent or object, we may exercise professional judgement
in determining whether the use or disclosure of PHI is in your best
interests. For example, if you are brought into this office and are
unable to communicate normally with your therapist for some reason,
we may find it is in your best interest to give your home instructions
or medical supplies to the friend or relative who brought you in
for treatment. We may also use and disclose PHI to notify such persons
of your location or general condition. We may also use professional
judgement and our experience with common practice to make reasonable
decisions about your best interests in allowing a person to act on
your behalf to pick up filled home exercise programs, medical supplies,
equipment, or other things that contain PHI about you.
OTHER USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR
WRITTEN AUTHORIZATION OR OPPORTUNITY TO AGREE OR OBJECT
We may use and disclose PHI about you in the following
circumstances without your authorization or opportunity to agree
or object, provided that we comply with certain conditions that may
apply.
Required By Law: We may use and disclose PHI as required
by federal, state, or local law. Any disclosure complies with the
law and is limited to the requirements of the law.
Public Health Activities: We may use or disclose PHI
to public health authorities or other authorized persons to carry
out certain activities related to public health, including the following
activities:
* To prevent or control disease, injury, or disability;
* To report disease or injury;
* To report child abuse or neglect;
* To report reactions to medications or problems with products or
devices regulated by the federal Food and Drug Administration or
other activities related to quality, safety, or effectiveness of
FDA-regulated products or activities;
* To locate and notify persons of recalls of products they may be
using;
* To notify a person who may have been exposed to a communicable
disease in order to control who may be at risk of contracting or
spreading the disease; or
* To report to your employer, under limited circumstances, information
related primarily to workplace injuries or illness, or workplace
medical surveillance.
Abuse, Neglect, or Domestic Violence: We may disclose
PHI in certain cases to proper government authorities if we reasonably
believe that a patient has been a victim of domestic violence, abuse,
or neglect.
Health Oversight Activities: We may disclose PHI to
a health oversight agency for oversight activities including, for
example, audits, investigations, inspections, licensure, and disciplinary
activities and other activities conducted by health oversight agencies
to monitor the health care system, government health care programs
and compliance with certain laws.
Lawsuits and Other Legal Proceedings: We may use or
disclose PHI when required by a court or administrative tribunal
order. We may also disclose PHI in response to subpoenas, discovery
requests, or other required legal process when efforts have been
made to advise you of the request or to obtain an order protecting
the information requested.
Law Enforcement: Under certain conditions, we may disclose
PHI to law enforcement officials for the following purposes where
the disclosure is:
* About a suspected crime victim if, under certain
limited circumstances, we are unable to obtain a person’s agreement
because of incapacity or emergency;
* Required by law;
* In response to a court order, warrant, subpoena, summons, administrative
agency request, or other authorized process;
* To identify or locate a suspect, fugitive, material witness, or
missing person;
* About a crime or suspected crime committed at our office; or
* In response to a medical emergency not occurring at the office,
if necessary to report a crime, including the nature of the crime,
the location of the crime or the victim, and the identity of the
person who committed the crime.
Specialized Government Functions: Under certain circumstances
we may disclose PHI:
* For certain military and veteran activities, including
determination of eligibility for veterans for veterans benefits and
where deemed necessary by military command authorities;
* For national security and intelligence activities;
* To help provide protective services for the president and others;
* For the health or safety of inmates and others at correctional
institutions or other law enforcement custodial situations for the
general safety and health related to corrections facilities.
Disclosures required by HIPAA Privacy Rule: We are required
to disclose PHI to the Secretary of the United States Department
of Health and Human Services when requested by the Secretary to review
our compliance with the HIPAA Privacy Rule. We are also required
in certain cases to disclose PHI to you upon your request to access
PHI or for an accounting of certain disclosures of PHI about you.
OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
REQUIRE YOUR AUTHORIZATION
All other uses and disclosures of PHI about you will
only be made with your written authorization. If you have authorized
us to use or disclose PHI about you, you may revoke your authorization
at any time, except to the extent we have taken action based on the
authorization.
1. YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION
ABOUT YOU
Under federal law, you have the following rights regarding
PHI about you:
Right to Request Restrictions: You have the right to
request additional restrictions on the PHI that we may use for treatment,
payment and health care operations. You may also request additional
restrictions on our disclosure of PHI to certain individuals involved
in your care that are otherwise permitted by the Privacy Rule. We
are not required to agree to your request. If we do agree to your
request, we are required to comply with our agreement except in certain
cases, including where the information is needed to treat you in
the case of an emergency. To request restrictions, you must make
your request in writing to our Privacy Official. In your request,
please include (1) the information that you want restricted (2) how
you want to restrict the information (for example, restricting use
to this office, only restricting disclosures to persons outside this
office, or restricting both); and (3) to whom you want these restrictions
to apply.
Right to Receive Confidential Communications: You have
the right to request that you receive communications regarding PHI
in a certain manner or at a certain location. For example, you may
request that we contact you at home, rather than at work. You must
make your request in writing to our Privacy Official. You must specify
how you would like to be contacted. We are required to accommodate
reasonable requests.
Right to Inspect and Copy: You have the right to request
the opportunity to inspect and receive a copy of PHI about you in
certain records that we maintain. This includes your medical and
billing records but does not include psychotherapy notes or information
gathered or prepared for a civil, criminal, or administrative proceeding.
We may deny your request to inspect and copy PHI only in limited
circumstances. To inspect and copy PHI please contact out Privacy
Official. If you request a copy of PHI about you, we may charge you
a reasonable fee for the copying, postage, labor and supplies used
in meeting your request.
Right to Amend: You have the right to request that
we amend PHI about you as long as such information is kept by or
for our office. To make this type of request you must submit your
request in writing to our Privacy Official. You must also give us
a reason for your request. We may deny your request in certain cases,
including if it is not in writing or if you do not give us a reason
for the request.
Right to Receive an Accounting of Disclosures: You
have the right to request an accounting of certain disclosures that
we have made of PHI about you. This is a list of disclosures made
by us during a specified period of up to six years other than disclosures
made: for treatment, payment, and health care operations; for use
in or related to a facility director; to family members or friends
involved in your care; to you directly; pursuant to an authorization
of you or your personal representative, or for certain notification
purposes (including national security, intelligence, correctional,
and law enforcement purposes) and disclosures made before April 14,
2003. If you wish to make such a request, please contact our Privacy
Official identified on the last page of this Notice. The first list
that you request in a 12-month period will be free, but we may charge
you for our reasonable costs of providing additional lists in the
same 12-month period. We will tell you about these costs, and you
may choose to cancel your request at any time before costs are incurred.
To make the above requests you may call or come by
our office and fill out a form with all of the necessary information
we will need to review your request.
Right to a Paper Copy of This Notice: You have the
right to receive a paper copy of this Notice at any time. You are
entitled to a paper copy of this Notice even if you have previously
agreed to this Notice electronically.
To obtain a paper copy of this Notice, please contact
our Privacy Official listed on the last page of this Notice.
2. COMPLAINTS
If you believe your privacy rights have been violated
you may file a complaint with us or the Secretary of the United States
Department of Health and Human Services. To file a complaint with
our office, please contact our Privacy Official at the address and
number listed below. We will not be retaliate or take action against
you for filing a complaint.
3. QUESTIONS
If you have any questions about this Notice, please
contact our Privacy Official at the address and telephone number
listed below.
4. PRIVACY OFFICIAL CONTACT INFORMATION
You may contact our Privacy Official at the following
address and phone number:
Privacy Official
102 Grand Plaza
Grand Saline, TX 75140
1-903-962-7901
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