This Notice describes how medical information about you may be used, disclosed and how you can get access to this information. Please review it carefully.
Columbus Physical Therapy, P.C., is required by law to maintain the privacy of Protected Health Information (PHI) and to provide you with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify you and that related to your past, present or future physical or mental health or condition and related health care services.
This notice of Privacy Practices (Notice) describes how we may use and disclose PHI to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law. The Notice also describes your rights with respect to your PHI. We are required to provide this notice to you by the Health Insurance Portability and Accountability Act (HIPAA).
Columbus Physical Therapy, P.C., is required to follow the terms of this Notice. We will not use or disclose your PHI without your written authorization, except as described or otherwise permitted by this Notice. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. Upon request, we will provide any revised Notice to you.
If you have questions or would like additional information about Columbus Physical Therapy, P.C., you may contact our office. If you believe your privacy rights have been violated, you can file a complaint with Columbus Physical Therapy, P.C., or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
Effective date: April 13, 2003
Your Health Information Rights
Obtain a paper copy of the Notice upon request
You may request a copy of our current Notice at any time. You may obtain a paper copy from the therapist.
Request a restriction on certain uses and disclosures of PHI
You have the rights to request additional restrictions on our use of disclosure of your PHI by sending a written request to our office. We are not required to agree to those restrictions. We cannot agree to restrictions on uses or disclosures that are legally required or which are necessary to administer our business.
Inspect and obtain a copy of PHI
In most cases, you have the right to access and copy the PHI that we may maintain about you. To inspect or copy your PHI, you must send a written request to our office. We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request. We may deny your request to inspect and copy in certain limited circumstances.
Request an amendment of PHI
If you feel the PHI we maintain about you is incomplete or incorrect, you may request that we amend it. To request an amendment, you must send a written request to the office. You must include a reason that supports your request. In certain cases, we may deny your request for amendment.
Receive an accounting of disclosures of PHI
You have the right to receive an accounting of the disclosures we have made of your PHI after April 14, 2003, for most purposes other than treatment, payment, or heath car operations. The right to receive and accounting is subject to certain exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to our office. Your request must specify the time period. The time period may not be longer than six years and may not include dates before April 14, 2003.
Request communication of PHI by alternative means or at alternative locations
For instance, you may request that we contact you at a different residence or post office box. To request confidential communication of your PHI, you must submit a request in writing to the office. Your request must tell us how or where you would like to be contacted. We will accommodate all reasonable requests.
Incidental Disclosures
Columbus Physical Therapy, P.C., will make reasonable efforts to avoid incidental disclosures of protected health information. An example of an incidental disclosure is conversations that may be overheard between the staff and the patient while in treatment.
Minors
If you are a minor who has lawfully provided consent for treatment and you with Columbus Physical Therapy, P.C., to treat you as an adult for purposes of access to and disclosure of records related to such treatment, please notify your therapists at Columbus Physical Therapy, P.C.
