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.
Purpose of this Notice
The covered entity is required by law to give you a copy of this notice. It applies to the covered entity’s records regarding your health, health status, and the health care and services you receive through the covered entity.
This notice describes the information privacy practices followed by all of the covered entity’s personnel and any providers who provide on-call services for the covered entity. The covered entity is required by law to maintain the privacy of all of your protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to that protected health information.
All providers participating under the covered entity agree to abide by and follow the terms of this notice with respect to protected health information created or received by the covered entity as part of its health care operations practice. Providers participating under the covered entity may and will share protected health information with each other as necessary to carry out treatment, payment, or health care operations relating to the conduct of the covered entity.
Uses and Disclosures: How The Covered Entity May Use Your Health Information
- For Treatment:
- We may use your protected health information in order to make decisions necessary to provide you with medical treatment or services. This information may be disclosed to any doctors, nurses, office staff, or other personnel involved in taking care of you and your health.
- For example, your therapist may request information regarding your medical history. It is often necessary for your therapist to have this information in order to choose the most appropriate treatments and to avoid the introduction of further health complications. The therapist may also inform another doctor about your condition so that the doctor can make the most appropriate decisions regarding your health care.
- For Payment:
- We may use and disclose your protected health information so that the treatment/services you receive at this office may be billed to and payment may be collected from you, an insurance company or a third party.
- For example, we may provide protected health information to your health plan as is necessary for you to get reimbursement from your health plan.
- For Health Care Operations
- We may use and disclose your health information to make decisions about internal health care operations.
- For example, we may use your health information and combine it with the health information of others to analyze our services. This analysis may be used to determine treatment effectiveness or track changes in caseloads.
- For appointment reminders
- We may contact you to remind you of scheduled appointments. Please contact us if you do not wish to receive appointment reminders.
Other purposes for which the covered entity is permitted or required to use or disclose protected health information without the individual's written authorization, subject to all applicable legal requirements and limitations:
- Uses and disclosures required by federal, state or local law
- Uses and disclosures for public health activities
- Uses and disclosures about victims of abuse, neglect or domestic violence
- Uses and disclosures for health oversight activities
- Uses and disclosures for judicial and administrative proceedings
- Uses and disclosures for law enforcement purposes
- Uses and disclosures about decedents
- Uses and disclosures for cadaveric organ, eye or tissue donation purposes
- Uses and disclosures for research purposes
- Uses and disclosures to avert a serious threat to health or safety
- Uses and disclosures for specialized government functions
- Uses and disclosures for workers' compensation
Family and Friends
- The covered entity may disclose protected health information about you to your family or friends if the covered entity obtains your verbal agreement to do so, or if you are given the opportunity to object to this disclosure and you do not object. The covered entity may also disclose your protected health information to your family or friends if it can be inferred from the circumstances, based on the covered entity’s professional judgement, that you do not object. For example, we may infer that you agree to the disclosure of your protected health information to individuals who you have chosen to accompany you during your appointments with the covered entity.
We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Uses and disclosures that require an authorization:
- All other uses and disclosures not described in the notice will be made only with the individual's written, specific authorization.
- You may revoke an authorization.
- HIV or substance abuse information about you cannot be used or disclosed without a special, written authorization from you which complies with laws regarding HIV and substance abuse information.
- With the exception of retrospective chart reviews, we will obtain informed consent from you prior to involving you in any human research.
Individual Rights:
- You have the right to request restrictions on certain uses and disclosures of protected health information. You also have the right to request specific limits on information disclosed to specific parties involved in your care or the payment for it, like a family member or friend. We ask that restrictions be submitted in writing via email to tyler@veracitypt.com. The covered entity is not required to agree to a requested restriction, except in case of a disclosure restricted by law.
- You have the right to receive confidential communications of protected health information. This includes the right to request that we communicate with you about your health information only at certain locations or only through certain means of communication. For example, you may request that we communicate with you only through your home phone number. We ask that restrictions be submitted in writing via email to tyler@veracitypt.com.
- You have the right to inspect and copy your protected health information.
- You have the right to amend protected health information. For example, you may request that we amend records which you believe are incorrect or incomplete. We may deny this request if you ask us to amend information which we did not create or if the information is found to be correct and complete.
- You have the right to receive an accounting of disclosures of protected health information. This accounting is a list of the instances in which we have disclosed your information for purposes other than treatment, payment, and health care operations.
- You have the right to obtain a paper copy of this notice from the covered entity upon request. Email tyler@veracitypt.com for a paper copy of this notice.
The Covered Entity’s Duties:
- The covered entity is required by law to maintain the privacy of protected health information, to provide individuals with notice of its legal duties and privacy practices with respect to protected health information, and to notify affected individuals following a breach of unsecured protected health information.
- The covered entity is required to abide by the terms of the notice currently in effect.
- The covered entity reserves the right to change the terms of its notice and to make the new notice provisions effective for all protected health information that it maintains. In such an event, the covered entity will provide the individual with a revised notice via email and update online versions of this notice.
Complaints:
- Individuals may complain to the covered entity and to the Secretary of Health and Human Services (or any other officer or employee of HHS to whom the authority involved has been delegated) if they believe their privacy rights have been violated.
- The individual may file a complaint to the covered entity via email or by telephone.
- You will not be retaliated against for filing a complaint.
- If you need to file a complaint, you may contact Tyler Meis, owner of Veracity Physical Therapy, at 336-750-6692 or tyler@veracitypt.com
Contact:
- Any further questions regarding this notice may be directed to Tyler Meis, owner of Veracity Physical Therapy, at 336-750-6692 or tyler@veracitypt.com