notice of privacy policies for rebound rehab
physical therapy, inc.
this notice describes how information about you may be used and disclosed and how you can get access to this information. please review it carefully.
at rebound rehab physical therapy, we are committed to treating and using protected health information about you responsibly. this notice of health information practices describes the personal information we collect, and how and when we use or disclose that information. it also describes your rights as they relate to your protected health information. this notice is effective 1 april, 2003, and applies to all protected health information as defined by federal regulations.
understanding your health record / information
each time you visit rebound rehab physical therapy,
a record of your visit is made. typically, this
record contains your symptoms, examination and test
results, diagnoses, treatment, and a plan for future
care or treatment. this information, often referred
to as your health or medical record, serves as a:
understanding what is in your record and how your health information is used helps
you to: ensure its accuracy, better understand who,
what, when, where and why others may access your
health information, and make more informed decisions
when authorizing disclosures to others.
- basis for planning your care and treatment,
- means of communication among the many health professionals who contribute to your care,
- legal document describing the care you received,
verification that services billed were actually
- a tool in educating health professionals,
- a source of data for our planning and marketing,
- a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
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your health information rights
although your health record is the physical property of rebound rehab physical therapy, the information belongs to you. you have the right to:
- obtain a paper copy of this notice of information practices upon request,
- inspect and copy your health record as provided for in 45 cfr 164.524,
- amend your health record as provided in 45 cfr 164.528,
- obtain an accounting of disclosures of your health information as provided in 45 cfr 164.528,
- request communications of your health information by alternative means or at alternative locations,
- request a restriction on certain uses and disclosures of your information as provided by 45 cfr 164.522, and
- revoke your authorization to use or disclose health information except to the extent that action has already been taken.
rebound rehab physical therapy is required to:
we reserve the right to change our practices and to make the new provisions effective
for all protected health information we maintain.
should our information practices change, we will
mail a revised notice to the address you have supplied
us, of if you agree, we will email the revised notice
- maintain the privacy of your health information,
- provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,
- abide by the terms of this notice,
- notify you if we are unable to agree to a requested restriction, and
- accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
we will not use or disclose your health information
without your authorization, except as described
in this notice. we will also discontinue to use
or disclose your health information after we have
received a written revocation of the authorization
according to the procedures included in the authorization.
for more information or to report a problem
if you have questions and would like additional
information, you may contact the practices privacy
officer, chris gulbrandson, (916) 722-2909.
if you believe your privacy rights have been violated, you can file a complaint with the practices privacy officer, or with the office for civil rights, u.s. department of health and human services. there will be no retaliation for filing a complaint with either the privacy officer or the office for civil rights. the address for the ocr is listed below:
office for civil rights
examples of disclosures for treatment, payment and health operations
u.s. department of health and human services
200 independence avenue, s.w.
room 509f, hhh building
washington, d.c. 20201
we will use your health information for treatment.
for example: information obtained by a nurse,
physician, or other member of your health care team
will be recorded in your record and used to determine
the course of treatment that should work best for
you. your physician will document in your record
his or her expectations of the members of your health
care team. members of your health care team will
then record the actions they took and their observations.
in that way, the physician will know how you are
responding to treatment.
we will also provide your physician or a subsequent
health care provider with copies of various reports
that should assist him or her in treating you once
you are discharged from treatment at rebound rehab
we will use your health information for payment.
we will use your health information for payment.
for example: a bill may be sent to you or a third-party payer. the information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
we will use your health information for regular health operations.
for example: members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. this information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.
business associates: there are some services
provided in our organization through contacts with
business associates. examples include physician
services, certain laboratory test, and a copy service
we use when making copies of your health record.
when these services are contracted, we may disclose
your health information to our business associate
so that they can perform the job we have asked them
to do and bill you or your third-party payer for
services rendered. to protect your health information,
however, we require the business associate to appropriately
safeguard your information.
notification: we may use or disclose information
to notify or assist in notifying a family member,
personal representative, emergency contact, or another
person responsible for your care, your location,
and general condition.
communication with family: health professionals,
using their best judgment, may disclose to a family
member, other relative, close personal friend or
any other person you identify, health information
relevant to that persons involvement in your care
or payment related to your care.
marketing: we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
fund raising: we may contact you as part of a fund-raising effort.
food and drug administration (fda): we may disclose to the fda health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
workers compensation: we may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
public health: as required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
law enforcement: we may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
federal law makes provision for your health information
to be released to an appropriate health oversight
agency, public health authority or attorney, provided
that a work force member or business associate believes
in good faith that we have engaged in unlawful conduct
or have otherwise violated professional or clinical
standards and are potentially endangering one or
more patients, workers or the public.