Endurance Athletes Physical Therapy and Sport Performance, LLC
Joint Notice of Privacy Practices
Effective Date: August 1, 2013
This Joint Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
About This Notice:
This notices applies to, and covers, organizations that form an organized healthcare arrangement and includes Endurance Athletes Physical Therapy and Sport Performance, LLC as well as its staff, employees, students, and volunteers.
Our Pledge Regarding Protected Health information:
We understand that your health information is personal. When you receive healthcare, you give information about yourself to your physical therapist and others that care for you. We use the information you give to create a record about you and the care you receive. We need this record to provide you with the best quality care and to obey certain laws. This record is personal medical information that is protected by law and is called “protected health information”. We keep this protected health information in paper form such as a chart or electronic form on a computer. We are committed to keeping your protected health information safe.
By law, we must:
- Make sure that your protected health information is kept private;
- Give you this Notice of our legal duties and privacy practices; and
- Follow the terms of the Notice that are currently in effect.
This Notice will tell you about:
- The ways we may use and share your protected health information;
- Your rights; and
- Our responsibilities regarding the use and sharing of protected health information.
How We May Use and Share Your Protected Health Information (PHI)
We may use and share your PHI in certain ways. This allows us to better address your healthcare needs. We will explain how and when we may use or share your PHI. We are not able to list each specific way we may use or share your PHI, but each situation will fall into one of the categories below.
We may use and share your PHI to treat you. We may share your PHI with physicians, nurses, technicians, student trainees, and other people who help with your care. This is shared to coordinate services you need such as lab work, x-rays and other medical appointments. We may share your PHI outside of Endurance Athletes Physical Therapy and Sport Performance, LLC to help with keeping your care consistent and provide best practice to you.
We may use and share your PHI so that we are paid for the cost of your care. We may bill and share PHI with other providers, an insurance company, you, or a third party.
For Healthcare Operations
We may use your PHI for Endurance Athletes Physical Therapy and Sport Performance, LLC operations. The uses and disclosures are necessary to run Endurance Athletes Physical Therapy and Sport Performance, LLC and to make sure that all of our patients and clients receive quality care. We may use your PHI to contact you and see how your level of satisfaction with our services was, and how you are doing after treatment. We may use your PHI to review our treatment and services and to evaluate the performance of our staff in caring for you. We may use your PHI to determine additional services needed and to be provided by Endurance Athletes Physical Therapy and Sport Performance, LLC. We may use your PHI to see where we can make improvements in healthcare.
We may use and share your PHI to contact you to remind you of an appointment for care at Endurance Athletes Physical Therapy and Sport Performance, LLC.
Health Related Benefits and Services
We may use and share PHI to tell you about treatment options, benefits and services that may be of interest to you.
We may use and share your PHI to help find the best treatment options for injuries and diseases; for educational presentations and to help other patients’ injuries be prevented or treated to improve quality of life for all.
As Required by Law
We will share PHI about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety
We may use and share PHI about you when necessary to prevent a serious threat to your health and safety; the public’s health and safety; or another person’s health and safety.
Public Health Risks
As required by law, we may share your PHI with public health authorities to prevent or control disease, injury or disability; report medical device safety issues or adverse events to the Federal Food and Drug Administration; and report disease or infection exposure.
Victims of Abuse, Neglect, or Domestic Violence
We may share certain PHI with government agencies authorized by law to receive reports of abuse, neglect, or domestic violence if we believe that you have been a victim.
Health Oversight Activities
We may share PHI with a health oversight agency for actitivites permitted by law. For example, these may include audits, investigations, inspections, or licensure.
Judicial and Administrative Proceedings
We may share your PHI in the course of an administrative or judicial proceeding, such as in response to a court order.
We may share your PHI with a law enforcement official if required or permitted by law.
Specialized Government Functions
We may share your PHI with authorized federal officials for national security and intelligence, military, or veterans’ activities required by law.
Uses of Protected Health Information that Require Your Written Permission
In all other situations (situations that are not treatment, payment, health systems operations, or special situations, as we told you about above), we may only share your PHI with your written permission. You may revoke your permission, in writing, at any time. If you revoke your permission, then we will no longer use or share PHI about you for the reasons covered by your written permission, except to the extent that we have already used or shared your PHI.
Your Rights Regarding Your Protected Health Information
The physical form of your PHI and billing records is our business record and is the property of Endurance Athletes Physical Therapy and Sport Performance, LLC. The PHI contained in those records in your PHI. You have the following rights regarding your PHI.
Right to Review and Copy
You have the right to review and get a copy of PHI that may be used to make decisions about your care. Usually, this PHI includes information we use to make decisions about your care and billing records, but does not include psychotherapy notes, information compiled for use in or created in anticipation of a civil, criminal or administrative action proceeding, certain lab test results, other types of information we did not use to make decisions about your healthcare.
You must submit your request for your PHI in writing to Kari Brown Budde, PT, DPT, SCS at Endurance Athletes Physical Therapy and Sport Performance, LLC. If you request a copy of the PHI, then we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.
Right to Appeal a Denial of Access to PHI
You have the right to access your PHI. There are some limitations to that right including treatment reasons.
Right to Amend
If you feel that PHI we have about you is wrong or lacking information, then you may ask us to change the PHI.
Right to an Accounting of Disclosures
You have the right to request an accounting of disclosures of PHI. This is a list of certain disclosures of PHI we made in special situations listed above. These disclosures are not related to treatment, payment or healthcare operations. When we make these disclosures, we are not required to obtain your authorization before we share your PHI with others.
Right to Request Restrictions
You have the right to request a restriction or limitation on the PHI we use or share about you for treatment, payment or healthcare operations. We are not required to agree to your request.
Right to Request Confidential Communications
You have the right to request that we communicate with you about PHI in a certain way or at a certain location.
Right to a Paper Copy of This Notice
You have the right to ask for a paper copy of this notice.
Changes to this Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for PHI we already have about you and any PHI we receive in the future. Current copies will be posted at our website.
Endurance Athletes Physical Therapy and Sport Performance, LLC is dedicated to ensuring your privacy rights. If you believe your privacy rights have been violated, then you may file a complaint with Kari Brown Budde, PT, DPT, SCS at Endurance Athletes Physical Therapy and Sport Performance, LLC.