In accordance with the Health Insurance Portability and Accountability Act (HIPAA), this notice describes how medical information about individuals served by the Easter Seals Rehabilitation Center may be used and disclosed, and how individuals can get access to their own information. If you receive services from the Easter Seals Rehabilitation Center, or are the legal guardian of someone who does, please review the policy carefully.
I. The Easter Seals Rehabilitation Center has a legal duty to protect the privacy of your information. We call this information "Protected Health Information" or "PHI" for short. It includes information that we have created or received about your past, present, or future health or condition, information about how we provide services to you, and information related to payment of these services. We are required to give you this notice about our privacy practices that explains how, when and why we use and disclose your PHI. We are legally required to follow the privacy practices described in this notice.
We reserve the right to change the terms of this notice and our privacy policies at any time. Any changes will apply to the PHI we already have. Before we make an important change to our policies, we will change this notice and post a new notice in the main lobby of our facility. You can request a copy of this notice by calling 812-479-1411.
II. How we may use and disclose your protected health information: We use and disclose health information for many different reasons. For some of these uses or disclosures, we need your prior consent or specific authorization. The following is a description of the different types of uses and disclosures and examples.
A. Uses and Disclosures relating to treatment, payment, or health care operations that do NOT require your prior written consent. We may use and disclose your PHI WITHOUT your consent for the following reasons:
1. For treatment: We may disclose your PHI to therapists, students, physicians, and other health care personnel who are involved in your care. For example, if you are an Occupational Therapy client, your therapist may consult with a Speech Therapist to help determine if a speech delay should be addressed.
2. To obtain payment for treatment: We may use or disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to our billing department and your health plan to get paid for the services that we provided to you or for prior authorization for services. We may also provide your PHI to our claims processing companies and others that process our health care claims ("Business Associates"). In addition, your billing statement is sent to the responsible party indicated on the account and includes information on all family members listed on that account.
3. For health care operations. We may disclose your PHI in order to operate the Easter Seals Rehabilitation Center. For example, we may use your PHI in order to evaluate the quality of services that you received or to evaluate the performance of the health care professionals who provided services to you. We may also provide your PHI to our accountants, attorneys, consultants and others in order to make sure we are complying with laws that affect us. For example, we may review your Medical Record to determine whether or not we follow up as suggested. (A follow-up is recommended in 1 year following an orthopedic evaluation. We would check to be sure that we contact you to schedule an appointment at the end of that year.)
Appointment reminders: We may use and disclose PHI to contact you as a reminder that you have an appointment for treatment or medical care.
Treatment alternatives: We may use and disclose PHI to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-reated benefits and services: We may use and disclose PHI to tell you about health-related benefits or services that may be of interest to you.
Fundraising activities: We may use and disclose PHI to contact you in an effort to raise money for the Easter Seals Rehabilitation Center and its operations. We would only release information such as your name, address and phone number and the dates you received treatment or services at the Easter Seals Rehabilitation Center.
Individuals involved in your care or payment for your care: Unless you object, we may release certain limited PHI about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.
The above examples are not all inclusive of the situations when we may use and disclose PHI for treatment, payment and operations.
B. Other uses and disclosures that do NOT require your consent. We may use and disclose your PHI WITHOUT your consent or authorization for the following reasons:
1. Public health: We may disclose PHI to public health authorities as required by law. This may include the following:
To prevent or control disease, injury or disability;
To report births and deaths;
To report child abuse or neglect;
To report reactions to medications or problems with products;
To notify people of recalls of products they may be using;
To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
To notify the appropriate government authority if we believe a Client has been the victim of abuse, neglect or domestic violence.
2. Health oversight activities: We may disclose PHI to a health oversight agency for activities authorized by law such as audits, investigations and inspections and reviews for licensure purposes.
3. Abuse and neglect: The Easter Seals Rehabilitation Center is required to report any suspicion of abuse or neglect of a child or dependent person. We are permitted to disclose PHI to government authorities authorized by law to receive reports of child abuse or neglect. We may also disclose your PHI in situations of domestic abuse or elder abuse.
4. Legal proceedings: We may disclose PHI in the course of a judicial or administrative proceeding in response to a court order.
5. Law enforcement: We may disclose PHI for law enforcement purposes in response to state or federal law, to identify a suspect, fugitive, material witness or missing person; about criminal conduct that may occur at the Easter Seals Rehabilitation Center, and in emergency circumstances to report a crime, location of the crime or victims, or the identity of the person who committed the crime.
6. To prevent harm: In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.
7. Miltary activity and national security: We may use or disclose the PHI of individuals who are Armed Forces personnel and we may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state, or conduct special investigations.
8. Workers' compensation: We may release PHI to workers' compensation or similar programs.
C. All other uses and disclosures require your prior written authorization. In any situation not described in this Privacy Notice, we will ask for your written authorization before using or disclosing any of your Health Information. If you choose to sign an authorization to disclose your Health Information, you can later revoke that authorization in writing to stop any future uses and disclosures.
III. YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION: You have the following rights regarding your Health Information:
1. The right to request limits in uses and disclosures of your Protected Health Information. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
2. The right to choose how we send information to you. You have the right to ask that we send information to you at an alternate address (for example, sending information to your work address instead of your home address) or by alternate means. If you make this request in writing, we must agree to your request so long as we can easily provide it in the form you requested.
3. The right to view and obtain copies of your Health Information. In most cases, you have the right to view or obtain copies of your PHI. You must make this request in writing. We will respond to you in writing within 30 days after receiving your written request. If we deny the request, we will tell you in writing our reasons for the denial of your request, and your right to have the denial reviewed. If you request copies of your PHI, we will charge appropriately by the number of pages you are requesting. Instead of providing the PHI you requested, we may provide you with a summary or explanation of the PHI.
4. The right to obtain a list of the disclosures we have made. You have the right to get a list of instances in which we have disclosed your Health Information. The list will not include uses and disclosures for...
5. The right to correct or update your Personal Health Information. If you believe there is a mistake in your PHI or a piece of important information is missing, you have the right to request that we amend the existing information or add the missing information. You must provide the request and your reason for the request in writing. We will respond within 60 days of receiving your request. We may deny your request stating the reasons for the denial and explain your right to file a written statement of disagreement with the denial.
IV. HOW TO COMPLAIN ABOUT PRIVACY PRACTICES: If you feel we may have violated your Privacy Rights or you disagree with a decision we made about access to your PHI, you may file a complaint with the Privacy Officer (see Section V below). We will take no retaliatory action against you if you file a complaint about our privacy practices.
V. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR PRIVACY PRACTICES: If you have any questions about this notice or any complaints about our privacy practices or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact HIPAA Privacy Officer, Easter Seals Rehabilitation Center, 3701 Bellemeade Avenue, Evansville, IN 47714, or telephone 812-479-1411, or send an email to: email@example.com.
VI. EFFECTIVE DATE OF THIS NOTICE: This notice is effective April 14, 2003.