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Physical Therapy Consultants of Tulsa, Inc.                           Effective April 1, 2003

NOTICE OF PRIVACY PRACTICES

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.

Our practice values your privacy and is committed to protecting medical information about you or your dependent. Protected Health Information (PHI) is any health information that can be used to identify you/your dependent, which we maintain or transmit in written, oral, or electronic form. It may relate to you/your dependents past, present, or future medical health services.

This notice of privacy practices tells you how we may use and disclose your PHI that deals with treatment, payment or for other lawful purposes. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to: (1) Make sure that PHI that identifies you/your dependent is kept private (2) Give you this notice of our legal duties and privacy practices with respect to protected medical information about you/your dependent and follow the terms of the notice that is currently in effect but may be modified from time to time to maintain compliance.

HOW MAY WE USE AND DISCLOSE YOUR MEDICAL INFORMATION

The following categories describe different ways that we use and disclose PHI. Your PHI may be used or disclosed by those within our office to those outside our office who have a need to know that information in order to provide health care services related to your treatment, payment or health care operations. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of these categories.

             Treatment:  We may use or disclose PHI about you/your dependent to provide health care services in our office for use by staff, or other health care professionals involved in providing you/your dependent with care. We also may disclose PHI about your medical care such as but not limited to family members or others we use to provide services that are a part of the care.

             Payment:  We may use and disclose PHI as necessary to assist you in providing us with payment for your health care services, or for obtaining other medical services on your behalf. This may include but is not limited to: Providing health care plans or insurance companies with information about services, dates and conditions you/your dependent are being treated for in order for them to make a decision regarding eligibility, coverage, or payment for those services. We may also use and disclose your information to obtain payment from third parties that may be responsible for costs and we may use your information to bill you directly for services and items.

             Health care Operations:  We may use and disclose your PHI in order to conduct the normal, ordinary, reasonable business operations for our office on a day-to-day basis. These activities may include but are not limited to, our office, and the directing and managing of our staff. From time to time we may use or disclose your PHI in order to train staff, students, and evaluate actions or performance of staff. We may use your PHI to keep ordinary and necessary business records including but not limited to sign in when you visit our clinic, contacting you to remind you of an appointment, and calling your name in the waiting room.

            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.          

   Family Members, Friends, Guardians and Caregivers:  We may disclose a portion of your PHI that relates to the listed persons' need to know to provide you with healthcare. In making this decision we will determine what we believe your best interest to be. This may include notifying one of the parties of your location and general condition. We may also disclose a portion of your PHI to assist authorized persons in disaster or emergency relief efforts. 

                As Required by Law:  We will disclose PHI about you/your dependent when required to do so by federal, state or local law.

              Public Health:  As required by law we may report you/your dependent's PHI to any county, state or federal health agency whom we are required to for specific purposes.

              Law Enforcement:  If we are presented with a proper court order or other legal presentations or lawful demand from a law enforcement agency or officer. We will disclose your PHI to the extent that such order, presentation, or demand requires.  These requests may include court order, subpoenas and issued by a court of proper jurisdiction or government audits and inspections. We will also disclose PHI if necessary for law enforcement authorities to identify, arrest or apprehend a suspect or other individual or if we believe that by reporting such information the disclosure will help protect the health or safety of a person. We may disclose to authorized agencies instances of abuse, neglect or violence, or other injuries which we are required to report by law.

              Homeland and National Security:  We may disclose you/your dependents PHI to any authorized country, state, or federal official who is authorized by state or federal law or who has an order from a court of competent jurisdiction to receive such information for homeland or national security reasons.

                 Your Rights:  You have the following rights with respect to your PHI which you can exercise by presenting a written request to the office manager: (1) The right to request restrictions on certain uses and disclosures of PHI, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a request restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it (2) The right to reasonable requests to receive confidential communications of PHI from us by alternative means or at alternative locations (3) The right to inspect a copy of your PHI (4) The right to amend your PHI (5) The right to receive an accounting of disclosures of PHI (6) The right to obtain, and we have the obligation to receive, a written acknowledgement that you have received a copy of our Notice of Privacy Practices.

 

    

OUR COMMITMENT TO YOU

 You and/or your dependent are a valued part

of our practice and the information you

provide to use is safe and used responsibly.

 

 

THE FULL VERSION OF THIS POLICY CAN BE ACCESSED AT OUR WEBSITE WWW.HIPAADOCS.COM/SITE/PTCONSULTANTS.COM

OR UPON REQUEST TO RECEIVE A COPY.