Privacy Policy
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATIOIN. PLEASE REVIEW IT CAREFULLY.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical and dental records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper or orally, are kept properly confidential. This Act gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse Protected Health Information (PHI).
This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
Uses and Disclosures of Protected Health Information
Your Protected Health Information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the practice, and any other use required by law.
Treatment: We will use and disclose your Protected Health Information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the health care professional has the necessary information to diagnose or treat you.
Payment: Your protected health information will be used, as needed, to obtain payment for health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of your physician's practice. These activities include, but are not limited to, quality assessment activities, employee review activities, and conducting or arranging for other business activities. We may use or disclose, as needed, your protected health information to support the business activities of this practice. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment. We may call your home and leave a message (either on an answering machine or with the person answering the phone) to remind you of an upcoming appointment, the need to schedule a new appointment or to call our office. We may also mail a postcard reminder to your home address. If you would prefer that we call or contact you at another telephone number or location, please let us know.
We may use or disclose your protected health information in the following situations without your authorization. These situations include: as Required By Law, Public Health issues required by law, Communicable Diseases: Health Oversight: Abuse or Neglect: Food and Drug Administration requirements: Legal Proceedings: Law Enforcement: Coroners, Funeral Directors, and Organ Donation: Research: Criminal Activity: Military Activity and National Security: Workers' Compensation: Inmates: Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of HIPAA.
Other Permitted and Required Uses and Disclosures Will Be Made Only With Your Consent, Authorization or Opportunity to Object unless required by law.
You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician's practice has taken an action in reliance on the use or disclosure indicated in the authorization.
Your Rights
The Following is a statement of your rights with respect to your protected health information.
- You have the right to inspect and copy your protected health information. Under federal law, however, you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information.
- You have the right to request a restriction of your health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in you care or for notification purposes described in this Notice of Privacy Practices. Your request must state the specific restriction and to whom you want the restriction to apply.
Your physical therapist is not required to agree to a restriction you may request. If yourphysical therapist believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another Healthcare Professional.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. You have the right to obtain a paper copy of this Notice from us, upon request, even if you have agreed to accept this Notice alternatively (i.e. electronically).
You may have the right to have your physical therapist amend your protected health information. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.
We reserve the right to change the terms of this Notice and will inform you of any changes. You then have the right to object or withdraw as provided in this Notice.
Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy officer of your complaint at our office and main telephone number.
We will not retaliate against you for filing a complaint.
This Notice was published and becomes effective on/or before 1/01/2010.
Momentum Physical Therapy & Sports Rehab, PLLC© Clinics
the Burger Rehabilitation Systems, Inc.'s policy to respect and protect the privacy of our members and the users of www.burger-rehab.com (hereinafter, the "Site"). Through this Privacy Statement, we want to reassure users of the Site that we will not sell, share, or rent user information to others in a manner different than as set forth in this Internet Privacy Statement.
- Burger Rehabilitation Systems, Inc. collects and/or requests information when a user:
- Submits an application or other document online
- Submits an E-mail for any reason
- Prints and completes any form data (which is returned via fax or mail)
We use this information for such purposes as responding to your requests, improving our site, and communicating with you via email, regular mail, or phone.
Our Site also contains links to external Internet sites which may be operated by an external party and they may have privacy practices that differ from those here at www.burger-rehab.com. When you click on links that take you to such external sites, you will be subject to their privacy policies, and we encourage you to become familiar with that party's privacy policies as these may differ from those utilized on our Site. Please note that this privacy statement applies solely to information collected by Burger Rehabilitation Systems, Inc. on our Site and, while we strongly support the protection of privacy on the Internet, we cannot be responsible for the privacy practices of other Websites, uses of the information collected by other Websites, or the content of those other Websites.
Consent
By using our Site, the user agrees to the terms and conditions set forth in this Internet Privacy Statement and the Site Terms of Use INCLUDING ALL LIMITATIONS OF DAMAGES PROVISIONS which are an integral part hereof and the user consents to the collection and use of this information by Burger Rehabilitation Systems, Inc. as disclosed in this Internet Privacy Statement. We may revise this Internet Privacy Statement or the Site Terms of Use at any time by updating these postings. By using this Site you agree to be bound by any such revisions in effect at the time of use and should therefore periodically visit this page and the Site Terms of Use page to determine the then current policies applicable to users of the Site.
