Provides Royal Therapy Care
751 Route 37 West Toms River, New Jersey
Phone (732) 608-0147
Fax (732) 353-5123
I. HIPAA Defined - The Health Insurance Portability and Accountability Act of 1996 ("HIPAA") is a federal law which requires that medical records and individually identifiable health information be kept confidential, and that its uses and disclosures be in accordance with the law. The regulations which pertain to HIPAA ("privacy rules") went into effect in 2003. The HIPAA standards, which require that patients be given a printed notice explaining the new privacy rules, are in addition to the longstanding confidentiality provisions under New York State law.
HIPAA applies to certain healthcare entities ("covered entities") which submit billing information electronically. Covered entities must safeguard all protected health information ("PHI") regardless of its form (i.e., paper, faxes, electronic files, etc.) As mandated by HIPAA, this notice is an explanation of the privacy requirements concerning your health information, and how your PHI may be used and disclosed.
II. LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION ("PHI")
By law your PHI is kept private. The PHI consists of information created or noted that can be used to identify you. It may contain data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. Use of PHI means to share, apply, utilize, examine, or analyze information. PHI is disclosed when there is a release transfer or other disclosure to a third party. With some exceptions (i.e., treatment) one may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made.
III. HOW YOUR PHI IS USED AND DISCLOSED
PHI is disclosed for various reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find categories of uses and disclosures, with some examples.
1. Uses and Disclosures Related to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent. A provider may use and disclose your PHI without your consent for the following reasons:
2. Certain Other Uses and Disclosures Do Not Require Your Consent.
Other use and/or disclosure of your PHI without your consent or authorization is permitted as follows:
3. Certain Uses and Disclosures Require That You Have the Opportunity to Object.
4. Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections IIIA, IIIB, and IIIC above, written authorization is required before using or disclosing any of your PHI. Even if you have signed, an authorization to disclose your PHI, you may later revoke that authorization in writing, to stop additional disclosures, other than those releases made relying on your prior authorization.
IV. RIGHTS YOU HAVE REGARDING YOUR PHI
These are your rights with respect to your PHI, which you can exercise by sending a written request to the Privacy Officer listed at the end of this notice:
V. HOW TO COMPLAIN ABOUT PRIVACY PRACTICES
If, in your opinion, there have been violations of your privacy rights, or if you object to a decision about access to your PHI, you are entitled to file a complaint with the person, listed in Section VI below. You may also send a written complaint to the Department of Health and Human Services, Office for Civil Rights, Jacob Javits Federal Building, 26 Federal Plaza, Suite 3312, NY, NY 10278. If you file a complaint about the privacy practices of this provider, there will be no retaliatory action against you.
VI. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT PRIVACY PRACTICES
If you have any questions about this notice or any complaints about the privacy practices of this provider, please contact: Amy Stein, Beyond Basics Physical Therapy, 212.354.2622.
VII. EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on April 14, 2003.