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AbiliKids Brunswick AbiliKids Cuyahoga Falls 839 Pearl Road 63 Graham Road Suite 2 Brunswick, Ohio 44212 Cuyahoga Falls, Ohio 44223 Phone: 330-225-4182 Phone: 330-752-4370 Fax: 330-225-4879 Fax: 866-851-8273 |
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Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can access this information.
How is this information used and disclosed? We may use and disclose medical information about you for treatment. This includes sending medical information to physicians, specialists, and school programs as part of a referral or collaborative services. We may use and disclose medical information about you in order to obtain payment for treatment such as sending billing information and requested documentation to your insurance company or Medicaid. We may use or disclose medical information about you without your prior authorization for several other reasons. Subject to certain requirements, we may give out medical information about you without prior authorization for public health purposes, required abuse or neglect reporting, health oversight audits or inspections and emergencies. We can also disclose medical information when required by law, such as in response to a request from law enforcement in certain circumstances or in response to valid judicial or administrative orders. We may also contact you for appointment reminders or to tell you about treatment options or services that may compliment your therapy services. We may disclose medical information about you to a caregiver or family members who is involved in your medical care. You may request in writing that we not use or disclose medical information about you to persons involved in your care except when specifically authorized by you during times of an emergency or when required by the law. We will consider your request but are not legally required to accept it in those situations. All written requests or appeals should be submitted to our Privacy Officer listed at the bottom of this notice.
Other uses of medical information: In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing medical information about you. If you chose to authorize our use of your medical information, you can later revoke that authorization by a written request. This request will not apply to information that has already been disclosed or information related to treatment, payment, or when required by law.
Our duty to protect your medical information: We understand that medical information about you is personal. AbiliKids is committed to protecting you medical information. We create written documentation of the care and services you receive in order to provide quality care and to comply with legal requirements. This notice applies to all records of care that we maintain whether it is created by our facility or other members of your care team. We are required by law to keep medical information about you private, give you this notice of our legal duties and privacy practices with respect to your medical information, and follow the terms of this notice that is currently in effect.
Your Rights Regarding Medical Information About You: You have a right to look at or get a copy of your medical information upon our reception of a written request. We may charge a fee for the cost of copying, mailing and/or other related supplies. If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we amend your records by submitting a written request. We may deny your request to amend a record if it was not created by us, if it is not part of the medical information maintained by us, or if we determine that the record is not accurate. You may appear, in writing, a decision by us not to amend a record. You have the right to a list of those instances where we have disclosed medical information about you other than for treatment, payment, or for legal situations. This request must be in writing and must state the time period desired for the accounting. The time period must be less than a 6-year period and must start after April 14, 2003. You may receive the list in paper or electronic form. If this notice was sent to you electronically, you have a right to a paper copy of this notice. You have a right to request that medical information about you be communicated to you in a confidential manner. This may include sending information to an address other than your home. You must notify us in writing of the specific way or location in which to communicate with you.
Complaints: If you are concerned that your privacy rights may have been violated, or you disagree with a decision that has been made about access to you records, you may contact our Privacy Officer. Under no circumstances will you be penalized or retaliated against for filing a complaint.
Privacy Office: Privacy Officer AbiliKids, LLC 839 Pearl Road Brunswick, Ohio 44212
Finally, you may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights. Our privacy office can provide you with the address. |