SENSORY ADVANTAGE, LLC NOTICE OF PRIVACY PRACTICES – HIPAA
AS REQUIRED BY THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA), THIS NOTICE, EFFECTIVE IMMEDIATELY, DESCRIBES HOW HEALTH INFORMATION ABOUT OUR CLIENTS MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW CAREFULLY. IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT JOYLYNN HOLLADAY AT (317) 721-2458.
I. Our Responsibility: We are required by law to maintain the privacy of all clients’ protected health information or PHI and make available a copy of our privacy practices. PHI refers to any information – whether oral, written, or electronic – that personally identifies a client and gives information about a client’s health status or condition. In the event that a breach occurs and PHI may have been compromised, the client will be notified promptly. We are required to follow the duties and privacy practices described in this notice and provide a client with a copy. Our practice will not use or share client information other than as described in this notice unless the client authorizes us to do so in writing. Any authorization provided may be revoked at any time. We have the right to change the terms of this notice, and these changes will apply to existing PHI. The revised notice will be available upon request, and posted on our web site.
II. Uses and Disclosures: The following categories describe the different ways we may use and disclose your PHI.
a. Treatment: Our practice may use the client’s PHI to provide, coordinate, and manage treatment and services. We may also disclose client’s PHI to a primary care physician or other health care provider for purposes related to the client’s treatment. We may disclose client’s PHI to family members or others who may assist in the client’s care.
b. Payment: As we are a private pay clinic, we will not directly disclose client’s PHI to third party entities for billing. However, upon request, we will provide clients with the necessary information for them to submit to insurance on their own for reimbursement. Should we end up accepting insurance in the future, we will amend this Notice to reflect that change.
c. Health Care Operations: Our practice may use a client’s PHI for the business aspects of running our practice. This includes quality assessment and improvement activities; employee review activities; training programs including those in which students, trainees or other health care practitioners learn under supervision; accreditation, certification, licensing, or credentialing activities; review and auditing; and business management and general administrative activities. In certain situations, we may disclose patient information to another provider for their health care operations.
d. Appointment Reminders: Our practice may use and disclose client’s PHI to contact clients to remind them of appointments.
e. Treatment Options: Our practice may use and disclose client’s PHI to inform clients of potential treatment options or alternatives.
f. Health-Related Benefits and Services: Our practice may use and disclose client’s PHI to inform clients of health-related benefits or services that may be of interest.
III. Other Uses and Disclosures: By law, we are allowed or required to share client PHI in specific situations.
a. When legally required by the law: We will disclose client PHI if state or federal law requires it.
b. When there is a risk to the public: We can share client PHI to prevent disease; notify a person regarding potential exposure to a communicable disease; help with product recalls; report adverse reactions to medications; report suspected abuse, neglect, or domestic violence; or prevent or reduce a serious threat to anyone’s health or safety.
c. Research: Our practice may disclose client PHI for research when the use or disclosure for research has been approved by an institutional review board that has reviewed the research proposal and protocols to address the privacy of PHI.
d. Law Enforcement/Legal Proceedings: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
IV. Client Rights: Although the client’s health record is the physical property of the healthcare practitioner or facility that compiled it, the client has certain rights when it comes to PHI.
a. Inspect and Copy: You have the right to inspect and obtain a copy of your health information, including billing records. A request must be submitted in writing to the Privacy Officer at Sensory Advantage, LLC. The client may be charged a fee for the costs of copying, mailing, or other costs incurred by our practice in complying with this request.
b. Amendment: The client may ask to amend health information that is incorrect or incomplete. The client has the right to request an amendment for as long as the information is kept by or for our practice. Any request for an amendment must be sent in writing to the Privacy Officer at Sensory Advantage, LLC. Request for amendment may be denied. Client will receive written notice for denial in 60 days.
c. Confidential Communications: The client has the right to request how PHI is communicated – e.g., the client can ask that we use a home number rather than a work number. All reasonable requests will be accommodated. Requests must be made in writing to our Privacy Officer.
d. Request Restrictions: The client has the right to request a restriction or limitation on the health information we use or disclose about treatment, payment, or healthcare operations. The client also has the right to request a limit on the health information we disclose to someone who is involved in the client’s care or the payment for client’s care (i.e., family member or friend). Any request for a restriction must be sent in writing to the Privacy Officer. We are not required to agree to this request and may say “no” if it would affect client care.
e. Accounting of Disclosures: The client has the right to request an accounting of disclosures. This is a list of disclosures our practice makes regarding client PHI for purposes other than treatment, payment, or healthcare operations where an authorization was not required.
f. Paper Copy of this Notice: The client has the right to a paper copy of this notice. A copy of this notice may be requested at any time.
g. Right to File a Complaint: Should the client feel these privacy rights have been violated, the client may file a complaint with this practice. The client may also file a complaint with the Secretary of the Department of Health and Human Services. The client will not be penalized for filing a complaint.