Notice of Privacy
At Woodlands Sports Medicine Centre, Physical Therapy and Rehabilitation, Inc., we are committed to treating and using protected health information about you responsibly. This Notice describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This Notice is effective April 14, 2003, and applies to all protected health information as defined by federal regulations. Your health or medical record, serves as a:
• Basis for planning your care and treatment,
• Means of communication among the many health professionals who contribute to your care,
• Means by which you or a third-party payer can verify that services billed were actually provided,
• A tool for routine healthcare operations such as assessing quality, education, marketing.
Your Health Information Rights
Although your health record is the physical property of Woodlands Sports Medicine Centre, Physical Therapy and Rehabilitation, Inc., the information belongs to you. You have the right to:
• Obtain a paper copy of this notice of privacy upon request,
• Inspect and receive a copy your health record as provided for in 45 CFR 164.524, a
fee will be charged as set forth by the Texas State Board of Medical Examiners,
• Amend your health record as provided in 45 CFR 164.528,
• Obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528,
• Request communications of your health information by alternative means or locations,
• Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522, and
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
Our Responsibilities
• Maintain the privacy of your health information,
• Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,
• Abide by the terms of this notice,
• Notify you if we are unable to agree to a requested restriction, and
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will post a revised notice in the lobby of our facility and provide a copy upon request.
We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.
For More Information or to Report a Problem
If have questions and would like additional information, you may contact the practice’s Privacy Officer at 281-364-7752. If you believe your privacy rights have been violated, you can file a complaint with the practice’s Privacy Officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W. ,Room 509F, HHH Building, Washington, D.C. 20201.
Our Notice of Privacy Policies is available upon request that provides a more complete description of information uses and disclosures. |
