Welcome to Namaste Physical Therapy. The place for all your pelvic health needs.

This policy describes how your medical information may be used and disclosed and how you can get access to this information. Please review this policy carefully and ask questions if there is anything you don’t understand.

Your Rights

• Getting a copy of your electronic medical record
  • You may request a copy of your electronic medical records. A copy or summary of your health information will be provided within 30 days of receipt of your request.
• Correct your medical record
  • A request may be submitted to have your health information that you think is incorrect or incomplete corrected. If your request is not met you will receive an explanation in writing within 30 days.
• Getting a copy of this privacy notice
  • A paper copy of this privacy notice can be requested and provided.
• Asking us to limit the information we share
  • A request may be submitted for us not to share certain health information for treatment, payment or our operations. We are not required to agree with your request if it affects your care.
  • If you pay for a service out-of-pocket in full you can request that we do not share that information for the purpose of payment or our operations with your health insurer. This request will be met unless a law requires us to share that information.
• Getting a list of those with whom we have shared your information
  • A list may be requested for all of the times your health information has been shared for up to six years prior to the date requested. All disclosures made will be included except for those about treatment, payment or health care operations, and certain other disclosures (those that were previously requested).
• Request confidential communication
  • You can ask to be contacted in a specific way (home vs office vs cell phone, email, mail)
• Choose someone to act for you
  • If another person has been given medical power of attorney for you or if they are a legal guardian, that person can make choices for you regarding your health information. Every effort will be made to ensure this person has that authority and is able to act for you before requests are carried out on your behalf.
• File a complaint if you believe your privacy rights have been violated.
  • Contact us if you feel your rights were violated. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue, S.W., Washington D.C., 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

Your Choices

You have some choices in the way that your health information is used for. For certain health information you can notify us of your choices about what we share. If you have a request it will be adhered to. For these circumstances you have the right and choice to:

• Share information with your family, close friends or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory
• If you are not able to communicate a preference (unconscious, coma), we may share your information if it is believed that it is in your best interest. We may also share your information if required to lessen a serious and imminent threat to health or safety.
• For these circumstances your health information will never be shared unless you give written permission
• Marketing purposes
• Sale of your information
• Sharing of psychotherapy notes
• In case of fundraising
• We may contact your for fundraising efforts but you can request not to be contacted.

Your Responsibilities

Our Uses and Disclosures

Your health information is typically used and shared in the following ways.Treatment: Your health information may be shared with other professionals who are treating you. Running our organization: Your health information may be used to run the practice, improve your care and contact you when necessary. Bill for services: Your health information may be used to assist you in getting payment from your health plan or other entities. Other: The practice is permitted to share your information in ways that contribute to the public good, such as public health and research. However many conditions must be met in order for this information to be shared for this purpose. For further information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Public Health and Safety: Health information can be shared about you for certain situations. For example, disease prevention, product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence and prevention of a serious threat to anyone’s health or safety. Research: Your information may be shared for research purposes. Compliance with the law: Your information will be shared if state or federal laws require it, including the Department of Health and Human Services if it wants to see that federal privacy laws are complied with. Work with a medical examiner or funeral director: Health information can be shared with a coroner, medical examiner, or funeral director when an individual dies. Address worker’s compensation, law enforcement, and other government requests: Your health information may be shared for workers’ compensation claims, law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law or for special government functions such a military, national security, and presidential protective services. Respond to lawsuits and legal actions: Health information can be shared in response to a court or administrative order, or in response to a subpoena.   *We do not create or manage a Hospital Directory.

Our Responsibilities

The law requires that the privacy and security of your health information is protected.
You will be notified promptly if a breach occurs that may have compromised the privacy or security of your information.
The duties and privacy practices described in this notice must be followed and you will receive copy of it.
Your information will not be used or shared other than as described in this notice unless you notify us in written. You may change your mind at any time by notifying us in writing. Changes to the Terms of this NoticeThe terms of this notice may be changed and the changes will apply to all information we have concerning you. The new notice will be available upon request and on the website.
Effective 01/2017 This notice of Privacy Practices applies to the following organizations
Namaste Physical Therapy, PLLC