Notice of Privacy Practices

We use PHI to treat you, obtain payment for your care and related services, and conduct health care operations. Examples include maintaining records of the care and services you receive, sharing an evaluation or re-evaluation report with your referring physician, billing a third-party payer, monitoring the quality of care, business planning, compliance monitoring, and investigating or resolving complaints.

If you pay for services in full without involving a third party such as an insurer or employer, you may request that we not disclose information regarding those services for payment purposes.

We may use or disclose PHI to update a workers’ compensation case worker or employer; remind you of appointments; follow up on home programs and discharge planning; release equipment or supplies to your designee; or advise you of new or updated services or home supplies. You may opt out of notices of this kind.

We may also carry out research that does not directly identify you, provide nominal promotional gifts, or contact you about fundraising projects. If we receive direct or indirect financial remuneration from a third party for marketing or fundraising, we will offer you the opportunity to opt out of receiving these materials.

If you do not verbally object, we may share relevant PHI with a family member or friend involved in your care. We may also use PHI in an emergency when you are unable to express yourself.

Law may require or permit disclosure for public health activities, reports of neglect, abuse, or domestic violence, regulatory oversight, judicial or administrative proceedings, valid law-enforcement requests, prevention of a serious threat to health or safety, certain military activities, and organ donor programs. Body Balance Physical Therapy will obtain authorization for research even where disclosure may otherwise be permitted.

In some situations, we must ask for and receive your written authorization before using or disclosing PHI. An authorization includes specific instructions and limits on use or disclosure. You may revoke an authorization in writing at a later date; however, revocation does not affect uses or disclosures already made in reliance on your authorization.

• Request limited use or disclosure: You may request that we not use or disclose PHI in a particular way. We are not required to agree, but if we do, we must follow the agreement.
• Request confidential communication: You may ask to receive communications at a location or phone number you specify.
• Inspect and copy PHI: You may inspect and copy PHI. We generally respond within 30 days and may charge reasonable copying and labor fees.
• Request an amendment: You may request an amendment to your record in writing.
• Request an accounting: You may request an accounting of certain disclosures made during the past six years.
• Receive breach notification: We will notify you of a breach of unsecured PHI as required by law, generally no later than 60 days after discovery.
• Complain: You may file a complaint without retaliation.
• Receive a copy of this notice: You may receive a copy of this Notice of Privacy Practices at any time.

We are required by law to maintain the privacy and security of your protected health information, notify you promptly if a breach may have compromised its privacy or security, follow the duties and privacy practices described in this notice, and provide you with a copy. We will not use or share your information other than as described here unless you tell us in writing that we can. If this notice changes, we will provide a revised notice when you next seek treatment.