PRIVACY STATEMENT

 

We protect the privacy of our patient’s health information as required by law, practice standards, and our internal policies and procedures.  This privacy statement explains your rights, our legal duties, and our privacy practices.

 

Your Health Information

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW CAREFULLY.

 

We collect, use, and disclose information provided by and about you for medically necessary treatment, health care payment and operations or when we are otherwise permitted or required by law to do so.

 

For Payment:  We may use and disclose information about you in managing your medical file, to secure treatment authorization, to confirm insurance coverage, for medical billing and receiving payments for medical care through your health plan or other similar entities.  We may also provide information to a doctor’s office, hospital, or other health care providers or health plans to confirm your eligibility for benefits, medical diagnosis, treatment, and other medically necessary information in order to provide appropriate services and receive payment.  

 

For Health Care Operations:  We may use and disclose medical information about you for our operations.  For example, we may use information about you to review the quality of care and services you receive; to provide you medical file management or coordination of medical services such as between treating therapists or between doctor and therapist.

 

As Permitted or Required by Law:  Information about you may be used or disclosed to regulatory agencies, such as during audits, licensure, or other proceedings; for administrative or judicial proceedings; to public health authorities; or to law enforcement officials, such as to comply with a court order or subpoena.

 

Authorization:  Other uses and disclosures of protected health information will be made only with your written permission, unless otherwise permitted or required by law.  You may revoke this authorization, at any time, in writing.  We will then stop using your information for that purpose.  However, if we have already used your information based on your authorization, you cannot take back your agreement for those past situations.

 

Your Rights

Under regulations that will be in effect on April 14, 2003, you will have additional rights over your health information.  Under the new rules, you will have the right to:

  • Send us a written request to see or get a copy of information that we have about you, or amend your personal information that you believe is incomplete or inaccurate.  If we did not create the information, we will refer you to the source, such as your physician or hospital.

  • Request additional restrictions on uses and disclosures of your health information.  We are not required to agree to these requests. 

  • Request that we communicate with you about medical matters using reasonable alternative means or at an alternative address if communications to your home address could endanger you.

  • Receive an accounting of our disclosures of your medical information, except when those disclosures are made for treatment, payment, or health care operations, or the law otherwise restricts the accounting.  We are not required to give you a list of disclosures made before April 14, 2003.

 

Complaints

If you believe your privacy rights have been violated, you have the right to file a complaint with us, or with the federal government.  You will not be penalized for filing a complaint.

 

Copies and Changes

You have the right to receive an additional copy of this notice at any time.  We reserve the right to revise this notice.  A revised notice will be effective for information we already have about you as well as any information we may receive in the future.  We are required by law to comply with whatever privacy notice is currently in effect.  We will communicate any changes to our notice through direct mail.

 

Contact Information

If you want to exercise your rights under this notice or if you wish to communicate to us about privacy issues or to file a complaint with us, please contact our privacy officer, John Dravillas, PT, OCS, MTC.

THE CLINIC

719 Santa Monica Blvd

Santa Monica, CA 90401

tel:  310 260 9039

fax: 310 260 1091

info@physicaltherapyworks.com

Mon -Fri: 8am -7:30pm

Saturday: Closed

​​Sunday: Closed

CONTACT

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