Venture Rehabilitation Group is required by law to maintain the privacy of the health information it maintains about its patients (also known as “Protected Health Information” or “PHI”) and to provide its patients with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify your child and that relates to your child’s past, present, or future physical or mental health condition and related health care services. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, obtain payment, or perform our health care operations and for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to PHI about your child.
Venture Rehabilitation Group will follow the practices described in this Notice. We will not use or disclose PHI about your child without your written authorization, except as described in this Notice. We reserve the right to change our practices and this Notice. In the event that we revise this Notice, the new Notice provisions will be effective for all PHI we maintain. We will provide you with a revised Notice upon request.
EXAMPLES OF HOW WE MAY USE AND DISCLOSE YOUR PHI
The following categories describe different ways that we may use and disclose your child’s PHI. These categories are provided for illustrative purposes only and not every use or disclosure is listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories below.
• We may use and disclose your child’s PHI for treatment;
• We may use and disclose your child’s PHI for payment;
• We may use and disclose your child’s PHI for health care operations.
In addition, we may use or disclose your child’s PHI for the following purposes:
• We may provide your child’s PHI to companies (known as “business associates”) who provide services to VRG when disclosure of that information is essential to the proper performance of that service;
• In communication with individuals involved in your child’s care or payment for your child’s care;
• Regarding health-related communications with you;
• For the prevention or control of disease and in the interests of public health;
• When and as required by law, for law enforcement purposes, or in response to a court order;
• To avert a serious threat to your child’s health or safety; or
• If, in VRG’s professional opinion, the patient is a victim of abuse, neglect or domestic violence.
OTHER USES AND DISCLOSURES OF PHI
Venture Rehabilitation Group must obtain your written authorization before using or disclosing PHI about your child for purposes other than those provided for above or as otherwise permitted or required by law. You may revoke an authorization in writing at any time. Upon receipt of a written revocation, we will stop using or disclosing PHI about you, except to the extent that we already have taken action in reliance on the authorization.
YOUR HEALTH INFORMATION RIGHTS
You have the following rights with respect to your child’s PHI that we maintain:
• You may obtain a paper copy of this Notice upon request by contacting us at our website, in person, or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official”.
• You may request a restriction on certain uses and disclosures of PHI. To request such a restriction, please provide a written request in person or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official” We are not required to agree to accept your requested restrictions unless the disclosure is to a health plan for purposes of carrying out payment or health care operations and the information pertains solely to a health care item or service for which you have paid Venture Rehabilitation Group out-of-pocket and in full. In the event that we do grant your request, however, we will abide by the restriction as it related to your child’s PHI on a going forward basis.
• You have the right to inspect or obtain a copy of PHI about your child. To inspect or copy PHI about your child, you must send a written request in person or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official”. We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request. We may deny your request in certain limited circumstances. If you are denied access to your child’s PHI, you may request that the denial be reviewed.
• You may request an amendment of PHI. If you feel that PHI we maintain about your child is incomplete or incorrect, you may request that we amend it. To request an amendment, you must send a written request in person or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official”. You must include a reason that supports your request for amendment. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may provide a rebuttal to your statement.
• Receive an accounting of disclosures of PHI. You have the right to receive an accounting of certain disclosures we have made of PHI about your child for most purposes other than treatment, payment and health care operations. To request an accounting, you must submit a written request in person or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official”. Your request must specify the time period for which the accounting is requested, which may not be longer than six years. The first accounting you request within a twelve month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.
• Request communications of PHI by alternative means or at alternative locations. You may request that we contact you concerning your child’s PHI by alternative means and/or at alternative locations. To request to receive communications of your child’s PHI by alternative means or at alternative locations, you must submit a written request in person or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official”. Your request must state how or where you would like to be contacted.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions or would like additional information about Venture Rehabilitation Group’s privacy practices, you may contact us in person or by mail addressed to our P.O. Box listed above location and directed to “Attention: HIPAA Privacy Official”. If you believe your child’s privacy rights have been violated, you may submit a complaint via the contact information and address set forth above. There will be no retaliation for filing such a complaint.
RIGHT TO CHANGE TERMS OF THIS NOTICE
We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for your child’s entire PHI that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new notice on our website. You also may obtain any new notice by contacting us through our website, in person or by mail addressed to our P.O. Box listed above and directed to “Attention: HIPAA Privacy Official”.