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The Health Insurance Portability
& Accountability Act of 1996 (HIPAA) requires all health care records
and other individually identifiable health information (protected health
information) used by, or disclosed to us, in any form be kept confidential.
Orlanu Therapies
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
The Health Insurance Portability & Accountability
Act of 1996 (HIPAA) requires all health care records and other individually
identifiable health information (protected health information) used
or disclosed to us in any form, whether electronically, on paper, or
orally, be kept confidential. This federal law gives you, the patient,
significant new rights to understand and control how your health information
is used. HIPAA provides penalties for covered entities that misuse personal
health information. As required by HIPAA, we have prepared this explanation
of how we are required to maintain the privacy of your health information
and how we may use and disclose your health information.
Without specific written authorization, we are
permitted to use and disclose your health care records for the purposes
of treatment, payment and health care operations.
• Treatment means providing, coordinating, or managing health care
and related services by one or more health care providers. Examples
of treatment would include therapeutic exercise, neuromuscular reeducation,
mobilization, etc.
• Payment means such activities as obtaining reimbursement for
services, confirming coverage, billing or collection activities, and
utilization review. An example of this would be billing your health
insurance for your physical therapy services.
• Health Care Operations include the business aspects of running
our practice, such as conducting quality assessment and improvement
activities, auditing functions, costmanagement analysis, and customer
service. An example would include a periodic assessment of our documentation
protocols, etc.
In addition, your confidential information may
be used to remind you of an appointment (by phone or mail) or provide
you with information about treatment options or other health-related
services including release of information to friends and family members
that are directly involved in your care or who assist in taking care
of you. We will use and disclose your protected information when we
are required to do so by federal, state or local law. We may disclose
your PROTECTED HEALTH INFORMATION to public health authorities that
are authorized by law to collect information, to a
health oversight agency for activities authorized by law included but
not limited to: response to a court or administrative order, if you
are involved in a lawsuit or similar proceeding, response to a discovery
request, subpoena, or other lawful process by another party involved
in the dispute, but only if we have made an effort to inform you of
the request or to obtain an order protecting the information the party
has requested. We will release your PROTECTED HEALTH INFORMATION if
requested by a law enforcement official for any circumstance required
by law. We may release your
PROTECTED HEALTH INFORMATION to a medical examiner or coroner to identify
a deceased individual or to identify the cause of death. If necessary,
we also may release information in order for funeral directors to perform
their jobs. We may release PROTECTED HEALTH INFORMATION to organizations
that handle organ, eye or tissue procurement or transplantation, including
organ donation banks, as necessary to facilitate organ or tissue donation
and transplantation if you are an organ donor. We may use and disclose
your PROTECTED HEALTH INFORMATION when necessary to reduce or prevent
a serious threat to your health and safety or the health and safety
of another individual or the public. Under these circumstances, we will
only make disclosures to a person or organization able to help prevent
the threat. We may
disclose your PROTECTED HEALTH INFORMATION if you are a member of U.S.
or foreign military forces (including veterans) and if required by the
appropriate authorities. We may disclose your PROTECTED HEALTH INFORMATION
to federal officials for intelligence and national security activities
authorized by law. We may disclose PROTECTED HEALTH INFORMATION to federal
officials in order to protect the President, other officials or foreign
heads of state, or to conduct investigations. We may disclose your PROTECTED
HEALTH INFORMATION to correctional institutions or law enforcement officials
if you are an inmate or under the custody of a law enforcement official.
Disclosure for these purposes would be
necessary: (a) for the institution to provide health care services to
you, (b) for the safety and security of the institution, and/or (c)
to protect your health and safety or the health and safety of other
individuals or the public. We may release your PROTECTED HEALTH INFORMATION
for workers' compensation and similar programs.
Any other uses and disclosures will be made only
with your written authorization. You may revoke such authorization in
writing and we are required to honor and abide by that written request,
except to the extent that we have already taken actions relying on your
authorization.
You have certain rights in regards to your PROTECTED
HEALTH INFORMATION, which you can exercise by presenting a written request
to our offices:
• The right to request restrictions on certain uses and disclosures
of PROTECTED HEALTH INFORMATION, including
those related to disclosures to family members, other relatives, close
personal friends, or any other person identified by you.
We are, however, not required to agree to a requested restriction. If
we do agree to a restriction, we must abide by it unless
you agree in writing to remove it.
• The right to request to receive confidential communications of
PROTECTED HEALTH INFORMATION from us by
alternative means or at alternative locations.
• The right to access, inspect and copy your PROTECTED HEALTH INFORMATION.
• The right to request an amendment to your PROTECTED HEALTH INFORMATION.
• The right to receive an accounting of disclosures of PROTECTED
HEALTH INFORMATION outside of treatment,
payment and health care operations.
• The right to obtain a paper copy of this notice from us upon
request.
We are required by law to maintain the privacy
of your PROTECTED HEALTH INFORMATION and to provide you with notice
of our legal duties and privacy practices with respect to PROTECTED
HEALTH INFORMATION.
We are required to abide by the terms of the Notice
of Privacy Practices currently in effect. We reserve the right to change
the terms of our Notice of Privacy Practices and to make the new notice
provisions effective for all PROTECTED HEALTH INFORMATION that we maintain.
Revisions to our Notice of Privacy Practices will be posted on the effective
date and you may request a written copy of the Revised Notice from this
office.
You have the right to file a formal, written complaint
with us at the address below, or with the Department of Health &
Human Services, Office of Civil Rights, in the event you feel your privacy
rights have been violated. We will not retaliate against you for filing
a complaint.
Orlanu Therapies
1025 W. Glen Oaks Lane, Suite 207.
Mequon, WI 53092
(262) 241-7887
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