NOTICE OF PRIVACY PRACTICES / HIPPA PURPOSE 

 

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. In accordance with the requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPPA”), Self Care Therapy Inc. is required to inform you of its practices in relation to the protected health information that is maintained about you. HIPPA mandates minimum standards that a covered entity such as Self Care Therapy Inc. must maintain in relation to your protected health information. This Notice of Uses is being provided to help you understand how Self Care Therapy Inc. meets those minimum standards. It is also meant to inform you of the ways that Self Care Therapy Inc. may use the personal information it collects about you and how it may disclose it.

 

Self Care Therapy Inc. believes that the information we gather about you is of a very private nature and we are dedicated to keeping this information confidential. The records we create in providing you with care are by law kept confidential. We are also required to inform you of our policies concerning the use and storage of your personal health information. Self Care Therapy Inc. maintains the right to update our Notice of Privacy Practices. Your personal health information will always be maintained by our current policies designated in our current Notice of Privacy Practices. If you have any comments or questions about our Notice of Privacy Practices, you may call our Privacy Officer at (910)798-4051

 

 UNDERSTANDING YOUR PROTECTED HEALTH INFORMATION 

 

When you receive care from a healthcare provider, a record of that treatment is made. This record will typically contain information on your diagnosis, treatment, and future plan of treatment and is often collectively referred to as your medical record. This medical record includes protected health information and lays the foundation for determining your plan of care and treatment and allows for a successful means of communicating between all healthcare professionals who contribute to your care. 

 

HIPPA protects information found in your medical record from disclosure without your authorization. The information protected by HIPAA includes: 

1. Any information related to your past, present, or future physical or mental health 
2. The past, present, or future payment for health services you have received 
3. The specific care that you have received is receiving or will receive 
4. Any information that identifies you as the individual receiving the care 
5. Any information that someone could reasonably use to identify you as receiving the care This information is referred to as protected health information throughout this notice. 

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TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS 

 

As a covered entity, Self Care Therapy Inc. is required to inform you of how it may use your protected health information. In providing treatment to you, Self Care Therapy Inc. will use your protected health information for the purposes of treatment, payment, and healthcare operations. 

 

Treatment – As it pertains to Self Care Therapy Inc. treatment means providing you supplies, and durable medical equipment services as ordered by your physician. Treatment also includes coordination and consultation with your physician and other healthcare. As Self Care Therapy Inc. provides these services to you, information obtained during this process will be recorded in your medical record. Self Care Therapy Inc. Will use this information, in coordination with your physician, to determine the best course of treatment for you. 

 

Payment – Payment purposes consist of activities required to obtain reimbursement from your insurance carrier for the services ordered by your physician and provided to you by Self Care Therapy Inc. This includes, but is not limited to, eligibility determination, pre-certification, billing, and collection activities, obtaining documentation required by your insurer, and when applicable, disclosure of limited information to consumer reporting agencies. 

 

Healthcare operations – Operations can include, but are not limited to, a review of your protected health information by members of Self Care Therapy Inc., and professional healthcare staff to ensure compliance with all federal and state regulations. This information will then be utilized to continually improve the quality and effectiveness of the services provided to you by Self Care Therapy Inc. healthcare operations also include Self Care Therapy Inc. business management and general administrative activities. 

 

OTHER USES AND DISCLOSURES

 

 In order to release information contained in your medical record for purposes other than treatment, payment, or healthcare operations, Self Care Therapy Inc. must obtain a specific signed authorization form from you. You may revoke such authorization at any time, except to the extent Self Care Therapy Inc. has taken action in reliance on the authorization. There are a limited number of other uses and disclosures of protected health information that do not require specific authorization from you. Self Care Therapy Inc. may in the following circumstances disclose your protected health information. 

1. Self Care Therapy Inc. may disclose limited health information about you to notify local agencies (i.e. power, gas, phone, and emergency medical services), in the event of an emergency (i.e. flood hurricanes, etc.), of your need for life-sustaining equipment or assistance in evacuation due to your medical condition. 
2. Self Care Therapy Inc. may disclose to a member of your family, another relative, a close personal friend, or any other persons identified by you, the protected health information directly relevant to such person’s involvement with your care or payment related to health care. 

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3. Self Care Therapy Inc. may disclose protected health information to others as required by law 
4. Self Care Therapy Inc. may disclose protected health information for certain public health activities and purposes. 
5. Self Care Therapy Inc. may disclose protected health information to a legally authorized government authority, such as a social service or protective services agency if we reasonably believe you are a victim of abuse, neglect, or domestic violence. 
6. Self Care Therapy Inc. may disclose protected health information for law enforcement purposes and in response to court orders or subpoenas 
7. Self Care Therapy Inc. may disclose protected health information to agencies authorized by law to conduct health oversight activities, including audits, investigations, licensing, and similar activities. 
8. Self Care Therapy Inc. may disclose protected health information to attorneys, accountants, and others acting on behalf of Self Care Therapy Inc. provided they have signed written contracts agreeing to safeguard the confidentiality of the information. 
9. Self Care Therapy Inc. may leave a message for you on your answering machine or at an alternative phone number or contact that you have given us for that purpose 
10. Self Care Therapy Inc. may mail marketing information, as requested by you, while you are a customer of Self Care Therapy Inc. 

 

PRIVACY POLICY 

 

The following describes the manner in which we will use and disclose your personal health information: 

1. We may collect and share appropriate information about you to document the medical necessity of the equipment, supplies, or services we are providing. Examples include diagnosis, prescription, referral, and physician or health care provider information. 
2. We may share appropriate information about you to bill and collect payment for the health care we provide, including insurance companies and third parties, which includes family members or other financially responsible parties of which you have informed us. Examples include insurance coverage and eligibility verification. 
3. We may use and disclose information to monitor and operate our business. Examples include satisfaction surveys, health care outcomes and utilization reporting, accreditation bodies, reports provided to any federal, state or local authority (as required by law), or to remind you of equipment, supplies or service needs. 
4. We may release appropriate information about you to family or friends who are helping you with financial responsibilities incurred while receiving equipment, supplies or services from us. 
5. We may use and disclose information about you to respond to a court or legal authoritative body that legally requests information about you. Examples include providing documents for legal subpoenas or discovery proceedings and having our staff testify about the care we have provided. 

 

The following describes your rights to the information we maintain about you: 

1. You may request, in writing, additional restrictions to the use or disclosure of your protected health information; however, Self Care Therapy Inc. is not required to agree to the request for restrictions. 2. You have the right to request amendments to your medical record. 

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3. You have the right to obtain a copy of this Notice of Uses. 
4. You have the right to access, inspect, and, obtain a copy of your medical record, subject to certain limitations. 
5. You have the right to obtain an accounting of disclosures of your medical record for purposes other than treatment, payment, and healthcare operations. 
6. You have the right to request communications of your medical record by alternative means (i.e. electronically) or at alternative locations 
7. You have the right to revoke authorization to use or disclose your protected health information except to the extent that action has already occurred. 
8. You have the right to direct the use of your personal health information at any of our locations. 
9. You have the right to terminate or revise your authorizations or consents that pertain to our use of your personal health information and have those terminations or revisions affect any new equipment, supply, or service provisions. We are not required to accept your terms. If we do accept your restrictions, we will honor your specifications, except where prohibited by law. All requests must be in written form. 
10. You have the right to request a copy of your personal health information as long as any federal, state, or local law does not prohibit it. This request must be in writing. There is a charge for copying, producing, and delivering your information. 
11. You have the right to request, in writing, a revision to your personal health information. Revision requests will be evaluated on an individual basis and amended, if appropriate. At no time will a revision be made that may erroneously record the personal health information stored by us. Your written request must detail the requested revision and the reasons for the modification. If no explanation is provided, no revision will be made. If we deny your request for amendment, you have the right to file a statement of disagreement. 
12. You have the right to request an accounting of non-routine disclosures we have made with your personal health information. You can receive one free accounting in a twelve- month period. We will charge for any accounting services that exceed one per twelve months. You must agree to this charge before we will provide any accounting of services. These requests cover dates of service on or after April 14th, 2003. 
13. You have the right to file a complaint about our use of your personal health information with us or the Secretary of the Department of Health and Human Services. 

 

RESPONSIBILITIES OF SELF CARE THERAPY INC. 

 

In accordance with HIPPA, Self Care Therapy Inc. is required to: 

1. Maintain the confidentiality of your protected health information. Your state laws may provide more protection than the federal laws and in that case, we will abide by the more restrictive statute. 
2. Provide you with the notice of our legal obligations and privacy practices regarding information it may accumulate about you and are obligated to abide by the terms of this notice. 
3. Notify you if it is unable to agree to a requested restriction, and make every effort to accommodate reasonable requests for communication of health information by alternative means 
4. Post its Notice of Uses on its website at selfcaretherapy.com 

 

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5. Please be advised that in addition to these responsibilities, Self Care Therapy Inc. reserves the right to change the terms of its Notice of Uses and make those changes applicable to all protected health information maintained at that time. If there is a change to its Notice of Uses, it will provide you with a revised notice to the most recent address you have supplied to Self Care Therapy Inc. 

 

Self Care Therapy Inc. will not use or disclose your protected health information without your authorization except as described in this notice. 

 

FOR MORE INFORMATION OR TO REPORT A PROBLEM 

 

If you have questions, would like additional information or if you suspect misuse of your protected health information and believe that your rights have been violated, you may, without fear of retaliation, contact 

The office of Civil US Department of Health and Human Services 200 Independence Ave Rm 509F HHH Building Washington DC 20201 1-800-368-1019 

 

OR 

 

Self Care Therapy Inc. 6626 Gordon rd. Suite H, Wilmington, NC, 28411 (910)-798-4051 

 

CONSUMER COMPLAINT AND ABUSE HOTLINES  

 

• In the event of a complaint that is not resolved, the client or immediate family or caregiver has a right to report complaints, abusive, neglectful, or exploitive practices  
• To report a complaint regarding the services you receive Please call BOC toll free 877- 776-2200to report a disabled adult or elderly person please call 800-962-2873  
• If your concerns meet the definition of an emergency situation First call 911 then call the abuse hotline  
• To report Medicaid Fraud Call 1-866-966-7226  
• To report Medicare Fraud call: 1-800-MEDICARE (1-800-633-4227)