Notice of Privacy Practices

 

This notice describes how medical information about you may be used and disclosed. Please review it carefully. If you have any questions you may contact The Kid's Therapy Center LLC privacy officer, Valerie Meyers, at 701.751.0384.

 

This Notice of Privacy Practice describes how we may use and disclose your protected health information (PHI) to obtain payment, treatment purposes, or other health care operations. Your PHI may also be disclosed when required by law. The notice also describes your rights and our obligations to protect your health information. Uses and disclosures not described will generally only be made with your written permission. You have the right to revoke this at any time.

Your PHI is your health information that we have collected such as your identifying information. We may have received this information from you or your health care provider. It may include information about your past, present, or future. It may also include your physical or mental health condition, the provision of your health care, and payment of your services.

 

How we use and disclose your health information (PHI):

A. Uses and disclosures made with your written consent:

a. For treatment. You may sign our consent to use and disclose your health information to provide you better treatment or for other reasons you may need. We may also disclose your health information among our clinicians and other staff.

b. For payment. We may use or disclose your health information so your services are billed to, and payment is collected from, your health insurance or other third party payer.

c. For health care operations. We may use and disclose your health information for the operations of our center.

d. Health related benefits and services. We may use and disclose health information to inform you about health related benefits or services that you maybe interested in.

B. Uses and Disclosures that may be made without your consent or opportunity to object:

a. Emergencies. We may use or disclose your health information in an emergency situation so you may receive proper care (e.g. tell the paramedic your information as they are transporting you to the local hospital).

b. As required by law. We may use or disclose information about you or your minor child when we are required by law or mandated to report. For example, in North Dakota we are mandated to report any suspicion of a child, elderly, or a person with a disability who may be a victim of sexual, physical, emotional abuse, or neglect.

c. To avoid a serious threat to health or safety. We may use or disclose your health information to prevent a serious or imminent threat to your health, your safety, or that of another person.

d. For public health reasons. We may disclose health information about you as necessary for public health reasons.

e. Health oversight agencies. We may disclose your health information to a health oversight agency that may be needed for an inspection, certification, or licensure.

f. Disclosure of legal proceedings. We may disclose your health information to the court system when a judge or administrative agency orders us to do so.

g. Law enforcement activities. We may disclose health information to law enforcement for enforcement purposes when a court order, subpoena, warrant, summons, or similar order requires us to do so.

h. In the event of a death. We may provide health information to medical examiners, coroners, or funeral directors to carry out the duties that are needed.

i. Military and veterans. We may disclose your health information as required by military authorities if you are a member of the armed forces.

j. National security and protective services for the president and others. We may disclose medical information about you to authorized federal officials for intelligence, counter-intelligence, and other national security activities required by law.

k. Inmates. If you are an inmate of a correctional institute or under the custody of law enforcement we may disclose your health information to them.

l. Workers compensation. We may disclose health information about you to comply with the state’s Workers Compensation law.

 

Your rights regarding your health information:

a. Right to review and copy your health information. You have the right to inspect or review your health information about your care. This may include your treatment or payment of your care. Under certain circumstances we may deny your review of health information (for example, if we suspect a child may be harmed) if you are aware of information in the health information.

b. Right to amend. You have the right to amend the treatment services or your payment of your treatment. In order to amend you must submit a written document to the privacy officer, Valerie Meyers, at The Kid’s Therapy Center LLC 1701 South 12th Street, Bismarck, ND 58504 and tell us why you would like us to amend the information. We may not honor your request if the current PHI is correct and complete or not a part of our records.

c. Right to request a list of the disclosures we have made. You have the right to request that we provide you with an accounting disclosure we have made of your health information.

d. Right to request restrictions. You have the right to request a restriction on the health information we use or disclose about you for treatment, payment or health care operations. You may also ask that any part or all not be disclosed to family members or friends who may be involved in your care or for notification purposes.

e. Right to request confidential communications. You have the right to request that we communicate with you about your health care only in a certain location or through a certain method such as contacting you only on your cell phone or through e-mail.

f. Right to paper copy of this notice.

 

Complaints:

If you believe your privacy rights have been violated you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us please call Valerie Meyers at 701.751.0384 or send a written complaint to at The Kid’s Therapy Center LLC 1701 South 12th St Bismarck, ND 58504. No one will face retaliation for filing a complaint.

 

Changes in this notice:

We reserve the right to change the terms of this notice. We also reserve the right to make the revised or changed notice of privacy practices effective for all health information we already have and any new health information we receive. We will post a copy of the new information in the main waiting area and you will be verbally informed that there are changes. You may also view our Notice of Privacy Practices at our website www.thekidstherapycenter.com, by calling 701.751.0384, writing The Kid’s Therapy Center LLC 1701 South 12th St Bismarck, ND 58504 or by requesting a copy at your next visit.

 

Who will follow this notice:

The staff at The Kid’s Therapy Center will follow this notice. In addition, the staff may share health information with each other for treatment, payments, or health care operations