Notice of Privacy Policies
Effective 08/01/2016
THIS NOTICE TELLS YOU HOW YOUR MEDICAL RECORD MAY BE USED AND SHARED AND HOW YOU MAY GET THIS INFORMATION.
PLEASE READ IT CAREFULLY
OUR PLEDGE TO YOU
Your health information is something that South Tampa Voice Therapy, LLC treats as privileged and protected. We are ethically and legally obligated to keep it confidential under state and federal laws.
WHAT IS THIS DOCUMENT?
This document, called a Notice of Privacy Practices, tells you how we may use and share your health information. This includes using and sharing it so that we may provide you with health care and be paid for it, and so that we may run our business and follow state and federal legal rules. We must follow the terms of this notice.
WHO FOLLOWS THIS NOTICE:
This notice is for patients of South Tampa Voice Therapy, LLC.
WAYS WE MAY USE AND SHARE YOUR HEALTH INFORMATION WITHOUT YOUR PERMISSION
Treatment: We will use and share your medical record for your care.
Ex. Doctors
Payment: We may use and share your medical information in order to receive payment for the care and services we provided you.
Ex. We may contact your insurance company to learn if a service is covered. We may bill you or your insurance company for the services we provide if we accept insurance.
Health-Care Operations: We need to use and share your health information to run our health care business.
Ex. Staff members of South Tampa Voice Therapy, LLC or if a third party billing agency is hired, your information may be used to make sure billing is done correctly.
Appointment Reminders: We may contact you via phone, text, or email to remind you of an appointment or change one. We may also let you know that it is time for a re-assessment or follow-up appointment.
Required Disclosures: The Secretary of the State of Florida Department of Health may investigate privacy violations. If your health information is requested as part of an investigation, we must share your information with the Secretary of the State of Florida Department of Health. We will share you information if they ask for it as part of an investigation of privacy violation. Under the same laws, we must give you information in your medical record. We are allowed to keep some information from you.
Required by Law: We must share medical information if federal, state, or local law requests.
Public Health and Safety: We may share your medical information for public health reasons. These include:
∙ To prevent or control disease, injury, or disability;
∙ To report child abuse or neglect;
∙ To report information to the FDA about the products it oversees;
∙ To let you know that you may have been getting or spreading a disease or condition; or ∙ To provide information to your employer in certain limited instances.
Abuse and Neglect: The law requires us to reported suspected abuse, neglect, or domestic violence to state and federal agencies. Your information may be shared with these agencies for this purpose. Generally, you will be told that we are sharing this information with these agencies.
Health Oversight Activities: Certain health agencies are in charge of overseeing health-care systems and government programs or to make sure that civil rights laws are being followed. We may share your information with these agencies for these purposes.
Legal Proceedings: If a court or administrative authority orders us to do so, we may release your health records. We will only share the information required by the order. If we receive any other legal request, we may also release your health record. However, for other requests we will only release the information if we are told that you know about it, had a chance to object, and did not.
Research: We may share your medical record with researchers, without your permission, in very limited situations. In most cases, a researcher must submit his/her request to see your information to a special group called the International Review Board (IRB). This group will decide whether it should allow the researcher to share your information. Your medical information may be used or shared with researchers to prepare for research, but only under strict conditions. Under similar strict conditions, medical information about the deceased can be used or shared.
To Prevent a Serious Threat to Safety: We may use and share your medical information to prevent a serious threat to your health and safety or the health and safety of others.
WAYS WE MAY USE AND SHARE YOUR HEALTH INFORMATION WITHOUT YOUR PERMISSION
Individuals Involved in Your Care or Payment for Your Care: We may share medical information about you with your family members, friends, or any other person you tell us who is involved in your medical care or who helps pay for it. We share medical information about you to a disaster relief agency so that your family can be told of your condition and location. Usually you will have a change to object to the sharing of this information.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have certain rights regarding your health information, described below. These rights apply to the health information we keep. You must submit a written request to use any of these rights. You can send your written request to the Privacy Officer for South Tampa Voice Therapy, LLC at the address given at the end of this notice.
Right to Request Special Communications: You have the right to ask us to contact you about medical matters in a certain way or at a certain place. We will follow all reasonable requests. Your request must tell us how you wish to be contacted.
Right to Inspect, Copy, and Request Changes: You have the right to read or get a copy of your health information. If you believe the health information that we created is wrong or incomplete, you may ask us to change it. You must provide a reason why you want the change. We cannot take out or destroy any information already in your medical record. We also are not required to agree to make the change. If we do not agree to the change, you can write a letter about the changes. We will send you one back saying why we will not make the changes. You may then send another disagreeing with us. It will be attached to the information you wanted changed or corrected.
Right to an Accounting of Disclosures: We are required to track who we share your health information with under certain circumstances. You have the right to ask for a copy of this list. We do not have to track every time we share your health information with others. Your request must give a time period, which may not be longer than 6 years.
Right to Request Restrictions: You have the right to ask for a restriction or limitation on the medical information we use or share about you for payment, treatment, or health-care operations and the information we may share with your family, friends, or others involved in your care. We are not required to agree to your request. If we agree, we will follow your request unless the information is needed to provide you with emergency treatment. You must tell us the type of restriction you want and to whom it applies.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. Copies of this notice will be available with the treating therapist where medical services are provided.
OTHER USES AND SHARING OF YOUR HEALTH INFORMATION
All other uses and sharing of your health information will be done only with your written permission.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for your health information we already have as well as any we get in the future. Any changes in this notice will be available with the treating therapist where medical services are provided.
WHAT IF I HAVE QUESTIONS OR NEED TO REPORT A PROBLEM?
If you have any questions about this notice or about how your health information is used or shared by us, please contact the Privacy Officer for South Tampa Voice Therapy, LLC at 813- 728-6601.
If you believe your privacy rights were violated, you may file a complaint with us through the Privacy Officer at 813-728-6601 or write to: Privacy Officer, South Tampa Voice Therapy, LLC 4707 W Gandy Blvd Suite 3, Tampa, FL 33611.
Please give as much information as possible so that the complaint can be properly investigated. You may also file a complaint with the Secretary of the Florida Department of Health and Human Services.
