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Privacy Policy
For
Autism Treatment Centers
DEAR CONSUMER:
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
INTRODUCTION
At Autism Treatment Centers; we are committed to treating and using protected health information about you responsibly. This Notice describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they related to your protected health information.
This Notice is effective April 14, 2003 and applies to al protected health information as defined by federal regulations.
UNDERSTANDING YOUR MEDICAL RECORD / HEALTH INFORMATION
The Autism Treatment Centers have file containing your records. Typically, this record contains information about you including your examination, diagnosis, test results, treatment as well as other pertinent healthcare data. This information, often referred to as your health or medical record, serves as a:
- Basis for planning your care and treatment
- Means of communication with other health professionals involved in your care
- Legal document outlining and describing the care you received
- A tool that you, or another payer (your insurance company) will use to verify that services billed were actually provided
- An education tool for medical health providers
- A source for medical research
- Basis for public health officials who might use this information to assess and/or improve state as well as national healthcare standards
- A source of data for planning and/or marketing
- A tool that we can reference to ensure the highest quality of care and patient satisfaction
YOUR RIGHTS
You have certain rights under the federal privacy standards. These include:
- The right to request restrictions on the use and disclosure of your protected health information
- The right to receive confidential communications concerning your medical condition and treatment
- The right to inspect and copy your protected health information
- The right to amend or submit corrections to your protected health information
- The right to receive an accounting of how and to whom your protected health information has been disclosed
- The right to receive a printed copy of this notice
Autism Treatment Centers are required to:
- Maintain the privacy of your health information
- Provide you with this Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
- Abide by the terms of this notice
- Notify you if we are unable to agree to a requested restriction
- Accommodate reasonable requests you may have regarding communication of health information via alternative means and locations
HOW WE MAY USE AND/OR DISCLOSE YOUR HEALTH INFORMATION
We will use your health information for treatment.Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example: results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
We will use your information for payment. Your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated in order to pay for the service rendered to you.
We will use your information for regular health operations. Your health information may be used as necessary to support the day-to-day activities and management of Autism Treatment Centers. For example: information on the services you received may be used to support budgeting and financial reporting and activities to evaluate and promote quality.
Business Associates. In some instances, we have contracted separate entities to provide services for us. These associates require your health information in order to accomplish the tasks that we ask them to provide. Some examples of these business associates might be a billing services, collection agency, answering service and computer software/hardware provider and other professional consultants.
Communication with family. Due to the nature of our field, we will use out best judgment when disclosing health information to a family member, other relative, or any other person that is involved in your care or that you have authorized to receive this information. Please inform the Center when you do not wish a family member or other individual to have authorization to receive your information.
Research / Teaching / Training. We may use your information for the purpose of research, teaching, and training.
Healthcare Oversight. Federal law requires us to release your information to an appropriate health oversight agency, public health authority, or other federal/state appointee if there are circumstances that require us to do so.
Public Health Reporting. Your health information may be disclosed to public health agencies as required by law.
Law Enforcement. Your health information may be disclosed to law enforcement agencies, with out your permission, to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.
Appointment Reminders. The Center may use your information to remind you about upcoming appointments. Typically, appointment reminders are sent by mail in a closed envelope, or, a brief, non-specific message may be left on your message machine. If you don’t approve of these methods, or, if you prefer alternative methods (i.e. e-mail) please inform the Center.
Other Uses And Disclosures. Disclosures of your health information or its use for any purpose other than those listed above require your specific written authorization. If you change your mind after authorizing a use or disclosure of your information you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have complaints, questions or would like additional information regarding this Notice or the privacy practices of Autism Treatment Canters please contact:
Traci TomilliIf you believe that your privacy rights have been violated, please contact the aforementioned practice Privacy Official, or, you may file a complaint with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the practice’s Privacy Official or with the Office for Civil Rights. The address for the Office for Civil Rights is listed below:
Autism Treatment Centers
10503 Metric Dr.
Dallas, Texas 75243
972.644.2076
OFFICE FOR CIVIL RIGHTS
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
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