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PRIVACY NOTICE SUMMARY
HIPPA - Your Information. Your Rights. Our Responsibilities.

All medical information about you is regarded as protected health information (PHI) and is treated as confidential and will be released only to those authorized to receive it.

Protected health information will be disclosed for the treatment, payment and health care operations to:

  • You or someone you have approved to receive it and/or someone that has the legal right to act in your behalf
  • Medicare, health insurance plans, workers compensation insurance and other payers, for billing purposes

Referring medical practices to report evaluations:

  • Treatments, progress, recommendations and changes
  • Interns and/or students pursing a career in physical therapy or athletic training that are temporarily present in the practice or
  • Where required by federal, state or local law

Berryville Physical Therapy and Wellness, PLC may use or give out phi for the following purposes under limited circumstances:

  • For judicial and administrative proceedings in response to court order
  • For research studies that meet all privacy law requirements
  • Your authorization (signature) is required to use or give out your protected health information for any purpose that is not set out in this notice

Your authorization (signature) is required to limit the disclosure of PHI by identifying to whom it shall not be released and/or the content that shall not be released. Upon request to the office manager, arrangements can be made for you to review or receive a copy of your medical information.

If there is any concern regarding this information, an appointment will be scheduled with the attending physical therapist to discuss the concern.

This information may be amended when deemed appropriate. Upon request you may receive an accounting of disclosures. This is a list to whom information has been released.

Submit all requests, in writing, to the office manager.

 

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