| PRIVACY NOTICE
Notice of Policies and Practices to Protect the Privacy
of Your Healthcare Information
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.
New Dimensions Physical Therapy creates and maintains
a medical record each time you are treated at our clinic.
injuries, evaluation and test results, treatment, and
of care are documented. This information is referred
to as your “healthcare or medical record,” and
is the means through which we plan your treatment and
communicate to other health professionals who contribute
to your care.
Understanding what information is retained in your record
and how that information may be used will help you to
ensure its accuracy, and enable you to relate to who,
where, and why others may be allowed access to your health
information. This effort is being made to assist you
informed decisions before authorizing the disclosure
of your medical information to others.
Healthcare Information Rights
Your healthcare record is the physical property of
New Dimensions Physical Therapy. However, because this
of details regarding your care, you have the right
to inspect and obtain a copy of your health information
and be given
an account of all disclosures. You also have the right
to request restrictions on certain uses and disclosures
information, and to request amendments be made to your
medical record. You may also request that confidential
by us regarding your health information be made by
means or to alternative locations. Other than activity
that has already occurred you may revoke any further
authorizations to use or disclose your health information.
If you receive
this Notice electronically, you are entitled to receive
Notice in written form.
New Dimensions Physical Therapy is required to maintain
the privacy of your health information and to provide
notice of our legal commitment and privacy practices
with respect to the information we collect and maintain
you. New Dimensions Physical Therapy is required
to abide by the terms of this notice and to notify you
if we are
unable to grant your requested restrictions or reasonable
to communicate your health information by alternative
means or to alternative locations. New Dimensions
reserves the right to change its practices and effect
new provisions that enhance the privacy standards
of all patient
health information. In the event that changes are
made, while you are receiving care New Dimensions Physical
notify you at your next appointment or at the current
address provided in your medical file. Other than
in this notice, New Dimensions Physical Therapy agrees
not to use or disclose your health information without
To receive additional information or report a problem
For further explanation of this notice you may contact our
Privacy Officer at 1-512-328-8950. If you believe your
privacy rights have been violated, you have the right to
file a complaint with the Secretary of Health and Human
Services with no fear of retaliation by New Dimensions
Your health information will be used for treatment, payment,
and healthcare operations
Treatment – Information
obtained by your therapist at New Dimensions Physical Therapy
be recorded in your
medical record and used to determine the course of treatment.
This consists of your therapist recording his/her own expectations
and those of others involved in providing your care. The
sharing of your health information may progress to others
involved in your care, such as physicians.
Payment – Your
healthcare information will be used in order to receive
payment for services rendered by New
Dimensions Physical Therapy. A bill may be sent to either
you or a third party payer with accompanying documentation
that identifies you, your diagnosis, procedures performed
and supplies used.
Operations – The
medical staff at New Dimensions Physical Therapy will
use your health information to
assess the care you received and the outcome of your case compared
to others like it. Your information may be reviewed
for risk management or quality improvement purposes in
to continually improve the quality and effectiveness
of the care and services we provide.
Dimensions Physical Therapy’s
policy for specific disclosures
Business Associates – Some or all of your health information
may be subject to disclosure through contracts for
services to assist New Dimensions Physical Therapy in providing health
care. To protect your health information, we require
these Business Associates to follow the same standards held by
New Dimensions Physical Therapy through terms detailed
in a written agreement.
Notification – Your
health record may be used to notify or assist family members,
or other persons responsible for your care to enhance your well-being
or your whereabouts.
with Family – Using
best judgment, a family member, or close personal
by you, may be given information relevant to your care and recovery.
Compensation - New Dimensions Physical Therapy will release information
to the extent authorized
by law in matters of worker’s compensation.
Health - New Dimensions Physical Therapy is required
by law to disclose health information to public
health and/or legal authorities charged with tracking reports of birth
and morbidity. New Dimensions Physical Therapy
is further requred be law to report communicable disease, injury, or
Enforcement – (1) Your
health information will be disclosed for
law enforcement purposes
as required under state law or in response to a valid subpoena. (2) Provisions
of federal law permit the disclosure of
your health information
to appropriate health oversight agencies,
public health authorities, or attorneys in the event that a staff member or
business associate of New Dimensions Physical Therapy
good faith that there has been unlawful
conduct or violations of professional or Clinical standards
that may endanger one
or more patients, workers, or the general
of Privacy Practices Availability
All individuals receiving care will be given
a hard copy of the terms described in
this notice and asked
This Notice takes effect on April 14,
2003, and will remain in effect until
may deny the request to amend
need to be in writing
Pharmacy: You have the right to receive a list of instances
in which we
or our business
associates disclosed your health information for purposis, other than
treatment, payment healthcare operations and
certain other activities, for the last 6 years, but not
2003. If you requist this accounting more than
once in a 12-month period, we may charge you a reasonable, cost-based
fee for responding to these additional requests.
of name of patients daily.
Officer at 1-512-328-8950 = RKS
Associates = Transcription services or someone who might
come in and
help us with efficiency.
the event that changes are made, New Dimensions Physical
Therapy will notify
you at your next appointment
or at the current address provided in your medical file.
it have to posted?