Notice of Privacy Practices

Questions About This Notice

Privacy Contact: Privacy Officer, Imagine Pediatric Therapy of Brevard, LLC
Phone: 321-223-8791
Email: imaginetherapy.slp@gmail.com

Imagine Pediatric Therapy of Brevard, LLC is required by law to protect the privacy of your protected health information (PHI), provide you with this Notice, and explain our legal duties and privacy practices. This Notice applies to health information created or maintained by our practice.

Your Rights

You have the right to:

• Get an electronic or paper copy of your medical record and other health information we maintain about you.
• Ask us to correct or amend health information that you believe is incorrect or incomplete. We may deny the request in certain circumstances and will explain the reason in writing.
• Request that we contact you in a specific way or at a specific location. We will accommodate reasonable requests.
• Ask us to limit certain uses or disclosures of your PHI. We are generally not required to agree, except when you pay in full out-of-pocket and ask us not to disclose that information to a health plan for payment or health care operations, unless disclosure is required by law.
• Request an accounting of certain disclosures of your PHI made during the six years before your request. One accounting in any 12-month period is provided without charge; additional requests may involve a reasonable, cost-based fee.
• Receive a paper copy of this Notice at any time, even if you agreed to receive it electronically.
• Have a legally authorized personal representative exercise your privacy rights on your behalf.
• File a complaint if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.

Your Choices

In certain situations, you may tell us your preferences about how we share your information. For example, you may identify family members, caregivers, or others involved in your care or payment for your care with whom we may share relevant information. If you are unable to tell us your preference, we may share information when we determine that doing so is in your best interest and is permitted by law.

We will obtain your written authorization before using or disclosing your PHI for purposes that require authorization, including most marketing uses and any sale of PHI. If you give us written authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.

How We May Use and Disclose Your Health Information

Treatment

We may use your PHI and share it with other health care professionals involved in your care. For example, we may share relevant information with another provider who is participating in your treatment.

Payment

We may use and disclose your PHI to obtain payment for services. For example, we may provide information needed to process payment or support reimbursement for services.

Health Care Operations

We may use and disclose your PHI to operate our practice, improve the quality of care, conduct training or supervision, manage our services, and perform other permitted business activities. For example, we may review records to evaluate the quality of our services.

Other Uses and Disclosures Permitted or Required by Law

We may use or disclose PHI without your written authorization when permitted or required by law, including for:

• Public health and safety activities, including reporting suspected abuse, neglect, or domestic violence as required by law.
• Health oversight activities, such as audits, inspections, investigations, and licensure activities.
• Judicial or administrative proceedings, subpoenas, court orders, and other lawful legal processes.
• Law enforcement purposes and certain other government functions as permitted or required by law.
• Workers' compensation and similar programs as authorized by law.
• Research when the requirements of applicable law are met.
• Coroners, medical examiners, and funeral directors as permitted by law.
• Other situations in which federal or state law requires or permits the use or disclosure of health information.
• If we receive substance use disorder records protected by 42 CFR Part 2, additional federal privacy protections may apply to those records, including restrictions on their use in investigations or legal proceedings.

Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI.
• We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in the Notice that is currently in effect and provide you with a copy.
• Uses and disclosures not described in this Notice will be made only with your written authorization when required by law.
• If another federal or state law provides greater privacy protection than HIPAA, we will follow the more protective law when it applies.

Changes to This Notice

We may change the terms of this Notice, and the changes may apply to all PHI we maintain, including information created or received before the change. The current Notice will be available upon request, at our practice and on our website.

Complaints

If you believe your privacy rights have been violated, you may contact our Privacy Officer using the contact information above.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201; phone 1-877-696-6775; or through the HHS Office for Civil Rights complaint website. We will not retaliate against you for filing a complaint.