THIS 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.
ESD Health, LLC (“ESD Health”) is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to notify you following a breach of unsecured PHI.
1. How We May Use and Disclose Your Health Information
For Treatment
We may use and disclose PHI to provide, coordinate, and manage your occupational therapy care, including coordinating with your physician, the clinical staff of your residential community, and other healthcare providers involved in your care.
For Payment
We may use and disclose PHI to obtain payment for services we provide — for example, to bill private-pay clients, residential communities contracting for services, or, where applicable, third-party payors.
For Health Care Operations
We may use and disclose PHI for internal operations such as quality improvement, clinical training and supervision, outcomes review, compliance audits, and other administrative functions.
To Family Members and Others Involved in Your Care
With your agreement (or where you are unable to agree, when in our professional judgment it is in your best interest), we may share relevant PHI with family members or other persons involved in your care.
Required by Law
We may use and disclose PHI when required by federal, state, or local law, including for public health activities, reports of suspected abuse or neglect, judicial proceedings, law enforcement requests, and to avert a serious threat to health or safety.
2. Uses and Disclosures Requiring Your Authorization
Other uses or disclosures of PHI not described in this Notice will be made only with your written authorization. Specifically, we will obtain authorization before using or disclosing PHI for marketing, before selling PHI, and before using or disclosing psychotherapy notes (where applicable). You may revoke an authorization in writing at any time, except to the extent we have already acted on it.
3. Your Rights Regarding Your Health Information
- Right to inspect and copy your PHI maintained in a designated record set, subject to limited exceptions.
- Right to request amendment of PHI you believe is incorrect or incomplete.
- Right to an accounting of certain disclosures of your PHI made by us.
- Right to request restrictions on certain uses and disclosures. We are not required to agree, except for disclosures to a health plan for payment or operations when you have paid in full out-of-pocket.
- Right to request confidential communications at an alternative address or by alternative means.
- Right to a paper copy of this Notice, even if you have received it electronically.
- Right to be notified following a breach of unsecured PHI.
4. Our Duties
We are required by law to maintain the privacy of your PHI, to provide individuals with notice of our legal duties and privacy practices, and to abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new provisions effective for all PHI we maintain. Updated Notices will be posted on this site and made available at the point of service.
5. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer at the address below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
6. Contact
ESD Health, LLC · Privacy Officer
Atlanta, Georgia
Email: privacy@esdhealthcare.com
This Notice is a draft and will be reviewed by healthcare counsel prior to delivery of clinical services. The effective date will be the date services begin or as otherwise required by law.