Notice of HIPAA Privacy Practices

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HIPAA Notice of Privacy Practices

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.

The Virtual PT is committed to keeping your protected health information (PHI) private and secure. Examples of PHI include your name, address, phone, email, and more. The Virtual PT may receive and create records using your PHI in documentation of physical therapy evaluation, treatments, and discharge planning associated with your plan of care. This information will be stored in a HIPAA compliant digital platform. Video conferencing will also take place on a HIPAA compliant platform and will not be recorded. The Virtual PT is required by law to protect your privacy as well as provide a written copy of its privacy practices.

The current privacy notice takes effect on 4/20/2020. The Virtual PT reserves the right to change this notice as needed to ensure compliance with current healthcare laws. If a change to this document takes place, an updated copy will be posted on its website. Copies of this privacy notice are available upon request.

Protected Health Information. The HIPAA Privacy Rule protects all "individually identifiable health information" held or transmitted by The Virtual PT or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."

“Individually identifiable health information” is information, including demographic data, that relates to:

your past, present or future physical or mental health or condition,
the provision of health care to you, or
the past, present, or future payment for the provision of health care to you,

and that identifies you or for which there is a reasonable basis to believe it can be used to identify you. Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

The Privacy Rule excludes from protected health information employment records that The Virtual PT maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act, 20 U.S.C. §1232g.

De-Identified Health Information. There are no restrictions on the use or disclosure of de-identified health information. De-identified health information neither identifies nor provides a reasonable basis to identify an individual. There are two ways to de-identify information; either: (1) a formal determination by a qualified statistician; or (2) the removal of specified identifiers of you and of your relatives, household members, and employers is required, and is adequate only if the The Virtual PT has no actual knowledge that the remaining information could be used to identify you.

General Principle for Uses and Disclosures

Basic Principle. A major purpose of the Privacy Rule is to define and limit the circumstances in which your protected heath information may be used or disclosed by covered entities. The Virtual PT may not use or disclose protected health information, except either: (1) as the Privacy Rule permits or requires; or (2) as the individual who is the subject of the information (or the individual’s personal representative) authorizes in writing.

Required Disclosures. The Virtual PT must disclose protected health information in only two situations: (a) to you (or your personal representatives) specifically when you request access to, or an accounting of disclosures of, your protected health information; and (b) to HHS when it is undertaking a compliance investigation or review or enforcement action.

Permitted Uses and Disclosures. The Virtual PT is permitted, but not required, to use and disclose protected health information, without your authorization, for the following purposes or situations: (1) To you (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure; (5) Public Interest and Benefit Activities; and (6) Limited Data Set for the purposes of research, public health or health care operations. The Virtual PT may rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make.

(1) To The Individual. The Virtual PT may disclose protected health information to the individual who is the subject of the information.

(2) Treatment, Payment, Health Care Operations. The Virtual PT may use and disclose protected health information for its own treatment, payment, and health care operations activities. The Virtual PT also may disclose protected health information for the treatment activities of any health care provider, the payment activities of another covered entity and of any health care provider, or the health care operations of another covered entity involving either quality or competency assurance activities or fraud and abuse detection and compliance activities, if both covered entities have or had a relationship with you and the protected health information pertains to the relationship.

Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.

Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual.

Health care operations are any of the following activities: (a) quality assessment and improvement activities, including case management and care coordination; (b) competency assurance activities, including provider or health plan performance evaluation, credentialing, and accreditation; (c) conducting or arranging for medical reviews, audits, or legal services, including fraud and abuse detection and compliance programs; (d) specified insurance functions, such as underwriting, risk rating, and reinsuring risk; (e) business planning, development, management, and administration; and (f) business management and general administrative activities of The Virtual PT, including but not limited to: de-identifying protected health information, creating a limited data set, and certain fundraising for the benefit of The Virtual PT.

(3) Uses and Disclosures with Opportunity to Agree or Object. Informal permission may be obtained by asking you outright, or by circumstances that clearly give you the opportunity to agree, acquiesce, or object. Where you are incapacitated, in an emergency situation, or not available, The Virtual PT generally may make such uses and disclosures, if in the exercise of their professional judgment, the use or disclosure is determined to be in your best interest.

For Notification and Other Purposes. The Virtual PT also may rely on your informal permission to disclose to your family, relatives, or friends, or to other persons whom you identify, protected health information directly relevant to that person’s involvement in your care or payment for care. This provision, for example, allows a pharmacist to dispense filled prescriptions to a person acting on behalf of the patient. Similarly, The Virtual PT may rely on an individual’s informal permission to use or disclose protected health information for the purpose of notifying (including identifying or locating) family members, personal representatives, or others responsible for your care, of your location, general condition, or death. In addition, protected health information may be disclosed for notification purposes to public or private entities authorized by law or charter to assist in disaster relief efforts.

(4) Incidental Use and Disclosure. The Privacy Rule does not require that every risk of an incidental use or disclosure of protected health information be eliminated. A use or disclosure of this information that occurs as a result of, or as “incident to,” an otherwise permitted use or disclosure is permitted as long as The Virtual PT has adopted reasonable safeguards as required by the Privacy Rule, and the information being shared was limited to the “minimum necessary,” as required by the Privacy Rule.

(5) Public Interest and Benefit Activities. The Privacy Rule permits use and disclosure of protected health information, without an individual’s authorization or permission, for 12 national priority purposes. These disclosures are permitted, although not required, by the Rule in recognition of the important uses made of health information outside of the health care context. Specific conditions or limitations apply to each public interest purpose, striking the balance between your privacy interest and the public interest need for this information.

(6) Limited Data Set. A limited data set is protected health information from which certain specified direct identifiers of individuals and their relatives, household members, and employers have been removed. A limited data set may be used and disclosed for research, health care operations, and public health purposes, provided the recipient enters into a data use agreement promising specified safeguards for the protected health information within the limited data set.

Authorized Uses and Disclosures

Authorization. The Virtual PT will obtain your written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule. The Virtual PT may not condition treatment, payment, enrollment, or benefits eligibility on an individual granting an authorization, except in limited circumstances.

An authorization must be written in specific terms. It may allow use and disclosure of protected health information by The Virtual PT seeking the authorization, or by a third party. Examples of disclosures that would require an individual’s authorization include disclosures to a life insurer for coverage purposes, disclosures to an employer of the results of a pre-employment physical or lab test, or disclosures to a pharmaceutical firm for their own marketing purposes.

All authorizations must be in plain language and contain specific information regarding the information to be disclosed or used, the person(s) disclosing and receiving the information, expiration, right to revoke in writing, and other data. The Privacy Rule contains transition provisions applicable to authorizations and other express legal permissions obtained prior to April 14, 2003.

The Virtual PT may use and disclose your PHI as follows:

For treatment purposes: this may include the physical therapist generating documentation which contains PHI obtained from intake forms, medical history, and live therapy services.
For communication with other medical providers: to discuss exam findings and collaborate for best patient care. This may include communication with your referring practitioner (via telephone or e-mail) or a referral to another qualified healthcare provider if warranted.
As required by law: The Virtual PT may disclose your PHI as required by law. This may include, but not be limited to: law enforcement, public health authorities, judicial proceedings, public health oversight agencies, and cases of abuse or neglect including domestic violence and child or elderly persons abuse, essential government functions, and for serious threat to health or safety.
For business operations: including quality control and customer service tasks. If a 3rd party requires access to your PHI to carry out necessary functions, they must sign a copy of this agreement in order to be bound by the same uses and disclosure agreement.
With authorization: The Virtual PT may disclose your PHI for any other reason only after obtaining written authorization and may only disclose to the extent that you authorized.

Limiting Uses and Disclosures to the Minimum Necessary

Minimum Necessary. A central aspect of the Privacy Rule is the principle of “minimum necessary” use and disclosure. The Virtual PT will make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request.

The minimum necessary requirement is not imposed in any of the following circumstances: (a) disclosure to or a request by a health care provider for treatment; (b) disclosure to you, as the subject of the information, or your personal representative; (c) use or disclosure made pursuant to an authorization; (d) disclosure to HHS for complaint investigation, compliance review or enforcement; (e) use or disclosure that is required by law; or (f) use or disclosure required for compliance with the HIPAA Transactions Rule or other HIPAA Administrative Simplification Rules.

Reasonable Reliance. If another covered entity makes a request for protected health information, The Virtual PT may rely, if reasonable under the circumstances, on the request as complying with this minimum necessary standard. Similarly, The Virtual PT may rely upon requests as being the minimum necessary protected health information from: (a) a public official, (b) a professional (such as an attorney or accountant) who is The Virtual PT’s business associate, seeking the information to provide services to or for The Virtual PT; or (c) a researcher who provides the documentation or representation required by the Privacy Rule for research.

Your Privacy Rights

It is the duty of The Virtual PT to adhere and in good faith comply with HIPAA privacy standards. Additionally, you have the following rights as it pertains to your PHI:

Communication: you may request alternate means of communication to carry out physical therapy services, as long as requests are within reasonable ability of The Virtual PT to accommodate. This request must be submitted in a written format.
Restrictions: you have the right to request restrictions as it pertains to the release of PHI for treatment and business operations. You also have the right to request restriction of PHI to only certain individuals involved in your medical care. If agreement is made by The Virtual PT, then the company will be bound by such request, except as required by law or in an emergency. Note that The Virtual PT is not obligated to comply with all requests.
Medical records: you have a right to request medical records pertaining to services received from The Virtual PT. A reasonable fee may be charged for printing, copying, mailing, or labor to distribute such documents. Except in certain circumstances, you have the right to review and obtain a copy of your protected health information in The Virtual PT’s designated record set. The “designated record set” is that group of records maintained by The Virtual PT that is used, in whole or part, to make decisions about individuals, or that is a provider’s medical and billing records about individuals or a health plan’s enrollment, payment, claims adjudication, and case or medical management record systems. The Rule excepts from the right of access the following protected health information: psychotherapy notes, information compiled for legal proceedings, laboratory results to which the Clinical Laboratory Improvement Act (CLIA) prohibits access, or information held by certain research laboratories. For information included within the right of access, The Virtual PT may deny you access in certain specified situations, such as when they believe access could cause harm to the you or another. In such situations, the you have the right to have such denials reviewed by a licensed health care professional for a second opinion.
Privacy breach: you have a right to be notified in the event of a breach in privacy relating to The Virtual PT documentation records and PHI.
Amendment. You have a right to request an amendment to your health records if you believe they are incorrect or incomplete. If the request is denied, The Virtual PT must provide you with a written denial and allow you to submit a statement of disagreement for inclusion in the record.
Disclosure Accounting. You have a right to an accounting of the disclosures of your protected health information by The Virtual PT and its Business Associates. The maximum disclosure accounting period is the six years immediately preceding the accounting request, except The Virtual PT is not obligated to account for any disclosure made before its Privacy Rule compliance date.The Privacy Rule does not require accounting for disclosures: (a) for treatment, payment, or health care operations; (b) to you or your personal representative; (c) for notification of or to persons involved in your health care or payment for health care, for disaster relief, or for facility directories; (d) pursuant to an authorization; (e) of a limited data set; (f) for national security or intelligence purposes; (g) to correctional institutions or law enforcement officials for certain purposes regarding inmates or individuals in lawful custody; or (h) incident to otherwise permitted or required uses or disclosures.
Privacy copy upon request: you have right to request a written copy of this privacy notice. Requests should be made to suzanne@thevirtual-pt.com.
File a complaint: if you believe that your privacy rights have been violated, you have the right to file a complaint to The Virtual PT by emailing suzanne@thevirtual-pt.com and/or the Secretary of State of the Department of Health and Human Services (1-800-942-5540).
No Retaliation: There will be no retaliation by The Virtual PT upon receiving a privacy complaint.
Further privacy information: if you would like more information about your privacy rights, please contact suzanne@thevirtual-pt.com.