HIPAA Notice of Privacy Practices

Our Duty to Protect Your Health Information

Dr. Viktoria Lemberikman MD, FABPMR is required by law 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 follow the terms of the notice currently in effect.

"Protected health information" (PHI) includes any information about your health status, the health care we provide to you, or payment for that health care that can be linked to you as an individual. This is regulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations at 45 CFR Part 164.

We reserve the right to change this notice. A revised notice will be provided to you at your next visit, and the current version will always be available on this website and at our reception desk.

How We Use and Disclose Your Health Information

Treatment

We may use your PHI to provide, coordinate, and manage your physical therapy treatment and related services. For example, we may share information with other treating providers (such as your referring physician) as part of your care.

Payment

We may use and disclose your PHI so that treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or another third party. For example, we may share your diagnosis and treatment codes with your health insurer to obtain reimbursement.

Health Care Operations

We may use and disclose your PHI for health care operations, including quality assessment, staff training, and business planning, as permitted by 45 CFR § 164.506.

Other Permitted or Required Disclosures

• As required by federal, state, or local law.
• To public health authorities for legally required public health activities.
• To avert a serious threat to health or safety.
• To respond to lawful requests by law enforcement or court orders.
• For workers' compensation purposes as required by law.

Uses Requiring Your Authorization

Other uses and disclosures of your PHI not described in this notice will be made only with your written authorization. You may revoke such authorization in writing at any time, except where we have already taken action in reliance on it.

Uses that always require your explicit authorization include: marketing communications that involve payment to us, sale of your PHI, and most disclosures of psychotherapy notes (if applicable).

Your Rights Regarding Your Health Information

Right to Access Your Records

You have the right to inspect and obtain a copy of your PHI in a designated record set, as governed by 45 CFR § 164.524. We may charge a reasonable, cost-based fee for copies. We will provide access within 30 days of your request (or 60 days if the records are stored off-site).

Right to Request an Amendment

You may request an amendment to your PHI if you believe it is inaccurate or incomplete (45 CFR § 164.526). We may deny your request under certain circumstances and will explain any denial in writing.

Right to an Accounting of Disclosures

You may request a list of disclosures of your PHI that we have made, other than those for treatment, payment, and health care operations (45 CFR § 164.528).

Right to Request Restrictions

You may request that we restrict how we use or disclose your PHI. We are not required to agree, except in the case where you request a restriction on disclosure to a health plan for a service you paid for in full out of pocket.

Right to Confidential Communications

You may request that we communicate with you by alternative means or at an alternative location (e.g., contact you only by mail, not phone). We will accommodate reasonable requests.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this notice at any time, even if you have agreed to receive it electronically. Ask our front desk staff.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

To file a complaint with us: Contact our Privacy Officer using the information below.

To file a complaint with HHS: Visit hhs.gov/ocr/privacy/hipaa/complaints or call 1-800-368-1019.

Contact Our Privacy Officer