Notice of Privacy Policy

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Pledge

Sankofa Pediatric Therapy understands that health information about you and your health care is personal. We are committed to protecting your health information. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this practice. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you, and describe certain obligations we have regarding the use and disclosure of your health information. We are required by law to:

Make sure that protected health information (“PHI”) that identifies you is kept private.
Give you this notice of our legal duties and privacy practices with respect to health information.
Follow the terms of the notice that is currently in effect.
Sankofa Pediatric Therapy can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request.

Health Information Use and Disclosure

The following categories describe different ways that Sankofa Pediatric Therapy uses and discloses health information.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. Sankofa Pediatric Therapy may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. Disclosures for treatment purposes are not limited to the minimum necessary standard. Because other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, Sankofa Pediatric Therapy may disclose health information in response to a court or administrative order. Sankofa Pediatric Therapy may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Authorization

Subject to certain limitations in the law, Sankofa Pediatric Therapy can use and disclose your PHI without your Authorization for situations such as public health activities, auditing purposes, emergencies or research purposes. Certain uses and disclosures require your authorization, in which Sankofa Pediatric Therapy will ask for in writing, which can be revoked at any time, with written request.

Patient's Rights

You have the right to request limits on uses and disclosures of your PHI. You have the right to request how Sankofa Pediatric Therapy sends PHI to you, as well as the right to receive a list of disclosures I have made, to be received with 60 days. You have the right to correct and/or update your PHI.

You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full. This information will be reviewed on an individual basis, although Sankofa Pediatric therapy is not legal required to accept.

You have the right to a paper copy of this Notice. You also have a right to a copy of this notice by e-mail.

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