Practice notice
Notice of Privacy Practices
Beelieve Occupational Therapy
Effective Date:
Your Information. Your Rights. Our Responsibilities.
This Notice describes how medical information about you or your child may be used and disclosed and how you can obtain access to this information. Please review it carefully.
Our Responsibilities
Beelieve Occupational Therapy is committed to protecting the privacy and security of health information entrusted to the practice.
When applicable, we are required to:
- Maintain the privacy and security of protected health information.
- Notify affected individuals following a breach when notification is required by law.
- Follow the privacy practices described in the Notice currently in effect.
- Provide you with a copy of this Notice.
- Not use or disclose health information other than as described in this Notice unless authorized or otherwise permitted or required by law.
Your Rights
You have certain rights regarding the health information maintained by Beelieve Occupational Therapy. You may:
Get a copy of health records
You may request to inspect or obtain an electronic or paper copy of health information maintained by the practice. We will provide the information as required by applicable law and may charge a reasonable, cost-based fee when permitted.
Request confidential communications
You may ask us to communicate with you in a particular way or at a particular location. We will accommodate reasonable requests as required by law.
Ask us to limit what we use or disclose
You may request restrictions on certain uses or disclosures of health information. We are not always required to agree to these requests. When you pay for a service completely out of pocket and request that information about that service not be disclosed to a health plan for payment or healthcare operations, we will honor that request when required by law.
Receive an accounting of certain disclosures
You may request information regarding certain disclosures of health information that we have made.
Receive a copy of this Notice
You may request a paper or electronic copy of this Notice at any time.
Choose someone to act for you
If someone has legal authority to act on behalf of you or your child, such as a parent, legal guardian, or other authorized personal representative, that person may exercise applicable privacy rights on the individual's behalf.
File a complaint
You may file a complaint if you believe your privacy rights have been violated. Beelieve Occupational Therapy will not retaliate against you for filing a complaint.
How We May Use and Disclose Health Information
We may use or disclose health information as permitted or required by law, including for purposes such as:
Treatment
We may use health information to provide, coordinate, or manage occupational therapy services. When permitted by law, this may include communicating with other healthcare professionals involved in your child's care.
Payment
We may use health information for payment-related activities, including collecting payment for services and providing documentation such as superbills when requested.
Healthcare Operations
We may use health information for activities necessary to operate the practice, such as quality improvement, licensing, compliance, business administration, and other healthcare operations permitted by law.
Other Uses and Disclosures
We may use or disclose health information without written authorization in circumstances permitted or required by law, which may include:
- When required by federal, state, or local law
- Public health and safety activities
- Reporting suspected abuse or neglect as required by law
- Responding to certain lawful judicial or administrative proceedings
- Workers' compensation or similar programs when applicable
- Health oversight activities
- Preventing or reducing a serious and imminent threat to health or safety
- Other disclosures permitted or required by applicable law
Uses Requiring Your Written Authorization
For uses or disclosures not otherwise permitted or required by law, we will obtain written authorization when required.
You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance upon it.
Complaints
If you believe your privacy rights have been violated, you may contact Beelieve Occupational Therapy using the contact information below.
You may also file a complaint with:
U.S. Department of Health and Human ServicesOffice for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
Changes to This Notice
Beelieve Occupational Therapy may change the terms of this Notice as permitted by law. Changes may apply to health information already maintained by the practice as well as information received in the future. The current Notice will be available upon request and posted on our website.
Privacy Contact
For questions about this Notice, to exercise your privacy rights, or to file a privacy complaint, please contact:
Beelieve Occupational TherapyPrivacy Contact: Michelle Freylekhman, OTR/L
michelle@beelieveot.com
425-365-9650