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.

Align Motion Physical Therapy is required by law to maintain the privacy of protected health information (PHI), to provide this notice of our legal duties and privacy practices, and to abide by the terms of the notice currently in effect.

How we may use and disclose your health information

• Treatment: to provide, coordinate, and manage your therapy care, including sharing information with your physician, senior living community staff, and other clinicians involved in your care.
• Payment: to bill and obtain payment from Medicare, your insurer, or another responsible party, including verifying coverage and obtaining authorization.
• Health care operations: for quality assessment, clinician training and review, and business management.
• As required by law: including public health reporting, health oversight activities, and reporting suspected abuse or neglect.

Uses requiring your written authorization

Most uses and disclosures not described above require your written authorization, including any marketing use and any sale of PHI. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your rights

• Inspect and obtain a copy of your health record.
• Request a correction to information you believe is inaccurate.
• Request confidential communications at an alternative address or by alternative means.
• Request a restriction on certain uses and disclosures. We are required to honor a request to restrict disclosure to a health plan when you have paid for the service in full out of pocket.
• Receive an accounting of certain disclosures we have made of your health information.
• Receive a paper copy of this notice on request.
• Be notified if a breach occurs that may have compromised the privacy or security of your information.

How we safeguard your information

Health information submitted through our referral portal is encrypted in transit and encrypted at rest. Uploaded prescriptions are stored encrypted outside any publicly accessible location and are retrievable only by authenticated staff. Every access to a referral record is recorded in an audit log. Notification emails contain no patient information.

Complaints

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

Privacy Officer

[[ PRIVACY OFFICER NAME ]]
Align Motion Physical Therapy
491 N Main Street
Naugatuck, CT 06770
203.518.6065
[[ EMAIL ]]

Effective date

[[ EFFECTIVE DATE ]]