Your Privacy Is Important to us
BH Field, LLC’s staff respects your privacy. It’s our policy to ensure that the operational activities and professional organization affairs between our agency and our clients are kept confidentially to the greatest possible extent. In Accordance with the HIPPA Privacy Rule, June 2, 2008, BH Field is required by law to maintain the privacy of your “Protected Health Information” (PHI) about you, to notify you of your legal rights, and to follow the privacy policies described in this notice. “PHI” means any information that we create or receive that identifies you and relates to your health or payment for services.
Use and Disclosure of Information about You
Your PHI will be used and disclosed to others as necessary to provide the best service to you. Here are some examples:
Throughout our provision of service to you, members of our staff may see your clinical record. This includes Behavior Analysts, Behaviors Technicians, and Paraprofessionals;
Information may be provided to your health Insurance or another treatment provider to arrange for a referral or clinical consultation. Your PHI will be used or disclosed as needed to arrange for payment for ABA service to you.
For example, information regarding your diagnosis and the service we delivered is included in the bills that BH Field submit to your health insurance plan. This information may be required by your health plan to confirm that the service rendered is covered by your benefit program and medically necessary. It may also be necessary to use or disclose PHI for our health care operations or those of another organization that have a relationship with you. For example, our quality assurance staffs reviewing records to be sure that BH Field deliver appropriate treatment of high quality. Your health plan may wish to review your records to be sure that BH Field meet national standards for quality of care.
At BH Field, our policy is to obtain a general written permission to use and disclose your PHI for treatment, payment, or health care operations purposes. You will be asked to sign a Consent form to permit all such uses and disclosures of your information. - and - also to obtain specific written permission for every disclosure of PHI to third parties other than for payment purposes. You will be asked to sign an Authorization form for disclosure to each person or organization that receives the information, However; If there is an emergency, BH Field will disclose your PHI as needed to enable people to care for you.
Disclosure to your family and friends: If you are an adult, you have the right to control disclosure of information about you to any other person, including family members or friends. If you ask BH Field to keep your information confidential, BH Field will respect your wishes. But if you don’t object, BH Field will share information with family members or friends involved in your care as needed to enable them to help you.
Disclosure to health oversight agencies: BH Field will disclose PHI to government agencies.
Disclosures to child protection agencies: BH Field will disclose PHI as needed to comply with the state law requiring reports of suspected incidents of child abuse or neglect.
Other disclosures without written permission: There are other circumstances in which BH Field may be required by law to disclose PHI without your permission. This may include:
Pursuant to court order;
To public health authorities;
To law enforcement officials in some circumstances;
To federal officials for lawful military or intelligence activities;
To researchers involved in approved research projects;
As otherwise required by law.
Written permission by you is necessary to disclose PHI to a third party, except for the circumstances described above. If a request for disclosure of records or information is received by our office, BH Field will contact you to ask whether you authorize or refuse such disclosure. If you refuse to authorize disclosure, or if it is not possible for us to contact you, BH Field will not disclose your information without a court order. Each request for disclosure will have a specific name and address to which the information will be sent. You will never be asked to sign a non-specific release of information form.
Your Legal Rights
Confidential communication: You may request that communications to you, such as appointment reminders, bills, or explanations of health benefits be made in a confidential manner. BH Field will accommodate any such request, if you provide a means for us to process payment transactions.
Restrictions on use and disclosure of your information: You have the right to request restrictions on our use of your PHI for purposes, or our disclosure of that information to certain third parties. BH Field is not obligated to agree to a request restriction, but we will consider your request.
Revoke a Consent or Authorization: You may revoke a written Consent or Authorization for us to use or disclose your PHI. The revocation will not affect any previous use or disclosure of your information.
Name a personal representative: A “personal representative” of a patient may act on their behalf in exercising their privacy rights. This includes the parent or legal guardian of a minor. An individual can also grant another person the right to act as his or her personal representative in an advance directive or living will.
Exercise Your Rights
Contact us at any time if you have questions about our policies and procedures, individual rights, and complaints. The contact person can be reached at firstname.lastname@example.org. This is a summary of your rights and protections under the federal health information privacy law. You can learn more about health information privacy and your rights in a fact sheet called “Your Health Information Privacy Rights.” You can get this from the website at www.hhs.gov/ocr/hipaa