• Talk Time Speech and Language Services

    Atlanta, GA 30319 Phone: (678) 938-4160 Fax: (678) 623-5289 Email: talktimespeechy@gmail.com
  • HIPAA: Privacy Regulations        

    Effective Date: April 14, 2003

    Notice of Our Privacy Practices 

    In 1996, the Federal Government established uniform privacy and security standards to protect patients’ medical information. The standard is known as the Health Insurance Portability and Accountability Act (HIPAA). The deadline for compliance is April 14, 2003.

    The purpose of this notice is to ensure that you (the health-care recipient) or your designated representatives are aware of your rights to ensure the privacy of your healthcare information Talk Time Speech and Language Services, LLC retains the right to update this notice at any time. To obtain the most recent notice, please submit a request in writing to April Atchison, Privacy Officer of Talk Time Speech and Language Services at the address listed above. The following is a condensed version of Talk Time Speech and Language Services, LLC’s Notice of Privacy Practices; to receive a copy of our Privacy Practices in entirety, please submit a written request to the Privacy Officer of Talk Time Speech and Language Services.

     1. Privacy of Patient Information

    We have created a record of the services and treatment that you receive through
    Talk Time Speech and Language Services. The privacy of your medical
    information is important to us and we are committed to protecting it. We are
    required by law to keep your medical information private and notify you of our
    legal rights and privacy practices.

     2. Use and Disclosure of Patient Information 

     Your medical information will be used for treatment, payment, and operations to maintain the highest quality of care possible. HIPAA allows disclosure of this
    information to your designated/authorized next of kin, licensed healthcare
    providers involved in your care, and other healthcare entities including insurance companies, state and federal regulation agencies, as well as law enforcement agencies in the interest of public safety. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order, subpoena, discovery request, or other lawful process. Any other uses and disclosures of your personal health information will be made only with your written authorization. You make revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

    You, the patient, however, reserve the right to request in writing restrictions on
    certain uses and disclosures.

    In addition to the above mentioned entities, Talk Time Speech and Language
    Services may communicate with the following persons on my behalf for my
    course of treatment and my health condition: for example, Babies Can’t Wait
    Program, Service Coordination Agency.

     

    3. Your Rights Regarding Medical Information About You

    You have the right to inspect and copy your personal health information kept on file with Talk Time Speech and Language Services • You have the right to amend information we have about you that is incorrect or incomplete. • You have a right to request restrictions on the medical information we use or disclose about you for treatment and payment. • You have a right to an accounting of disclosures we made of medical information about you. • All of the above requests may be submitted in writing to the Privacy Officer of Talk Time Speech and Language Services, LLC at the address listed above .

  • Patient's (or Designee's) Personal Communication:

    By initialing the following, I authorize you to communicate confidential information, including services, to me by the following means: 

  • 4. Patient's Access to Medical Information


  • You have the right to see and obtain a copy of your medical records at any time. You may request changes in your health information and request the reason for any disclosure (not including treatment, payment, and healthcare procedures). If Talk Time Speech and language Service does not agree with your changes, you must be allowed to insert a statement of disagreement into the record. Talk Time Speech and Language service is not required to agree to your requested restrictions. However, if we agree, the restriction is binding.

     

    5. Confidentiality of Patient Information

    Talk Time Speech and Language Services will attempt in all cases to preserve the confidentiality of all oral and written medical information. This includes progress information at the end of treatment sessions, written information, and electronic transmission of information to physicians, insurance companies, state and federal entities, and law enforcement agencies in the interest of public safety. Talk Time Speech and Language Services will not be held responsible in the event of natural disasters, theft, or burglary of their physical and electronic property, having taken reasonable precaution.  

     

    6. How to File a Complaint

    You may file a complaint if you feel that your privacy rights have been violated. Talk Time Speech and Language Services will not retaliate against you if you file a complaint. You may file a formal, written complaint with Talk Time Speech and Language Services or with the Department of Health & Human Services, Office of Civil Rights, in the event you feel your privacy rights have been violated.

     

    For more information about HIPAA or to file a complaint:

    The U.S. Department of Health & Human Services Office of Civil Rights 200
    Independence Avenue, S.W. Washington, D.C. 20201

    (877) 696-6775 (toll-free)

  • I, on behalf of have reviewed (Print name of parent or legal guardian) (Print Child's Name)
    a copy of Talk Time Speech and Language Services' Notice of Privacy Practices with an effective date of April 14, 2003.

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