As an employee/volunteer/student at Tiny Voice Therapy Services LLC, you may have access to “Confidential Information.” The purpose of this agreement is to help you understand your obligations regarding confidential information.
As an employee/volunteer/student, you are requires to conduct yourself in strict conformance with Federal and State laws and regulations. Your principal obligations in this area are explained below. You are required to read and to abide by these rules. Anyone who violates any of these rules will be subject to discipline. In addition, violation of these rules may lead to civil and criminal penalties under HIPAA and potentially other legal action.
As an employee/volunteer/student, you may have access to confidential information, which includes, but is not limited to, information relating to:
- Medical record information (includes all patient data, conversations, admitting information, demographic information and patient financial information).
- Protected Health Information (PHI) as defined by HIPAA includes, but is not limited to, names, all geographic subdivisions; all elements of dates (except year) for dates directly related to an individual, telephone numbers, fax numbers, electronic mail addresses, social security numbers, medical record numbers, health plan beneficiary numbers, account numbers; and any other unique identifying number, characteristic, or code.
In the event that you do have access to confidential information, you hereby agree as follows:
- You will only use confidential information/data as needed to perform your duties as an employee/volunteer/student affiliated with Tiny Voice Therapy Services LLC.
- You will not in any way divulge, copy, release, sell, loan, review, alter, or destroy any confidential information/data.
- You will not misuse confidential information/data or be careless with it.
- You understand that your obligations under this Agreement will continue after your affiliation with Tiny Voice Therapy Services LLC terminates.
- Tiny Voice Therapy Services LLC may take legal action including but not limited to civil litigation or criminal prosecution.
“I certify that I have read and understand the Confidentiality Statement printed above and hereby agree to be bound by it.”