THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU OR YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Arizona Institute For Autism, LLC/ABA Clinic Management, LLC is dedicated to maintaining the privacy of our client’s (the Client”) individually identifiable health information (also called protected health information, or PHI). In conducting our business, we will create records regarding the Client and the treatment and services we provide. We are required by law to maintain the confidentiality of health information that identifies Clients. We also are required by law to provide this notice of our legal duties and the privacy practices that we maintain in our practice concerning Client’s PHI. By federal and state law, we must follow the terms of the Notice of Privacy Practices that we have in effect at the time.
We realize that these laws are complicated, but we must provide you with the following important information:
● How we may use and disclose a Client’s PHI,
● Privacy rights in PHI,
● Our obligations concerning the use and disclosure of PHI.
The terms of this notice apply to all records containing a Client’s PHI that are created or retained by Arizona Institute For Autism, LLC, ABA Clinic AManagement, LLC. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment to this notice will be effective for all records created or maintained in the past, and for any records that we may create or maintain in the future. Arizona Institute For Autism/ABA Clinic Management will always post a copy of our current Notice in our offices in a visible location, and you may request a copy of our most current Notice at any time.
I. HOW Arizona Institute For Autism/ ABA Clinic Management WILL USE AND DISCLOSE PHI.
Arizona Institute For Autism Behavioral Services Inc. will use and disclose a Client’s PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find the different categories of our uses and disclosures, with some examples.
A. Uses and Disclosures Related to Treatment, Payment, or Health Care Operations Do Not Require Prior Written Consent.
Arizona Institute For Autism may use and disclose a Client’s PHI without consent for the following reasons: 1. For treatment. Arizona Institute For Autism may disclose PHI to physicians,
psychiatrists, psychologists, behavior interventionists, and other licensed healthcare providers who provide a Client with health care services or are otherwise involved in his or her care. Example: If a psychiatrist is treating a client, Arizona Institute For Autism may disclose PHI to her/him in order to coordinate services.
2. For health care operations. Arizona Institute For Autism may disclose PHI to facilitate
the efficient and correct operation of the services it provides. Examples: Quality control – Arizona Institute For Autism might use PHI in the evaluation of the quality of services that a Client receives or to evaluate the performance of the behavior interventionists who provided these services. Arizona Institute For Autism may also provide PHI to company attorneys, accountants, consultants, and others to make sure that Arizona Institute For Autism follows applicable laws.
3. To obtain payment for treatment. Arizona Institute For Autism may use and disclose PHI to bill and collect payment for the treatment and services Arizona Institute For Autism has provided. Example: We might send PHI to the Client’s Regional Center or insurance company in order to get payment for the services that Arizona Institute For Autism has provided. Arizona Institute For Autism could also provide PHI to business associates that provide services for Arizona Institute For Autism.
4. Other disclosures. Examples: Consent isn’t required if a Client needs emergency
treatment if Arizona Institute For Autism attempts to get consent after treatment is rendered. If Arizona Institute For Autism tries to get consent, however, you are unable to communicate with us, but Arizona Institute For Autism thinks that you would consent to such treatment if you could, Arizona Institute For Autism may disclose PHI.
B. Certain Other Uses and Disclosures Do Not Require Consent. Arizona Institute For Autism may use and/or disclose PHI without consent or authorization for the following reasons:
1. Required by Law. When disclosure is (a) required by federal, state, or local law; judicial, board, or administrative proceedings; or law enforcement; (b) compelled by a party to a proceeding before a court, arbitration panel or an administrative agency pursuant to its lawful authority; (c) required a search warrant lawfully issued to a government law enforcement agency; or (d) compelled by the patient or the patient’s representative pursuant to Arizona Health and Safety Codes or to corresponding federal statutes of regulations, such as the Privacy Rule that requires this Notice.
2. To avoid harm. When disclosure: (a) to law enforcement personnel or persons may be able to prevent or mitigate a serious threat to the health or safety of a person or the public; (b) is compelled or permitted by the fact that the Client is in such mental or emotional condition as to be dangerous to him or herself or the person or property of others, and if Arizona Institute For Autism determines that disclosure is necessary to prevent the threatened danger; (c) is mandated by the Arizona Child Abuse and Neglect Reporting law (for example, if we have a reasonable suspicion of child abuse or neglect); (d) is mandated by the Arizona Elder/Dependent Adult Abuse Reporting law (for example, if we have a reasonable suspicion of elder abuse or dependent adult abuse); and (e) if disclosure is compelled or permitted by the fact that you or your child tells us of a serious/imminent threat of physical violence against a reasonably identifiable victim or victims.
3. For public health activities. When disclosure is for: (a) maintaining vital records, such as births and deaths; (b)preventing or controlling disease, injury or disability, (c) notifying a person regarding potential exposure to a communicable disease; (d) notifying a person regarding a potential risk for spreading or contracting a disease or condition; (d) reporting reactions to drugs or problems with products or devices; or (e) notifying individuals if a product or device they may be using has been recalled.
4. For health oversight activities. Arizona Institute For Autism may disclose PHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example: investigations, inspections, audits, surveys, licensure, and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws, and the health care system in general.
5. For specific government functions. Examples: Arizona Institute For Autism may disclose PHI of military personnel and veterans under certain circumstances.
6. For Workers’ Compensation purposes. Arizona Institute For Autism may provide PHI in order to comply with Workers’ Compensation laws.
7. Appointment reminders and health-related benefits or services. Arizona Institute For Autism permitted to contact you, without prior authorization, to provide an appointment reminders or information about alternatives or other health-related benefits and services that may be of interest.
C. Certain Uses and Disclosures Require You to Have the Opportunity to Object. 1. Disclosures to family, friends or others. Arizona Institute For Autism may provide PHI
to a family member, friend, or another individual who you indicate as involved in the Client’s care or responsible for the payment of health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.
D. Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in Sections I.A, I.B, and I.C above, Arizona Institute For Autism will
request written authorization before using or disclosing any of the PHI. Even if you have signed an authorization to disclose PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (if Arizona Institute For Autism has not taken any action subsequent to the original authorization) of PHI by Arizona Institute For Autism.
II. RIGHTS REGARDING PHI
These are your rights with respect to PHI:
A. The Right to See and Get Copies of PHI. In general, you have the right to see PHI that is in Arizona Institute For Autism possession, or to get copies of it; however, you must request it in writing. If Arizona Institute For Autism does not have the PHI, but Arizona Institute For Autism knows who does, Arizona Institute For Autism will advise you how you can get it. You will receive a response from Arizona Institute For Autism within 30 days of receipt of your written request. Under certain circumstances, Arizona Institute For Autism may deny your request, but Arizona Institute For Autism will give you, in writing, the reasons for the denial. Arizona Institute For Autism will also explain your right to have the denial reviewed. Arizona Institute For Autism may see fit to provide you with a summary or explanation of the PHI, but only if you agree to it, as well as to the cost, in advance.
B. The Right to Request Limits on Uses and Disclosures of PHI. You have the right to ask that Arizona Institute For Autism limits how it uses and discloses PHI. While Arizona Institute For Autism will consider your request, Arizona Institute For Autism is not legally bound to agree. If Arizona Institute For Autism does agree to your request, Arizona Institute For Autism will put those limits in writing and abide by them except in emergency situations. You do not have the right to limit the uses and disclosures that Arizona Institute For Autism is legally required or permitted to make.