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Notice of Privacy Policy



Body Balance Lakeway is committed to treating and using protected health information about you responsibly. I am required by federal and state law to maintain the privacy of your protected health information. This Notice of Health Information Practices describes the personal information I collect, and how and when I use or disclose that information. It also describes your rights as they relate to your protected health information (PHI). This Notice is effective April 1st, 2012 and applies to all protected health information as defined by federal regulations.

Understanding Your Health Record/Information

Each time you receive treatment form Body Balance Lakeway, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, where, when, and why others may access your information, and make more informed decisions when authorizing disclosures to others.

Your Health Information Rights

Although your health record is the physical property of Body Balance Lakeway, the information belongs to you. You have the right to:

Our Responsibilities

Body Balance Lakeway is required to:

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will either mail or e-mail a revised notice to the addresses you've supplied us.

We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue using or disclosing your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

Uses and Disclosures of Protected Health Information

We may use and disclose PHI about you for treatment, payment, and healthcare operations. Following are the types of uses and disclosures that I am permitted to make.

We will use and disclose health information for treatment.

For example: Information obtained by a physical therapist or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. We will document in your record your plan of care, treatment and interventions, observations, symptoms, tests and measurements, and your response to treatment.

We will also provide your physician, case manager, or subsequent healthcare provider with copies of various reports that should assist him/her in your treatment and care.

We will use and disclose your health information for payment.

For example: A bill may be sent to you or a third-party payer. We may use and disclose your PHI to submit bills to you or a third-party payer for healthcare services provided to you. We may disclose your PHI to another health plan, to a healthcare provider, or other entity subject to the Federal privacy rules for their payment purposes. Payment activities may include processing claims, determining eligibility or coverage for benefits, reviewing services for medical necessity, and performing utilization review of your account.

We will use and disclose health information for regular healthcare operations.

For example: Healthcare operations include the business functions conducted by a healthcare provider. Members of the healthcare staff may use information in your health record to perform transcription duties, as well as assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide. These activities may include providing customer services, transcription duties, responding to complaints, conducting review of accounts and other quality assessments and improvement activities.

For More Information or to Report a Problem

If you have any questions and would like additional information, you may contact Jille Dorler, PT or Paul Hendricks, PT at 512-261-8699.

If you believe your privacy rights have been violated, you can file a complaint with Jille Dorler, PT, Paul Hendricks, PT or with the Office for Civil Rights, US Department of Health and Human Resources. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office of Civil Rights. The address for the OCR is listed below:

Office for Civil Rights
U.S Department of Health and Human Services
200 Independence Ave S.W.
Room 509F, HHH Bldg.
Washington, DC 20201

Or, call Toll Free: 1-877-696-6775

Federal law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that I have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.

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