Notice of Privacy Practices
This Notice describes how health information about you may be used and disclosed and how you can get access to this information.
This Notice applies to Sozo Physical Therapy PC as well as those employed and treating patients at Sozo Physical Therapy. If you have questions about this Notice, please contact 701-433-1717. You may also email your questions to firstname.lastname@example.org.
This Notice describes how we will use and disclose your health information. The terms of this Notice apply to all health information generated or received by Sozo Physical Therapy PC, whether recorded in your medical record, billing invoices, paper forms, video, or in other ways.
How We Use and Disclose Your Health Information
We use or disclose your health information as follows:
Treatment: We may use your health information to provide care and share it with others who are treating you. For example, your PT may disclose your health information to a specialist for the purpose of a consultation or a PT assistance or student who is treating you.
Payment: We may use and share your health information to bill and obtain payment for the health care services you receive. For example, we send information about you to your health insurance plan or other healthcare providers, so it will pay for your services.
Clinic Day-to-Day Operations: We may use and share your health information for our day-to-day operations. For example, we may use your medical information to review our treatment notes and services and evaluate how to improve our quality of care. We may disclose your information to physical therapy students for their education. We may also disclose your PT treatment notes and other protected health information (PHI) to other health care providers for their health care operations.
We may share your health information in the following situations unless you tell us otherwise. If you are not able to tell us your preference, we may go ahead and share your information if we believe it is in your best interest or needed to lessen a serious and imminent threat to health or safety:
Friends and Family: If you are a minor, we will share your medical information with your legal guardian. We will not share other information with family members unless you request, or unless there is a medical need.
Disaster Relief: We may disclose your health information to disaster relief organizations in an emergency so your family can be notified about your condition and location.
We may also use and share your health information for other reasons without your prior consent:
When required by law: We will share information about you if state or federal law require it, including with the Department of Health and Human services if it wants to see that we're complying with federal privacy law. This may include disclosing information about victims of abuse, neglect, or domestic violence.
For public health and safety: We can share information in certain situations to help prevent disease, report adverse reactions to treatment or medications, and to prevent serious threat to your safety or someone else's.
Law enforcement: We may share information for law enforcement purposes, such as when a crime is committed at our facility. We may also share information to help locate a suspect, fugitive, missing person or witness.
Lawsuits and legal actions: We may share information about you in response to a court or administrative order, or in response to a subpoena.
Medical examiner or funeral director: We can share information with a coroner, medical examiner, or funeral director when an individual dies.
Workers' compensation or other government requests: We can share information to employers for workers' compensation claims and other government agencies based on federal laws.
We may contact you in the following situations:
Appointment reminders: To remind you of appointments with us.
Treatment options: To provide information about treatment alternatives at Sozo PT that may be of interest to you.
Fundraising: We may contact you about fundraising activities, but you can tell us not to contact you again.
Your Rights That Apply to Your Protected Health Information (PHI)
When it comes to your health information, you have certain rights:
Get a copy of your medical record: You can ask to see or get a paper or electronic copy of your medical record and other health information we have about you. We will provide a copy or summary to you usually within 60 days of your request. We may charge a reasonable, cost-based fee. Access may be denied in some circumstances, such as when a certain law prohibits your access. In some circumstances you may have this decision reviewed.
Ask us to correct your medical record: You can ask us to correct health information that you think is incorrect or incomplete. We may deny your request, but we'll tell you why in writing. These requests should be submitted in writing to the contact listed below.
Request confidential communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. Reasonable requests will be approved.
Ask us to limit what we use or share: You can ask us to restrict how we share your health information for treatment, payment, or our operations. We are not required to agree to your request unless restricted by law.
Get a copy of this privacy notice: You can ask for a paper copy of this Notice at any time, even if you have agreed to receive it electronically. We will provide you with a paper copy promptly.
Choose someone to act for you: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
File a complaint if you feel your rights are violated: You can complain to the U.S. Department of Health and Human Services Office for Civil Rights if you feel we have violated your rights, and we can provide you with their address. You can also file a complaint with us by using the contact information below. We will not retaliate against you for filing a complaint.
Sozo Physical Therapy PC
9 N 5th St Ste A
Oakes, ND 58474
Our Responsibilities Regarding Your Health Information
We are required by law to maintain the privacy and security of your health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your health information.
We must follow the duties and privacy practices described in this Notice and offer to give you a copy.
We will not use or share your information other than as described here unless you tell us to in writing. You may change your mind at any time by letting us know in writing.
Changes to This Notice
We may change the terms of this Notice, and the changes will apply to all information we have about you. The new Notice will be available upon request and on our website www.sozo-physicaltherapy.com.
This Notice of Privacy Practices is effective August 1, 2021.