Keiki Communication

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU AS A CLIENT OF THIS PRACTICE MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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Keiki Communication Therapy is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Keiki Communication Therapy will notify you promptly if a breach occurs that may have compromised the privacy or security of your information. If you have questions about any part of this notice or if you want more information about the privacy practices at Keiki Communication Therapy please contact:
 

Contact Information: Megan Fienhold, Owner (808) 352-0177.
 

Effective Date of This Notice: November 15, 2015
 

I. How Keiki Communication Therapy may Use or Disclose Your Health Information

Keiki Communication Therapy collects health information about you and stores it in a file that is your record. We need this information to provide you with quality care and to create a record of the care and services you receive. Keiki Communication Therapy is committed to protecting the privacy of your health information. The law permits Keiki Communication Therapy to use or disclose your health information for the following purposes:
 

1. Treatment. We may use your health information to provide you with speech therapy or other related services. We may disclose medical information about you to doctors, and other health care providers involved in providing services to you.
 

2. Payment. We may use and disclose medical information about you so that the treatment and services you receive at Keiki Communication Therapy may be billed to, and payment may be collected from you and/or an insurance company. To the extent possible, we will make reasonable efforts to assure that the use and disclosure of your personal health information is conducted in a secure and confidential manner.
 

3. Information provided to you.
 

4. Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care. If you do not wish to receive appointment reminders, be sure to notify us in writing.
 

5. Required by law. As required by law, we may use and disclose your health information as described below:
a. Public health. We may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
b. Health oversight activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
c. Judicial and administrative proceedings. We may disclose your health information in the course of any administrative or judicial proceeding as required by a court order or subpoena.
d. Law enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
e. Deceased person information. We may disclose your health information to coroners, medical examiners and funeral directors when an individual dies.
f. Public safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
g. Specialized government functions. We may disclose your health information for military, national security, and prisoner purposes.
h. Worker’s compensation. We may disclose your health information as necessary to comply with worker’s compensation laws.
 

Only the minimum necessary health information will be disclosed to accomplish the above purposes.
 

II. When Keiki Communication Therapy May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, Keiki Communication Therapy will not use or disclose your health information without your written authorization. If you do authorize Keiki Communication Therapy to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. However, we will not be able to take back any disclosures that we have already made with your prior permission. .

 

III. Your Health Information Rights
When it comes to your health information, you have certain rights. This section explains your rights and Keiki Communication Therapy’s responsibilities to help you.

 

1. You have the right to request restrictions on certain uses and disclosures of your health information. We ask that such requests be made in writing. Keiki Communication Therapy is not required to agree to the restriction that you requested if it would affect your care. If you pay for a service out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will agree unless a law requires us to share that information.
 

2. You have the right to review and obtain a copy of your health information. You must submit your request for your therapy record in writing to Keiki Communication Therapy. If you request a copy of the information, a fee may be charged for the cost of copying, mailing, or other supplies associated with your request. A copy or summary of your health information will be provided within 30 days of your request.
 

3. You have a right to request that Keiki Communication Therapy amend your health information that is incorrect or incomplete. We ask that such requests be made in writing. Keiki Communication Therapy is not required to change your health information and will provide you with information about Keiki Communication Therapy’s denial and the reasons why within 60 days.
 

4. You have a right to receive an accounting of disclosures of your health information made by Keiki Communication Therapy, except that Keiki Communication Therapy does not have to account for the disclosures which include: treatment, payment, health care operations, information provided to you, and any other disclosures you authorized us to make.
 

5. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail. You must make your request for confidential communications in writing to Keiki Communication Therapy. Your request must specify how or where you wish to be contacted.
 

6. You have a right to a paper copy of this Notice of Privacy Practices.
 

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact:

Megan Fienhold, Owner (808) 352-0177
 

IV. Changes to this Notice of Privacy Practices
Keiki Communication Therapy reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, Keiki Communication Therapy is required by law to comply with this Notice. Revised notices will be distributed.
 

V. Complaints
Complaints about this Notice of Privacy Practices or how Keiki Communication Therapy handles your health information must be in writing and directed to:

 

Megan Fienhold
Keiki Communication Therapy
45-727 Puupele Street
Kaneohe, HI 96744
 

For further information about this process, call 808-352-0177. This number is not to be used to register a complaint, as complaints must be submitted in writing as stated above.

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If you are not satisfied with the manner in which this complaint is handled, you may submit a formal complaint to:

 

Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201