THIS NOTICE
DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT
CAREFULLY.
Treatment. Your health
information may be used by staff members or disclosed to other health care
professionals for the purpose of evaluating your health, diagnosing medical
conditions, and providing treatment. For
example, results of laboratory tests and procedures will be available in your
medical record to all health professionals who may provide treatment or who may
be consulted by staff members.
Payment. Your health information may be used to seek payment from your
health plan, from other sources of coverage such as an automobile insurer, or from
credit card companies that you may use to pay for services. For example, your health plan may request and
receive information on dates of service, the services provided, and the medical
condition being treated.
Health care operations. Your health information may be used as necessary to support
the day-to-day activities and management of
Tomorrow's Child Learning Center LLC..
For example, information on the services you received may be used to
support budgeting and financial reporting, and activities to evaluate and
promote quality.
Law enforcement. Your health
information may be disclosed to law enforcement agencies to support government
audits and inspections, to facilitate law-enforcement investigations, and to
comply with government mandated reporting.
Public health reporting. Your health information may be disclosed to public health
agencies as required by law. For
example, we are required to report certain communicable diseases to the state’s
public health department.
Other uses and disclosures require your authorization. Disclosure of
your health information or its use for any purpose other than those listed
above requires your specific written authorization. If you change your mind after authorizing a
use or disclosure of your information you may submit a written revocation of
the authorization. However, your
decision to revoke the authorization will not affect or undo any use or
disclosure of information that occurred before you notified us of your decision
to revoke your authorization.
Appointment reminders. Your health
information will be used by our staff to send you appointment reminders.
Information about treatments. Your health
information may be used to send you information that you may find interesting
on the treatment and management of your medical condition.. We may also send you information describing
other health-related products and services that we believe may interest you.
Promotions and Advertising. Unless you request us not to, we will use your
child's name and photo or video to support our promotions and advertising
efforts efforts. If you do not want to
participate in promotions and advertising efforts, please check off the
following box.
[ ]
Please do not use my information for promotions and advertising purposes.
You have certain rights under the federal privacy
standards. These include:
·
The right to
request restrictions on the use and disclosure of your protected health
information
·
The right to
receive confidential communications concerning your medical condition and
treatment
·
The right to
inspect and copy your protected health information
·
The right to
amend or submit corrections to your protected health information
·
The right to
receive an accounting of how and to whom your protected health information has
been disclosed
·
The right to
receive a printed copy of this notice
Tomorrow's Child
Learning Center LLC..
Duties
We are required by law to maintain the privacy of your
protected health information and to provide you with this notice of privacy
practices.
We also are required to abide by the privacy policies and
practices that are outlined in this notice.
As permitted by law, we reserve the right to amend or modify
our privacy policies and practices.
These changes in our policies and practices may be required by changes
in federal and state laws and regulations.
Upon request, we will provide you with the most recently revised notice
on any office visit. The revised
policies and practices will be applied to all protected health information we
maintain.
You may generally inspect or copy the protected health
information that we maintain. As
permitted by federal regulation, we require that requests to inspect or copy
protected health information be submitted in writing. You may obtain a form to request access to
your records by contacting the
Receptionist or Tony Bell the HIPAA Administrator. Your request will be reviewed and will
generally be approved unless there are legal or medical reasons to deny the
request.
If you would like to submit a comment or complaint about our
privacy practices, you can do so by sending a letter outlining your concerns
to:
Tony Bell the HIPAA Administrator
Tomorrow's Child Learning Center
LLC.
4407 Amarillo
Blytheville, Ar. 72315
If you believe that your privacy rights have been violated,
you should call the matter to our attention by sending a letter describing the
cause of your concern to the same address.
You will not be penalized or otherwise retaliated against for
filing a complaint.
The name and address of the person you can contact for
further information concerning our privacy practices is:
Charles A. Banks
Attorney.
Tomorrow's Child Learning Center
LLC.
100 Morgan-Keegan
Bldg.
Little Rock, Ar.
870-532-2229
This notice is effective on or after 10-4-2007.