Notice of Privacy Practices

Our commitment to your privacy

Texas Specialty Physical Therapy, Inc., doing business as PT ReVolution of Texas, is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. "Health information" means information that identifies you and relates to your past, present, or future physical or mental health, the care you receive, or payment for that care.

We are also required to notify you if a breach of your unsecured health information occurs.

How we use and share your health information

We typically use or share your health information in the following ways.

Treatment. We use your health information to evaluate and treat you, and we share it with other professionals involved in your care. Example: we may send your progress notes to your physician, surgeon, or other referring provider.

Payment. We use and share your health information to bill and get paid by health plans and others. Example: we give information about your visits to your insurance company so it will pay for your care, and we may contact your plan to verify benefits or obtain authorization.

Health care operations. We use and share your health information to run our clinic, improve care, train staff, and contact you when necessary. Example: we review records to evaluate the quality of our care and the performance of our therapists.

Appointment reminders and services. We may contact you by phone, text, email, or mail to remind you of appointments, follow up on your care, or tell you about treatment options and health-related services we offer. You may ask us to contact you in a different way (see "Your rights").

Business associates. We share information with companies that perform services for us, such as scheduling, electronic records, billing, and secure online intake. They are required by contract to protect your information.

Other uses and disclosures allowed or required by law

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We must meet many conditions in the law before we can share your information for these purposes.

As required by law, including by federal, state, or local law, and with the U.S. Department of Health and Human Services when it wants to confirm we are complying with federal privacy law.

Public health and safety, such as preventing disease, reporting adverse reactions to medications or problems with products, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.

Health oversight activities, such as audits, investigations, inspections, and licensure by agencies including the Texas Board of Physical Therapy Examiners.

Lawsuits and legal actions, in response to a court or administrative order, or in response to a subpoena when the law allows.

Law enforcement, for law enforcement purposes permitted by law.

Coroners, medical examiners, and funeral directors, and organ and tissue donation requests.

Research, when approved under the privacy protections the law requires.

Workers' compensation claims and similar programs.

Specialized government functions, such as military, national security, and presidential protective services.

When you have a say in how we share

For the following, you can tell us your choices about what we share. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

Sharing information with your family, close friends, or others involved in your care or payment for your care.

Sharing information in a disaster relief situation.

When we need your written permission

We will never share your information for the following purposes unless you give us written permission (an authorization): marketing purposes, and the sale of your information. We do not sell health information.

Other uses and disclosures not described in this notice, including sharing your story, photo, or video in a testimonial, will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your rights

When it comes to your health information, you have certain rights. To use any of them, contact our Privacy Officer using the information at the end of this notice.

Get a copy of your health and billing records. You can ask to see or get an electronic or paper copy of your records. We will provide a copy or a summary, usually within 30 days of your request, and may charge a reasonable, cost-based fee. Under Texas law, if we maintain your records electronically and you request them in electronic form, we will provide them within 15 business days of receiving your written request.

Ask us to correct your records. You can ask us to correct health information you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.

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. We will say yes to all reasonable requests.

Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and we may say no if it would affect your care. If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health insurer for payment or operations, and we will say yes unless a law requires us to share it.

Get a list of those with whom we've shared information. You can ask for an accounting of the times we have shared your information for six years prior to the date you ask, who we shared it with, and why. It will include all disclosures except those for treatment, payment, and health care operations, and certain other disclosures. We provide one accounting a year for free and may charge a reasonable, cost-based fee for another within 12 months.

Get a copy of this notice. You can ask for a paper copy at any time, even if you agreed to receive it electronically.

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. See "Complaints" below.

Electronic disclosure under Texas law

Texas law requires us to tell you that your health information may be subject to electronic disclosure. We may share your information electronically for treatment, payment, health care operations, and as otherwise permitted or required by law. Except in limited circumstances allowed by law, we will not electronically disclose your health information to anyone other than a covered entity without your authorization.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/complaints.

We will not retaliate against you for filing a complaint.

Changes to this notice

We can 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, in our clinics, and on our website.

Contact our Privacy Officer