AIAT is not an electronically-based service, and does not provide telehealth. Our HIPPA Policies are all office based, and are the following:

​

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.

​

WE HAVE A LEGAL DUTY TO SAFEGARD YOR PRTOECTED HEALTH INFORMATION(PHI). We are legally required to protect the privacy of your PHI, which includes information than can be used to identify you that we have created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. We must provide you with the Notice about our privacy practices and such notice must explain how, when, and why we will “use” and “disclose” your PHI. A “use” of PHI occurs when we share, employ, utilize, apply, or analyze such information within our agency; PHI is “disclosed” when it is released, transferred, has been given to, or is otherwise divulged to a third part outside of our agency. With some exception, we may not disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. And, we are legally required to follow the privacy practices described in this notice.

However, we reserve the right to change the terms of this notice and my privacy policies at any time. Any changes will play to PHI on file with us already. Before we make any important changes to our policies, we will promptly change this Notice and pose a new copy of it in our office. You can also request a copy of this notice from us, or you can ask to view it.

​

HOW WE MAY USE AND DISCLOSE YOUR PHI

We will use and disclose your PHI for many reasons. For some f these uses or disclosures, we will need your prior authorization; for others, however we do not. Listed below are the different categories of our uses and disclosure along with some examples if each category.

1. Uses and Disclosure Relating to treatment, Payment, or Heath care Operations Do Not Require Your Prior Written Consent. We can use and disclose your PHI without your consent for the following reasons:

1. To obtain payment for treatment. We can use and disclose your PHI to bill and collet payment from the treatment and services provided by us to you. We may also provide your PHI to our business associates, such as billing companies, claims processing companies, and others that process our health care claims.

2. For health care operations. We can disclose your Phi to operate our agency, For example, we might use your PHI to evaluate the quality of health care services that you receives or to evaluate the performance[M1]  of the health care professionals who provide such services to you. We may also provide your PHI to accountants, attorneys, consultants, and others to make sure we are complying with applicable laws.

3. Other disclosures. We may also disclose your PHI to others without your consent in certain situations.  For example your consent it isn’t required if you need emergency treatment, as long as we try to get your consent, after treatment is rendered, or if we try to get your consent but you are unable to communicate with us (for example, if you are unconscious or in severe pain) and we think that you would consent to such treatment if you were able to do so.

 

B. Certain use and Disclosures Do Not Require your consent, we can use and disclose you PHI without or consent or authorization for the following reasons:

1. When disclosure is required by federal, state or local law; judicial or administrative proceedings; or law enforcement. For example, we may make a disclosure to applicable officials when a law requires us to report information to government agencies and law enforcement personnel about victims of abuse or neglect, or when ordered in a judicial administrative proceeding.

2. For public health activities. For example, we may have to report information bout you to the county coroner.

3. For health oversight activities. For example we have to provide information to assist the government when it conducts an investigation or inspection of a health care provider in our organization.

4. For research purposes. In certain circumstances we may provide PHI in order to conduct medical research.

5. To avoid harm. In order to avoid serious threat to the PHI to law enforcement personnel or persons able to prevent or lessen such harm.

6. For specific government functions, We may disclose PHI of military personnel and veterans in certain situations, And we may disclose PHI for national security purposes, such as protecting the President of the Unites states for conducting intelligent operations.

7. For worker’s compensation purposes. We may provide PHI in order to comply with workers’ compensation laws.

8. Appointment reminders and health related benefits or services. We may use PHI to provide appointment reminders or give you information about treatment alternatives, or other health care services or benefits we offer.

 

C. Certain uses and Disclosures Require You to have the Opportunity to Object.

1. Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole o in part. The opportunity to consent may be obtained retroactively in emergency situations.

D. Other Uses and Disclosures Require your Prior Written Authorization. In any other situation not described above, we will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke such authorization in writing to stop any further uses and disclosures to the extent that we haven’t taken any action in reliance on such authorization) of your PHI by us.

​

IV. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI

You have the following rights with respect to your PHI:

1. The Right to request Limits on uses and Disclosure of your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but we are not legally required to accept it. If we accept your request we will put any limits in writing an abide by them except in emergency situations, You may both limit the uses and disclosures that we are legally required to allowed to make.

2. The Right to Choose How We Send PHI to You. You have the right to ask that we send information to you to at an alternate address (for example, sending information to your work address rather than your home address or by alternative means (for example e-mail instead of regular mail) We must agree to your request so long as we can easily provide the PHI to you in the format your request.

3. The right to SEE and Get Copies if your PHI. In most cases, you have the right to look at or get copies of you PHI that we have but you must make the request in writing. If we don’t have your PHI but we know who does, we will tell you how to get it. We will respond to you within 30 days of receiving your written request. In certain situations,, we may deny your request, if we do, we will tell you, in writing, our reasons for the denial and explain your right to have our denial reviewed. If you request copies of your PHI, we will charge you not more than .25 for each page, instead of providing the PHI you requested, we may provide you with a summary or explanation of the PHI as long as you agree to that and the cost in advance.

4. The Right to Get A List of the Disclosure We Have Made. You have the right to get a list of instances in which we have disclosed your PHI. The list will not include uses or disclosure that you have already consented to, such a those made for treatment payment or health care operations directly to you, or to your family. The lost also won’t; include uses and disclosures made for national security purposes, to connections or law enforcement personnel, or disclosure made before April 15, 2003.

5. ​

We will respond to your request for an accounting of disclosure within 60 days of reviewing your request, the list we will give you will include disclosures made in the last 6 years unless you request a shorter time, the lost will include the date of the disclosure, to whom the PHI was disclosed (Including their address, if known), a description of the information disclosed and the reason for the disclosure. We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge you  a reasonable cost based fee for each additional request.

​

1. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing you have the right to request that we correct eh existing information or add the missing information, you must provide the request an your reason for the request in writing, We will respond within 60 days of receiving your request to correct or update your PHI. We may deny your request in writing if the PHI is 1. Correct and completes , 2. Not created by us, 3. Not allowed to be disclosed, or 4. Not part of our records. Our written denial will state the reason for the denial and explain your right to file a written sateen of disagreement with the denial, if you don’t file one you have the right to request that your request ad our denial be attached to all future disclosure of your PHI. If we approve your request, we will make the change to your PHI, tell you that we have done it and tell others that need to know about the changes to you PHI.

2. The Right to get This Notice by E-Mai.  You have the right to get a copy of this notice by email. Even is you have agreed to receive notice via email, you also have the right to request a paper copy of it.

​

V. HOW TO COMPLAIN ABOUT MY PRIVACY PRACTICES

If you think that we have violated your privacy right, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of health and Human Services as 200 independence Ave S.W., Washington D.C, 20201. We will take no retaliatory action against you if you file a complaint about our privacy practices.

VI. Person to Contact For information About This Notice or To Complain About My Privacy Practices. If you have any questions about this notice or any complaints about my privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact us at: ABAT outpatient program, 1710 Hamilton Ave, 8 San Jose, CA 95125 (408) 448-0333.

VII. Effective DATE of This Notice

This notice will go into effect ___________________________.

 

 

​