HIPAA Privacy Form
Bethesda Workshops values you as a client, respects your right to privacy, and pledges our commitment to treating your information responsibly. The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires us to provide information which outlines the privacy practices we have in place to safeguard your health Information. The federal law gives you, the client, significant rights to understand and control how health information is used.
Bethesda Workshops reserves the right to change our privacy practices and the terms of this Notice at any time. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request. Our current Notice will be available on our website.
Privacy of Your Health Records
Your confidential information is kept private, under lock and key, in our secure office located in a locked building. The information in your file includes the registration form and information you completed or other healthcare professionals submitted on your behalf, progress notes, if any, record of payment, aftercare plans, and any correspondence with Bethesda Workshops before or after the program. Your file will be completely destroyed seven years after the latest attended program.
Use and Disclosure of Your Health Records
The following categories describe different ways that we use and disclose health information about you only upon the condition of a properly signed release.
Treatment. In the course of conducting programs, Bethesda Workshops will share your health information with consulting clinical staff. These Business Associates are under contract and bound by the same laws and rules of confidentiality as Bethesda . They are also subject to stringent professional rules of ethics. Employees of the facility where our programs are conducted have access to names only and no other health information.
We may use or disclose your health information for your treatment, such as to a doctor or other healthcare provider, for any purpose that you deem necessary. You may revoke your written release at any time by submitting written notice. Your revocation will not affect any use or disclosures permitted by your release while it was in effect.
Your Authorization. With your signed release, your health information may be disclosed to a family member, friend or other person or entity you authorize. Upon your written request, Bethesda Workshops will provide a statement that documents your dates of attendance and payment information.
Insurance Purposes. Bethesda Workshops does not accept insurance or provide diagnosis codes or other treatment information necessary to obtain insurance reimbursement.
Marketing Communications. We will not use your health-related information for marketing communications.
Research. We do not disclose health information for research purposes without your written consent. Information without patient identifiable data may be used for generic research.
The following categories describe different ways that we use and disclose health information about you without your signed release.
Danger to Self or Others. If there is clear and immediate danger to you or to someone you could endanger, we will take every reasonable step to protect you or an identifiable person you might harm. In such extreme cases, information would be given only to appropriate family members, professional workers, public authorities or threatened persons. Bethesda Workshops will make great attempts to first discuss any such concerns with you and let you know what steps you need to take before sharing information about you with others.
Abuse or Neglect. Bethesda Workshops will comply with all mandated reporting requirements, which include the physical or sexual abuse or significant neglect of a minor or elderly or incapacitated person.
Information Regarding Communications with Bethesda Workshops
Please be aware that Bethesda Workshops cannot guarantee the confidentiality of any information you share with us via email. Receiving an email from you will be understood as permission to respond to you by email. Giving us your email address implies consent to contact you via email regarding upcoming programs or administrative matters. You may revoke this implied permission at any time by contacting us by phone, email, or in writing. No personal health information will be transmitted unless it is in response to your email to us.
Likewise, the use of cell phones does not guarantee privacy in communicating. When you contact our office, you are calling a landline. Sometimes a clinical or administrative person may return your call using a cell phone, especially during times outside normal business hours, and you accept the risks associated with cellular transmissions by answering the call.
Your Client Rights
You have the right to request to review or get copies of your health information. You must submit your request in writing to our privacy official. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, staff time or other supplies associated with your request. You have the right to request that we amend your health information if you feel the information is incorrect or incomplete. To request an amendment, your request must be made in writing, explaining why the information should be amended, and submitted to our privacy official. We may deny your request under certain circumstances.
Questions and Complaints
Bethesda Workshops’ privacy officer is the director of workshop operations, who may be reached at 866-464-4325 or by email at firstname.lastname@example.org. If you are concerned that we may have violated your privacy rights, or you disagree with our handling of you health information you may complain to the above privacy officer. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address for filing your complaint to the USDHHS upon request. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.