Notice of privacy practices
As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Please review this notice carefully.
Why do we provide this notice?
This notice tells you about the ways in which we may collect, use, or share our clients’ protected health information. We understand that health information is personal and we are committed to protecting your privacy.
How do we typically use or share your health information?
We typically use or share your health information in the following ways:
Treatment: We can use your health information and share it with other professionals who are treating you. For example, we will use your health information to provide Applied Behavior Analysis (ABA) services and to manage and coordinate your medical care. Your information may be provided to a physician or other health care provider to whom you have been referred to ensure the physician or other health care provider has the necessary information to diagnose or treat you .
Bill for your services: We can use and share your health information to bill and get payment from you, health plans, or other entities. For example, we may give information about you to your health insurance plan so it will pay for your services.
Run our organization: We can use and share your information to run our ABA therapy business, improve your care, and contact you when necessary. For example, we may use your information to:
Internally review the quality of the treatment and services provided and to evaluate the performance of our team members in caring for you
For educational and learning purposes for Butterfly Effects employee
To contact you as a reminder for upcoming scheduled appointments
In the event that Butterfly Effects becomes a party to a lawsuit
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research.
We have to meet many conditions in the law before we can share your information for the purposes described below.
For more information, see: Your Rights Under HIPAA.
Comply with the law: We will share information about you if federal, state, or local laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Required by the Secretary of Health and Human Services: We may be required to disclose PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
Help with public health and safety issues: We may share health information about you for certain situations, such as: preventing disease; helping with product recalls; reporting adverse reactions to medications; reporting suspected abuse, neglect, or domestic violence; or preventing or reducing a serious threat to anyone’s health or safety.
Do research: We can use or share your information for health research.
Address workers’ compensation, law enforcement, and other government requests: We can use or share health information about you: for workers’ compensation claims; for law enforcement purposes or with a law enforcement official; with health oversight agencies for activities authorized by law; or for special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions: We can share health information about you in response to a subpoena or a court or administrative order.
Respond to organ and tissue donation requests: We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director: We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
Share information with your family, close friends, or others involved in your care
Share information in a disaster relief situation
Include your information in a hospital directory (Note: We do not maintain a hospital directory)
If you are not able to tell us your preference, for example if you are a child and we are unable to reach your parent or guardian, we may go ahead and share your information if we believe that it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
Most sharing of psychotherapy notes
Marketing purposes
Sale of your information
In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record: You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record: You can ask us to correct health information about you that you think is incorrect or incomplete. A request for amendment must be made in writing to the Privacy Officer at the address provided below and it must provide the reason for your request. We may deny your request, but we’ll tell you why in writing within 60 days.
Get a list of those with whom we’ve shared information: You can ask for a list (“accounting”) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. To request this list or accounting of disclosures, you must submit your request in writing to the Privacy Officer. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable cost-based fee if you ask for another one within 12 months.
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 to your request, and we may say “no” if it would affect your care. To request restrictions, you must make your request in writing to the Privacy Officer. Your request must state the specific restriction requested, whether you want to limit our use and/or disclosure; and to whom the restriction applies. If you pay for a service or health care item 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 say “yes” to these types of requests unless a law requires us to share that information.
Request confidential communications: You can ask us to contact you in a specific way (for example, you may request that we contact you by mail at a specific address or call you only at your work number). You must make any such request in writing and you must specify how or where we are to contact you. We will say “yes” to all reasonable requests.
Get a copy of this privacy notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
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. We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated: You can complain if you feel we have violated your rights by contacting us using the information below. You can 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 U.S. Department of Health & Human Services – Office for Civil Rights. We will not retaliate against you for filing a complaint.
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and provide you with a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. Let us know if you change your mind.
For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
How you can exercise these rights: You can exercise any of your rights by sending a written request to our Privacy Officer at the mailing or email address below.
Butterfly Effects
Attn: Privacy Officer
350 Fairway Drive, Suite 101
Deerfield Beach, FL 33441
Email: [email protected]