Notice of Privacy Practicies
This notice describes how protected health and medical information about you may be used and disclosed and how you can gain access to this information. Please review it carefully.
Blue Door ABA may collect private and/or potentially sensitive medical information about clients and/or the client’s family. This information is labeled “protected health information” (PHI). Blue Door ABA is committed to maintaining the confidentiality, integrity and security of the information we hold. We are required by law to a) protect the privacy of the protected health information we hold, b) present you with this notice of our legal duties and privacy practices regarding the health information about you, c) notify affected clients following a breach of unsecured protected health information, e) follow the terms of this privacy practices notice. This law is known as the Health Insurance Portability and Accountability Act (HIPAA) privacy rule. This notice explains the client’s privacy rights and addresses how Blue Door ABA may use and disclose protected health information.
Notice of Privacy Practices are posted at registration locations, within each client’s enrollment packet and on our website. If you have any questions regarding Blue Door ABA privacy practices, or to receive a paper copy of this notice, please contact our Privacy Officer at:
Blue Door ABA
2024 East 17th Street
Brooklyn, New York 11229
Protected Health Information (PHI)
Protected health information under the US Law is any past, present or future information about health status, provision of health care or payment for health care that is created, collected, maintained or transmitted and can be linked to a specific individual. Examples of protected health information include but are not limited to: information about a client’s diagnosis, health condition, medical records, mental or genetic information, treatment or payment for the treatment received, information about health care benefits under an insurance plan, each attached with identifying information such as name, address, date of birth, social security number, phone number, email address, medical record numbers, account numbers, any information that can be used to identify the specific client. Protected health information is only considered such when an individual could be identified from the information. PHI only relates to information on patients or health plan members. It does not include information contained in educational and employment records kept by employers. PHI relates to physical records, records created, stored, transmitted or received electronically.
How We May Use and Disclose Health Information
- Treatment, Payment, and Health Care Operations
The following section describes ways we may use, share and disclose protected health information, without your authorization.
Blue Door ABA may use and disclose a client’s protected health information to provide the client with services and may disclose this information to any and all Blue Door ABA providers and staff involved with the client’s treatment and care. Treatment includes all consultations with and between Blue Door ABA staff and other professionals involved in the client’s treatment. A Care Provider may share client health information with another to determine how to diagnose and treat you and to those you have been referred to, for future health care.
- b. Payment
Blue Door ABA may use and disclose the client’s protected health information so we or others may bill and receive payment for health care services. For example, we may share information with an insurance company, or another party for reimbursement of services that have occurred or to determine whether it will cover intended treatment.
- c. Health Care Operations
Blue Door ABA may use and disclose the client’s protected health information in order to maintain necessary general business functions such as any administrative, financial, educational, quality assurance and staff performance operations. For example, we may use a client’s protected health information to evaluate the performance of our staff in providing treatment for the client and for reference of how to improve this care. We may evaluate what additional services to offer a client. Additionally, we may use protected health information for review, analysis, and other teaching and learning purposes.
- Appointment Reminders, Treatment Alternatives, Benefits and Services
- Appointment Reminders
Blue Door ABA may use and disclose the client’s protected health information to contact the client with a reminder that he/she may have an appointment for treatment or services.
- Treatment Information, Alternatives, Benefits and Services
Blue Door ABA may use and disclose the client’s protected health information to contact him/her about treatment information, to recommend possible treatment alternatives, health related benefits and services that may be of interest to the client.
- c. Satisfaction Surveys
Blue Door ABA may use and disclose the client’s protected health information to contact him/her about client satisfaction surveys and quality reviews.
- Individuals Involved in Your Care or Payment for Your Care
When appropriate and unless you object, Blue Door ABA may disclose your health information to an individual such as a family member, caretaker or close friend that is involved in the client’s care or the payment of client’s care. Blue Door ABA may do this if the client consents or if the client knows we are sharing the client’s protected health information with these individuals and the client expresses no objection or makes no reasonable attempt to prevent us from doing so.
- Business Associates
Blue Door ABA may use and disclose client health information to our company “business associates”, including contractors, agents, or billing parties who may need the information to carry out our business operations or conduct business on our behalf. Examples of the referenced “business associates” may include but are not limited to, a billing company that works with Blue Door ABA to obtain payments from the client’s insurance company, law firms or accounting firms that provide us with professional advice or guidance. In the event the health information is disclosed to these business associates, we will have a written contract with them to ensure they protect the privacy of your health information.
- Incidental Disclosures
Blue Door ABA is committed to protecting client health information and accepts responsibility for safeguarding privacy. Discretion and privacy is of the utmost importance. Although, there are times certain disclosures may be unavoidable as a result of otherwise permissible uses or disclosure of information we hold. An example of this circumstance would be clients exposed to one another during time in a waiting or treatment area or unintentional overhearing discussion or view of health information of another. All reasonable guidelines are followed yet incidental disclosures may occur.
SPECIAL CIRCUMSTANCES FOR USES AND DISCLOSURES OF HEALTH CARE INFORMATION
Blue Door ABA may use or disclose the client’s health information without the client’s permission in the following circumstances:
- Required by Law
Blue Door ABA must disclose client health information as required by federal, state, or local law. Clients will be notified of these uses and disclosures if notice is required by law.
- b. Public Health Risks, Immunization, Victims of Abuse, Neglect or Domestic Violence
Blue Door ABA may use and disclose protected health information for public health activities. When authorized by law or with consent, information may be released to authorized public health officials for public health reasons such as, in order to prevent or control disease, injury, or disability; or to report births, deaths, disease or condition, reactions to medications or problems with products. Information may be disclosed to a person who may have been exposed to a communicable disease or be at risk for the contraction or spread of a disease, if permitted by law. If required by State law and by parent consent, proof of an immunization record may be disclosed to a client’s school. Protected health information may be released to an authorized official if there is suspected abuse or neglect, non- accidental physical injuries or domestic violence.
- c. Health Oversight Activities
Blue Door ABA may disclose protected health information to agencies authorized to receive reports for health oversight activities. These government oversight agencies conduct audits, investigations, inspections, licensing reviews, as well as monitor the health care system, government benefit programs such as Medicaid and Medicare and monitor compliance with regulatory programs and compliance of civil rights laws.
- d. Workers’ Compensation
Blue Door ABA may disclose protected health information for workers’ compensation or similar programs, in accordance with employment laws. These programs provide benefits for work related injuries or illnesses.
- e. Data Breach Notification Purposes
Blue Door ABA may disclose your protected health information to provide legally required notices in the event there has been unauthorized access to client’s health information.
- Lawsuits, Disputes, Legal Proceedings and Law Enforcement
Blue Door ABA may disclose protected health information in response to a subpoena or court or administrative order, if the client is involved in a lawsuit or dispute. Information may be necessary to disclose in response to a court order, discovery request, subpoena, warrant, summons or similar process, or if requested to do so by law enforcement. In the case of a lawful request of an individual the client may be in a dispute with, we will make effort to notify the client and require judicial or legal authorization for the disclosure. Blue Door ABA may release protected health information to law enforcement, upon their request, if the information is: (1) in response to a court order, warrant, subpoena, summons or similar process (2) limited information to locate or identify a suspect, fugitive, material witness or missing person (3) about a death that is believed to be caused by misconduct or crime (4) about criminal conduct on our premises (5) in an emergency to report a crime, (on or off site) the location of a crime, victims, the identity or description, location of a person who committed a crime (identifying fugitives).
- Coroners, Medical Examiners, Funeral Directors, and Organ and Tissue Donation
Blue Door ABA may disclose protected health information to a coroner or medical examiner, (as necessary, for example to identify a deceased person or determine cause of death) or to a funeral director, as necessary to allow them to carry out their activities. In the event the client is an organ donor we may disclose information to organizations that handle organ procurement, banking or transportation of organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation, under applicable laws.
- h. To Avert a Serious Threat to Health or Safety
Blue Door ABA may disclose protected health information to appropriate individual(s)/organization(s) when necessary to prevent a serious threat to the client’s health and safety or that of the public or another person, or effort. We will disclose protected health information only to persons we believe to be able to prevent or diminish the threat and will limit disclosure to that which we deem necessary. Information may be disclosed to law enforcement if the client admits they have committed a violent crime, have caused serious physical harm to another individual or have escaped from incarceration, lawful custody or a health institution.
- Military and Veterans
Blue Door ABA may disclose protected health information if the client is a member of the armed forces. The information may be released to appropriate military command authorities or foreign military authority if the client is a member of a foreign military, if required.
- j. National Security, Intelligence Activities and Protective Services
Blue Door ABA may disclose information to federal officials for intelligence, counterintelligence, and other national security activities authorized by law. This includes activities related to protection of the President, other authorized persons or foreign heads of state, or related to the conduct of special investigations.
- Inmates and Correctional Facilities
Blue Door ABA may make disclosures to a correctional facility or a law enforcement official if the client is an inmate of the facility or under custody of law enforcement. This release may be necessary if the institution needs to provide the client with appropriate health care and treatment or to protect the client’s, inmates or others’ health and safety, including the security of the correctional facility.
- Disaster Relief
Blue Door ABA may disclose your protected health information to disaster relief organizations that request your information to coordinate care or notify family and friends of your location or condition in the event of a disaster. We will provide the client with an opportunity to agree or object to this disclosure when we can do so.
- m. Research
Blue Door ABA may use or disclose protected information for research purposes under certain limited circumstances. Before use or disclosure of the information the project would be subject to an approval process. Information will not be disclosed for research purposes until the particular research project has been approved through the institutional review board.
WHEN WRITTEN AUTHORIZATION IS REQUIRED
Blue Door ABA’s commonly requires the client’s written authorization before using or disclosing client information outside of our company and business associates, as explained previously in this notice. There are uses and disclosures that will be made only with client’s written authorization. Uses and disclosures of protected health information for marketing purposes, including subsidized treatment communications, require the client’s written authorization. Disclosures that constitute a sale of your protected health information need written authorization. The sale of protected health information does not include a disclosure for public health purposes, for research purposes in which Blue Door ABA may only receive renumeration for any costs to prepare and transmit information. Blue Door ABA does not sell protected health information to third parties.
Other uses and disclosures of protected health information not covered by this notice or the laws that apply to us will only be made with written authorization. If the client grants us written authorization for disclosure, the client can withdraw this authorization at any time. The authorization must be revoked in writing. In order to withdraw the authorization, the client must deliver, mail or email to our Privacy Officer:
Blue Door ABA
2024 East 17th Street
Brooklyn, New York 11229
If the client revokes the authorization, we will discontinue the use or disclosure of the client’s protected health information to the extent that we relied on client authorization for the use and disclosure. However, we cannot take back or undo any use or disclosure made under the client’s grant of authorization prior to our receipt of the client’s written revocation of that authorization. We must continue any use and disclosure that is necessary in keeping records of the client’s treatment. These records may be transferred upon client’s written request and completion of the transfer authorization form.
CLIENT RIGHTS REGARDING THE ACCESS AND CONTROL OF PROTECTED HEALTH INFORMATION
You, “the client”, have the following rights regarding your protected health information:
- Right to Inspect and Copy
You have the right to inspect and copy your protected health information that may be used to make decisions about your care and treatment. This includes any medical and billing records. The request must be submitted in writing, directed to our Privacy Officer. You have the right to request an electronic copy of your record to be given or transmitted to you. We will make every effort to accommodate your request but if the information is not readily producible in the form or format you request, your record will be produced in standard electronic form or readable hard copy form. If you are requesting record copies, there may be a fee for costs of copying, mailing or other preparation, based on the specific request.
- Right to Amend
If you believe that your protected health information is inaccurate or incomplete, you have the right to request we amend the information. You may request an amendment for as long as our office holds your information. The request to amend your information must be in writing and include a reason to support the requested amendment. Blue Door ABA may deny the request for an amendment if the request is not properly submitted, or if it asks us to amend information that (a) we did not create (b) is not part of the health information we keep, (c) is part of record that a client would not be permitted to inspect and copy, or (d) is already accurate and complete. In the case of denial, you will receive notice in writing.
- Right to an Accounting of Disclosures
You have the right to request an accounting of disclosures. An accounting of disclosures is a list of certain disclosures we made regarding the client’s protected health information. The list does not include all disclosures. For example, it does not include disclosure to the client, disclosure for treatment, payment, and health care operations purposes described above, or disclosure made with the client’s authorization as described above. You have the right to receive one every 12 month period for free of charge, however, if additional lists are requested within the same 12 months, fees may be applied. Your request must be in writing, submitted to our Privacy Officer.
- Right to Request Restrictions
You have the right to request a further restriction or limitation on the health information we use or disclose about the client regarding treatment, collecting payment, health care operations, or regarding someone who is involved in the client’s care or the payment for it, such as a family member or friend. You have the right to request your health information not be disclosed to a health plan if you have paid for the services, in full, out of pocket and the disclosure is not otherwise required by law. The restriction will only apply to that particular service and you will have to make additional requests for each service thereafter. Your request for restriction must be submitted, in writing, to our Privacy Officer. We are not required to agree to the client’s restriction request. In the case Blue Door ABA denies or agrees to a restriction request, it will be a written notification. Upon any agreement to your request, we will comply with the restriction unless the information is needed to provide you with emergency care or comply with the law. Blue Door may revoke this approval of restriction at any time. We will notify you before doing so.
- Right to Receive Notification of a Breach
You have the right to be notified if there is a breach of any of your unsecured protected health information. If there is a probable compromise of your unsecured information, you will be notified within sixty (60) days of the breach. The notice will provide incident and investigation details including steps you should take to protect yourself from potential harm and protection against further breaches. Contact information for further information or to answer questions will be included.
- Right to Request Confidential Communications
You have the right to request we communicate with you about health matters by certain means, methods or at a certain location. For example, you can ask that we only contact you at home or by mail rather than a workplace. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
- Right to Appoint Someone to Act on Your Behalf
You have the right to appoint a personal representative to act on your behalf to represent and control the privacy of your information. You must submit written authorization to our Privacy Officer to notify us of the permission. This may be revoked, in writing, as needed. Parent and guardians have the right to control the privacy of health information for their minors.
- Use and Disclosure Where Special Protections May Apply
There is health information that is considered highly sensitive by state and federal law. Based on this level of sensitivity the state and federal laws provide special protections for them. Examples of this information are alcohol and substance abuse treatment information, mental health information, genetic information, HIV-related information, sexually transmitted diseases information. Therefore, some parts of this general Notice of Privacy Practices may not apply to these types of information. For questions or concerns you may have regarding these specific types of information and the way they may be disclosed, please contact your health care provider.
- Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. If you are receiving it electronically or would like another copy, you may request a paper copy from our office and one will be mailed to you by our Privacy Officer. Please contact:
Blue Door ABA
2024 East 17th Street Brooklyn, NY 11229
- 9. Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Secretary of the Department of Health and Human Services. Complaints must be in writing. You will not be penalized, and Blue Door ABA will not withhold services or take action against you, based on your complaint.
Changes to This Notice
We reserve the right to amend this notice regarding your protected health information that we hold to date and for future information we obtain. If there are revisions to this notice, a revised and most current notice will be posted and available in our office, within our enrollment packet and on our website. Effective dates are posted on the notice. Effective Date 1/1/2021
Blue Door ABA
2024 East 17th Street
Brooklyn, New York 11229