Adapt Therapy Parent Handbook
Table of Contents:
About Adapt Therapy
Website
Types of Therapy Services Provided
Who we Serve
Areas of Support Offered
Scheduling
Patient Portal
Points of Contact
Financial Information
Policies and Procedures
General Policies
Sick Policy
Acknowledgement of Risk
Clinic Policies Regarding Siblings and Friends of Clients
Clinical Education Policy
Behavior and Aggression Policy
Code of Conduct
Privacy Practices
About Adapt Therapy
Website
Types of Therapy Services Provided
Who we Serve
Areas of Support Offered
Scheduling
Patient Portal
Points of Contact
Financial Information
Policies and Procedures
General Policies
Sick Policy
Acknowledgement of Risk
Clinic Policies Regarding Siblings and Friends of Clients
Clinical Education Policy
Behavior and Aggression Policy
Code of Conduct
Privacy Practices
About Adapt Therapy
About Us
Adapt Therapy LLC (referred to as Adapt Therapy throughout the handbook) is a pediatric therapy clinic located in Meridian, Idaho. Our clinic provides individualized occupational and / or speech therapy services to meet each child's specific needs. Our knowledgeable and experienced therapists create customized interventions to help your child grow and thrive.
Our Website
If you would like to learn more about the services we offer to our community, please visit our website at https://www.adapttherapyidaho.com.
Types of Therapy Services Provided
Occupational Therapy
Speech Therapy
Who We Serve
Infants
Toddlers
School-Aged Children
Teens
Areas of Support Offered
Scheduling
Evaluation: We require a referral on file from the Primary Care Physician unless desiring to continue without billing of insurance or doing private pay. An evaluation is to be completed before recurring weekly sessions are scheduled.
Recurring Schedule: Therapists have a certain number of recurring spots available on a weekly basis. If your schedule aligns with an opening of one of our therapists, you will be placed in that recurring time slot. If you need a schedule change, there is no guarantee you will remain with the therapist(s) assigned prior. Additionally, the treating therapist may be different than the evaluating therapist. We expect prompt communication and responses from caregivers when coordinating schedules.
Patient Portal
Our Electronic Medical Records (EMR) system has a patient portal that we utilize. Through the portal you can access reports related to their service and invoices.
Points of Contact
Scheduling and Front Desk - (208) 899-7992
Billing - (208) 899-7992
Compliance Officer: Katie Chase - [email protected]
About Us
Adapt Therapy LLC (referred to as Adapt Therapy throughout the handbook) is a pediatric therapy clinic located in Meridian, Idaho. Our clinic provides individualized occupational and / or speech therapy services to meet each child's specific needs. Our knowledgeable and experienced therapists create customized interventions to help your child grow and thrive.
Our Website
If you would like to learn more about the services we offer to our community, please visit our website at https://www.adapttherapyidaho.com.
Types of Therapy Services Provided
Occupational Therapy
Speech Therapy
Who We Serve
Infants
Toddlers
School-Aged Children
Teens
Areas of Support Offered
- Sensory Differences
- Emotional Regulation
- Executive Functioning
- Social Skills
- Handwriting & Fine Motor
- Gross Motor, Balance & Coordination
- Early Milestone Development (rolling, sitting, crawling)
- Articulation
- Phonology
- Reading & Listening Comprehension Apraxia of Speech
- Autism
- Language
- Augmentative and Alternative Forms of Communication (AAC)
- Late Talking
Scheduling
Evaluation: We require a referral on file from the Primary Care Physician unless desiring to continue without billing of insurance or doing private pay. An evaluation is to be completed before recurring weekly sessions are scheduled.
Recurring Schedule: Therapists have a certain number of recurring spots available on a weekly basis. If your schedule aligns with an opening of one of our therapists, you will be placed in that recurring time slot. If you need a schedule change, there is no guarantee you will remain with the therapist(s) assigned prior. Additionally, the treating therapist may be different than the evaluating therapist. We expect prompt communication and responses from caregivers when coordinating schedules.
Patient Portal
Our Electronic Medical Records (EMR) system has a patient portal that we utilize. Through the portal you can access reports related to their service and invoices.
Points of Contact
Scheduling and Front Desk - (208) 899-7992
Billing - (208) 899-7992
Compliance Officer: Katie Chase - [email protected]
Financial Information
Know your Benefits
Your health insurance policy/HSA/FSA is a contract between you and your health insurance company (or your employer with the health insurer as the administrative agent). Please be aware that it is your responsibility to know your benefits, rules and regulations. You should be knowledgeable of any deductibles, co-payments, co-insurance, annual visit maximums and prior authorization requirements. If you are not clear about your current health insurance policy benefits, you should review your plan’s details on your insurers web portal or speak with your employer to learn about your benefits and responsibilities.
As an in-network patient, it is your responsibility to notify us of any change in insurance eligibility or any additional insurance plans. The failure to do so can result in the pausing of services and direct patient financial responsibility.
Out-of-Network Status
If your insurance is not in-network with Adapt Therapy, some insurance plans have out-of-network benefits that can be used. However, this means we cannot negotiate or guarantee the payment of claims for you. The insurance company may pay you directly. Adapt Therapy will send you an invoice for payment. It is very important that you are familiar with any deductibles, co- payments, co-insurance, annual visit maximums, and any prior authorization requirements, as we cannot perform guaranteed insurance benefit eligibility for services.
Good Faith Estimate
A good faith estimate will be prepared to the best of our ability when requested. Insurance companies will not typically give us an exact amount that will be covered before service begins. This estimate is based on your insurance type and historical reimbursement rates from that insurer. This is an estimate only and not a guaranteed price. Prices are subject to change.
Primary Insurance with Secondary Insurance
If you have a primary insurance plan with a secondary insurance (typically Medicaid), we are required to first file a claim with your primary insurance. Once your primary insurance has processed and completed that claim, we can then file the remaining patient responsibility to the secondary insurance.
If you are using out-of-network benefits through your insurer, we may request and require your support in providing us with copies of the Explanation of Benefits for each claim no later than 14 days of the claim processing. You also agree to pay Adapt Therapy all primary claim funds that are directly reimbursed to the policy holder no later than 14 days after receiving payment from the insurance company. Any delay in this process may result in the pausing of services and direct patient financial responsibility.
New or Updated Insurance
You are responsible for contacting our office as soon as possible whenever you have new insurance or become aware of any updates or changes to your existing insurance plan. Any delay in notification may result in the pausing of services and direct patient financial responsibility. You must either call the Clinic at (208) 899-7992 ext 2 and/or present a copy of your new insurance card (front and back) in person before your next appointment.
Courtesy Insurance Filing
Adapt Therapy may file a claim with your insurance on your behalf for services that were provided. If Adapt Therapy does so, we will start submitting claims from the date of the initial appointment.
Payment
Payment is due at the time of service. This applies to any co-payments, coinsurance or deductible amounts and all other costs for treatment/service not covered by insurance. Invoices will be available via Adapt Therapy’s patient portal every month for all outstanding balances that are due. Payment can be made in person, phone, or via patient portal.
If there is an outstanding balance owed to Adapt Therapy for services rendered, Adapt Therapy has the right to pause and/or terminate therapy services until balance is paid in full. Please see the chart below.
Know your Benefits
Your health insurance policy/HSA/FSA is a contract between you and your health insurance company (or your employer with the health insurer as the administrative agent). Please be aware that it is your responsibility to know your benefits, rules and regulations. You should be knowledgeable of any deductibles, co-payments, co-insurance, annual visit maximums and prior authorization requirements. If you are not clear about your current health insurance policy benefits, you should review your plan’s details on your insurers web portal or speak with your employer to learn about your benefits and responsibilities.
As an in-network patient, it is your responsibility to notify us of any change in insurance eligibility or any additional insurance plans. The failure to do so can result in the pausing of services and direct patient financial responsibility.
Out-of-Network Status
If your insurance is not in-network with Adapt Therapy, some insurance plans have out-of-network benefits that can be used. However, this means we cannot negotiate or guarantee the payment of claims for you. The insurance company may pay you directly. Adapt Therapy will send you an invoice for payment. It is very important that you are familiar with any deductibles, co- payments, co-insurance, annual visit maximums, and any prior authorization requirements, as we cannot perform guaranteed insurance benefit eligibility for services.
Good Faith Estimate
A good faith estimate will be prepared to the best of our ability when requested. Insurance companies will not typically give us an exact amount that will be covered before service begins. This estimate is based on your insurance type and historical reimbursement rates from that insurer. This is an estimate only and not a guaranteed price. Prices are subject to change.
Primary Insurance with Secondary Insurance
If you have a primary insurance plan with a secondary insurance (typically Medicaid), we are required to first file a claim with your primary insurance. Once your primary insurance has processed and completed that claim, we can then file the remaining patient responsibility to the secondary insurance.
If you are using out-of-network benefits through your insurer, we may request and require your support in providing us with copies of the Explanation of Benefits for each claim no later than 14 days of the claim processing. You also agree to pay Adapt Therapy all primary claim funds that are directly reimbursed to the policy holder no later than 14 days after receiving payment from the insurance company. Any delay in this process may result in the pausing of services and direct patient financial responsibility.
New or Updated Insurance
You are responsible for contacting our office as soon as possible whenever you have new insurance or become aware of any updates or changes to your existing insurance plan. Any delay in notification may result in the pausing of services and direct patient financial responsibility. You must either call the Clinic at (208) 899-7992 ext 2 and/or present a copy of your new insurance card (front and back) in person before your next appointment.
Courtesy Insurance Filing
Adapt Therapy may file a claim with your insurance on your behalf for services that were provided. If Adapt Therapy does so, we will start submitting claims from the date of the initial appointment.
Payment
Payment is due at the time of service. This applies to any co-payments, coinsurance or deductible amounts and all other costs for treatment/service not covered by insurance. Invoices will be available via Adapt Therapy’s patient portal every month for all outstanding balances that are due. Payment can be made in person, phone, or via patient portal.
If there is an outstanding balance owed to Adapt Therapy for services rendered, Adapt Therapy has the right to pause and/or terminate therapy services until balance is paid in full. Please see the chart below.
If applicable, the parent and/or guardian holding the insurance plan being billed is liable for collecting payments from any other persons or parties contributing to medical expenses. Adapt Therapy is not responsible for splitting invoices totals accordingly.
Policies and Procedures
General Policies
When allowing your child to participate in therapy services, the following general policies must be followed:
Your child can and will participate fully in therapy services and will cooperate and accept our guidance in standards of behavior. Failure to adhere to these standards may result in suspension or termination of services.
Rules for acceptance and participation in therapy services are the same for everyone, regardless of race, color, ethnicity, religion, or gender.
Sick Policy
While regular attendance at therapy sessions is crucial for your child’s progress, we also understand that children get sick and “life happens”. We want to make the clinic a safe environment for your child, all our clients and staff. We ask that you adhere to the following guidelines in determining whether your child is well enough to attend therapy.
Acknowledgement of Risk
Parents/caregivers acknowledge that there is some risk inherent in the use of the therapy equipment at this clinic and agree to indemnify and hold Adapt Therapy harmless from any and all losses and claims for any injuries or other damages occurring to themselves, their child(ren) or their belongings from the use of therapeutic equipment.
Clinic Policies Regarding Siblings and Friends of Clients
Parents/caregivers are welcome to accompany the child to the waiting room before the therapy session. Parents/caregivers are responsible for monitoring their child(ren) while on the premises. All siblings or accompanying children must remain in the waiting area under direct supervision of their respective parent / caregiver throughout the duration of the session and their time on the premises.
Clinical Education Policy
Adapt Therapy is committed to training students to provide evidenced based therapy to our clients. We may have graduate and/or doctorate students at Adapt Therapy to complete their fieldwork placement. These students have completed all of their coursework and have been interviewed by the clinic's owners before coming to Adapt Therapy. These students are typically assigned to one therapist and participate in treatment with that therapist. The therapists at Adapt Therapy will continue to be involved in the treatment planning and/or therapy session as the child will benefit from having the attention of two therapists, which often optimizes the treatment time. Additionally, there will periodically be an individual observing who is interested in pursuing a career in speech or occupational therapy.
Behavior and Aggression Policy
Positive attitude and cooperation of all parents and clients is a vital component of therapy services; therefore, any disrespectful or violent behavior will not be tolerated. Adapt Therapy reserves the right to determine who is or is not suitable for therapy services and will take all measures to provide a safe and constructive learning environment.
We have a zero-tolerance policy regarding disrespect or violence.
Instances of violent and/or aggressive behavior by a child or parent/caregiver will be reviewed on a case-by-case basis. Depending on the severity and consistency of the instances, services may be paused or terminated.
*This list is not an inclusive list and is subject to the interpretation of Adapt Therapy staff members.
If a parent and/or caregiver engage in behavior deemed to be aggressive, Adapt Therapy reserves the right to any of the following :
If you cannot maintain appropriate behavior, and continue to threaten the peace of the clinic, we reserve the right to contact local law enforcement to mitigate and resolve the situation.
Code of Conduct
Adapt Therapy is committed to providing a safe and welcoming environment for all of our children, parents, students, volunteers, and staff. To ensure safety and comfort for all, we expect all individuals to act in a mature and responsible way that respects the rights and dignity of others. This applies to all staff, students, parents, family members, and guests. Our code of conduct does not permit language or action that can hurt or frighten another person, or that falls below a generally accepted standard of conduct.
General Policies
When allowing your child to participate in therapy services, the following general policies must be followed:
Your child can and will participate fully in therapy services and will cooperate and accept our guidance in standards of behavior. Failure to adhere to these standards may result in suspension or termination of services.
Rules for acceptance and participation in therapy services are the same for everyone, regardless of race, color, ethnicity, religion, or gender.
Sick Policy
While regular attendance at therapy sessions is crucial for your child’s progress, we also understand that children get sick and “life happens”. We want to make the clinic a safe environment for your child, all our clients and staff. We ask that you adhere to the following guidelines in determining whether your child is well enough to attend therapy.
- Children should be free from fever, vomiting, or diarrhea without the use of medications for at least 24 hours prior to their appointment. A fever is considered to be a temperature at or above 100 ° F.
- Children who are home from school because of an illness should not attend therapy.
- Please be cautious about highly contagious illnesses like covid-19*, pink eye, head lice, scabies, whooping cough, strep throat, hand foot mouth, ringworm, and chicken pox. If your child presents with one of these illnesses, please do not bring him/her to therapy until the risk of transmission has passed.
- If your child is lethargic or unable to participate in daily activities due to an illness, please do not bring him/her to therapy.
- If your child develops a fever or falls ill during his/her appointment, we may end the session early. Please remain available/close by to pick your child up, if needed.
- If a sibling or other family member is actively sick and/or contagious, we ask that you also refrain from bringing them into the clinic.
Acknowledgement of Risk
Parents/caregivers acknowledge that there is some risk inherent in the use of the therapy equipment at this clinic and agree to indemnify and hold Adapt Therapy harmless from any and all losses and claims for any injuries or other damages occurring to themselves, their child(ren) or their belongings from the use of therapeutic equipment.
Clinic Policies Regarding Siblings and Friends of Clients
Parents/caregivers are welcome to accompany the child to the waiting room before the therapy session. Parents/caregivers are responsible for monitoring their child(ren) while on the premises. All siblings or accompanying children must remain in the waiting area under direct supervision of their respective parent / caregiver throughout the duration of the session and their time on the premises.
Clinical Education Policy
Adapt Therapy is committed to training students to provide evidenced based therapy to our clients. We may have graduate and/or doctorate students at Adapt Therapy to complete their fieldwork placement. These students have completed all of their coursework and have been interviewed by the clinic's owners before coming to Adapt Therapy. These students are typically assigned to one therapist and participate in treatment with that therapist. The therapists at Adapt Therapy will continue to be involved in the treatment planning and/or therapy session as the child will benefit from having the attention of two therapists, which often optimizes the treatment time. Additionally, there will periodically be an individual observing who is interested in pursuing a career in speech or occupational therapy.
Behavior and Aggression Policy
Positive attitude and cooperation of all parents and clients is a vital component of therapy services; therefore, any disrespectful or violent behavior will not be tolerated. Adapt Therapy reserves the right to determine who is or is not suitable for therapy services and will take all measures to provide a safe and constructive learning environment.
We have a zero-tolerance policy regarding disrespect or violence.
Instances of violent and/or aggressive behavior by a child or parent/caregiver will be reviewed on a case-by-case basis. Depending on the severity and consistency of the instances, services may be paused or terminated.
- The aggressive behaviors listed below will not be tolerated:
- Yelling or using raised voice
- Using curse words, derogatory language, or racial/cultural/sexual slurs
- Making threats in any form (verbal, written, text, email, letter, etc.)
- Physical touch or the insinuation of physical harm
- Using bullying techniques (intimidation, excessively talking over others, discrediting the observations or clinical reasoning of others)
- The use of or threat of firearms or other weapons
- Destruction of the physical property of Adapt Therapy
*This list is not an inclusive list and is subject to the interpretation of Adapt Therapy staff members.
If a parent and/or caregiver engage in behavior deemed to be aggressive, Adapt Therapy reserves the right to any of the following :
- Document aggressive behaviors in session notes or client files
- End a therapy session early
- Ask you to leave the building
- Request that another caregiver bring your child to therapy
- Discontinue providing therapy and remove your family from our schedules
If you cannot maintain appropriate behavior, and continue to threaten the peace of the clinic, we reserve the right to contact local law enforcement to mitigate and resolve the situation.
Code of Conduct
Adapt Therapy is committed to providing a safe and welcoming environment for all of our children, parents, students, volunteers, and staff. To ensure safety and comfort for all, we expect all individuals to act in a mature and responsible way that respects the rights and dignity of others. This applies to all staff, students, parents, family members, and guests. Our code of conduct does not permit language or action that can hurt or frighten another person, or that falls below a generally accepted standard of conduct.
Privacy Practices
PROVIDER NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We are required by law to maintain the privacy of your protected health information, to notify you of our legal duties and privacy practices with respect to your health information, as well as to notify affected individuals following a breach of unsecured health information. This Notice summarizes our duties and your rights concerning your information. Our duties and your rights are set forth more fully in 45 CFR Part 164. We are required to abide by the terms of our Notice that is currently in effect.
1. Uses and Disclosures We May Make Without Written Authorization. We may use or disclose your health information for certain purposes without your written authorization, including the following:
2. Disclosures We May Make Unless You Object. Unless you instruct us otherwise, we may disclose your information as described below:
3. Uses and Disclosures with Your Written Authorization. Other uses and disclosures not described in this Notice will generally be made only with your written authorization, including most uses or disclosures of psychotherapy notes; for most marketing purposes; or if we seek permission to sell your information. You may revoke your authorization by submitting a written notice to the Privacy Contact identified below. The revocation will not be effective to the extent we have already taken action in reliance on the authorization.
4. Patient Rights. We respect the dignity of each individual we serve. We comply with applicable Federal civil rights laws and do not discriminate on the basis of age, gender, disability, race, color, ancestry, citizenship, religion, pregnancy, sexual orientation, gender identity or expression, national origin, medical condition, marital status, veteran status, payment source or ability, or any other basis prohibited by federal, state, or local law.
Concerning Your Protected Health Information. You have the following rights concerning your health information. To exercise any of these rights, you must submit a written request to the Privacy Officer identified below.
You may request additional restrictions on the use or disclosure of information for treatment, payment or healthcare operations. We are not required to agree to the requested restriction except in the limited situation in which you or someone on your behalf pays for an item or service, and you request that information concerning such item or service not be disclosed to a health insurer.
We normally contact you by telephone, email, or mail at your home address. You may request that we contact you by alternative means or at alternative locations. We will accommodate reasonable requests.
You may inspect and obtain a copy of records that are used to make decisions about your care or payment for your care, including an electronic copy. We may charge you a reasonable cost-based fee for providing the records. We may deny your request under limited circumstances, e.g., if we determine that disclosure may result in harm to you or others.
You may request that your protected health information be amended. We may deny your request for certain reasons, e.g., if we did not create the record or if we determine that the record is accurate and complete.
You may receive an accounting of certain disclosures we have made of your protected health information. You may receive the first accounting within a 12-month period free of charge. We may charge a reasonable cost-based fee for all subsequent requests during that 12-month period.
You may obtain a paper copy of this Notice upon request. You have this right even if you have agreed to receive the Notice electronically.
5. Changes to This Notice. We reserve the right to change the terms of this Notice at any time, and to make the new Notice effective for all protected health information that we maintain. If we materially change our privacy practices, we will post a copy of the current Notice in our reception area and on our website. You may obtain a copy of the operative Notice from our receptionist or Privacy Officer.
6. Complaints. You may complain to us if you believe your privacy rights have been violated. You may file a complaint with us by notifying our Privacy Officer. All complaints must be in writing. We will not retaliate against you for filing a complaint.
7. Contact Information. If you have any questions about this Notice, or if you want to object to or complain about any use or disclosure or exercise any right as explained above, please contact:
Privacy Officer: Katie Chase
Phone: 208-899-7992
Address: 3368 E. Goldstone Dr. Meridian, ID 83642
E-mail: [email protected]
PROVIDER NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We are required by law to maintain the privacy of your protected health information, to notify you of our legal duties and privacy practices with respect to your health information, as well as to notify affected individuals following a breach of unsecured health information. This Notice summarizes our duties and your rights concerning your information. Our duties and your rights are set forth more fully in 45 CFR Part 164. We are required to abide by the terms of our Notice that is currently in effect.
1. Uses and Disclosures We May Make Without Written Authorization. We may use or disclose your health information for certain purposes without your written authorization, including the following:
- Treatment. We may use or disclose your information for purposes of treating you. For example, we may disclose your information to another health care provider so they may treat you; to provide appointment reminders; or to provide information about treatment alternatives or services we offer.
- Payment. We may use or disclose your information to obtain payment for services provided to you. For example, we may disclose information to your health insurance company or other payer to obtain preauthorization or payment for treatment.
- Healthcare Operations. We may use or disclose your information for certain activities that are necessary to operate our practice and ensure that our patients receive quality care. For example, we may use information to train or review the performance of our staff or make decisions affecting the practice.
- Incidental Disclosures. While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during or as an unavoidable result of our otherwise permissible uses or disclosures of your health information. For example, other patients in the treatment or waiting area may see, or overhear discussion of, your child’s health information.
- Other Uses or Disclosures. We may also use or disclose your information for certain other purposes allowed by 45 CFR § 164.512 or other applicable laws and regulations, including the following:
- To avoid a serious threat to your health or safety or the health or safety of others.
- As required by state or federal law such as reporting abuse, neglect or certain other events.
- As allowed by workers compensation laws for use in workers compensation proceedings.
- For certain public health activities such as reporting certain diseases.
- For certain public health oversight activities such as audits, investigations, or licensure actions.
- In response to a court order, warrant or subpoena in judicial or administrative proceedings.
- For certain specialized government functions such as the military or correctional institutions.
- For research purposes if certain conditions are satisfied.
- In response to certain requests by law enforcement to locate a fugitive, victim or witness, or to report deaths or certain crimes.
- To coroners, funeral directors, or organ procurement organizations as necessary to allow them to carry out their duties.
2. Disclosures We May Make Unless You Object. Unless you instruct us otherwise, we may disclose your information as described below:
- To a member of your family, friend, or other person who is involved in your healthcare or payment for your healthcare. We will limit the disclosure to the information relevant to that person’s involvement in your healthcare or payment.
- To maintain our facility directory. If a person asks for you by name, we will only disclose your name, general condition, and location in our facility. We may also disclose your religious affiliation to clergy.
- To contact you to raise funds for our facility. You may opt out of receiving such communications at any time by notifying the Privacy Officer identified below.
3. Uses and Disclosures with Your Written Authorization. Other uses and disclosures not described in this Notice will generally be made only with your written authorization, including most uses or disclosures of psychotherapy notes; for most marketing purposes; or if we seek permission to sell your information. You may revoke your authorization by submitting a written notice to the Privacy Contact identified below. The revocation will not be effective to the extent we have already taken action in reliance on the authorization.
4. Patient Rights. We respect the dignity of each individual we serve. We comply with applicable Federal civil rights laws and do not discriminate on the basis of age, gender, disability, race, color, ancestry, citizenship, religion, pregnancy, sexual orientation, gender identity or expression, national origin, medical condition, marital status, veteran status, payment source or ability, or any other basis prohibited by federal, state, or local law.
- You have the right to not be discriminated against.
- You have the right to know your provider's qualifications.
- You have the right to expect that therapists have met the minimum qualifications of training and experience required by state law.
- You have the right to be informed. You have the right to be informed of our assessment and to know available treatment alternatives.
- You have the right to refuse treatment.
- You have the right to voice grievances.
Concerning Your Protected Health Information. You have the following rights concerning your health information. To exercise any of these rights, you must submit a written request to the Privacy Officer identified below.
You may request additional restrictions on the use or disclosure of information for treatment, payment or healthcare operations. We are not required to agree to the requested restriction except in the limited situation in which you or someone on your behalf pays for an item or service, and you request that information concerning such item or service not be disclosed to a health insurer.
We normally contact you by telephone, email, or mail at your home address. You may request that we contact you by alternative means or at alternative locations. We will accommodate reasonable requests.
You may inspect and obtain a copy of records that are used to make decisions about your care or payment for your care, including an electronic copy. We may charge you a reasonable cost-based fee for providing the records. We may deny your request under limited circumstances, e.g., if we determine that disclosure may result in harm to you or others.
You may request that your protected health information be amended. We may deny your request for certain reasons, e.g., if we did not create the record or if we determine that the record is accurate and complete.
You may receive an accounting of certain disclosures we have made of your protected health information. You may receive the first accounting within a 12-month period free of charge. We may charge a reasonable cost-based fee for all subsequent requests during that 12-month period.
You may obtain a paper copy of this Notice upon request. You have this right even if you have agreed to receive the Notice electronically.
5. Changes to This Notice. We reserve the right to change the terms of this Notice at any time, and to make the new Notice effective for all protected health information that we maintain. If we materially change our privacy practices, we will post a copy of the current Notice in our reception area and on our website. You may obtain a copy of the operative Notice from our receptionist or Privacy Officer.
6. Complaints. You may complain to us if you believe your privacy rights have been violated. You may file a complaint with us by notifying our Privacy Officer. All complaints must be in writing. We will not retaliate against you for filing a complaint.
7. Contact Information. If you have any questions about this Notice, or if you want to object to or complain about any use or disclosure or exercise any right as explained above, please contact:
Privacy Officer: Katie Chase
Phone: 208-899-7992
Address: 3368 E. Goldstone Dr. Meridian, ID 83642
E-mail: [email protected]
