Notice of Privacy Practices

Your rights

Get a copy of health and claims records. You can ask to see or get a copy of your health records and other health information we have about you. Ask us how to do this. We’ll provide a copy or a summary within the time the law requires, and may charge a reasonable, cost-based fee.

Ask us to correct your records. You can ask us to correct health information that you think is incorrect or incomplete. Ask us how to do this. We may say no, but we’ll tell you why in writing.

Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say yes to all reasonable requests.

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. If you pay for a service or item out of pocket in full, you can ask us not to share that information with your health insurer for payment or operations. We will say yes unless a law requires us to share it.

Get a list of those we’ve shared information with. 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. 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 list a year at no charge, and may charge a reasonable, cost-based fee for another within 12 months.

Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

Choose someone to act for you. If someone has medical power of attorney for you or is your legal guardian, that person can exercise your rights and make choices about your health information. We’ll make sure the person has this authority before we act.

File a complaint if you feel your rights are violated. Contact our Privacy Officer using the information at the end of this notice. You can also 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 www.hhs.gov/hipaa/filing-a-complaint/index.html (opens in a new tab). We will not retaliate against you for filing a complaint.

Your choices

You can tell us whether we may share information with your family, close friends or others involved in your care, and whether we may share it in a disaster relief situation. If you can’t tell us your preference (for example, if you’re unconscious), we may share information if we believe it’s in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We do not sell your personal information. We will not use or share your information for marketing unless you give us written permission.

How we typically use or share your health information

Treat you. We can use your health information and share it with other professionals who are treating you. Example: your child’s doctor asks us about your child’s ABA progress.

Run our organization. We can use and share your health information to run our practice, improve your care and contact you when needed. Example: our clinical team reviews treatment records to check and improve the quality of care.

Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: we give information about your child to your health insurance plan so it can process the claim for ABA services.

Other ways we may use or share your information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes:

• Help with public health and safety issues, such as reporting suspected abuse, neglect or domestic violence, or preventing a serious threat to anyone’s health or safety.
• Do research. We can use or share your information for health research when the law allows.
• Comply with the law, including if state or federal laws require it, or if the Department of Health and Human Services wants to see that we’re complying with federal privacy law.
• 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, as the law allows.
• Address workers’ compensation, law enforcement and other government requests: for workers’ compensation claims; for law enforcement purposes or with a law enforcement official; with health oversight agencies for activities authorized by law; and for special government functions such as military, national security and presidential protective services.
• Respond to lawsuits and legal actions, such as a court or administrative order, or a subpoena.

Texas law

Texas law gives you additional protections for your health information, including notice if we disclose your information electronically when the law requires it. If Texas law protects your information more than federal law, we follow Texas law.

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 give you 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. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office and on our website.

Privacy Officer

Privacy Officer, Ludo ABA, 11606 Westlock Drive, Building 2, Suite 202, Tomball, TX 77377 · 346-778-1313 · admin@ludoaba.com