This notice describes how medical, drug and alcohol related information about you may be used and disclosed. It also includes information on how you can access this information about yourself. Please carefully review.
The Bridge, Inc. must obtain your written consent before it can disclose information about you for payment purposes. For example, The Bridge, Inc. must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before The Bridge, Inc. can share information for treatment purposes or for health care operations. However, federal law permits to disclose information without your written permission:
1. Pursuant to an agreement with a qualified service organization/business associate;
2. For research, audit or evaluations;
3. To report a crime committed on The Bridge, Inc.’s premises or against The Bridge, Inc.’s personnel;
4. To medical personnel in a medical emergency
5. To appropriate authorities to report suspected child abuse or neglect;
6. As allowed by a court order.
For example, The Bridge, Inc. can disclose information without your consent to obtain legal or financial services, or to another medical facility to provide health care to you, as long as there is a qualified service organization/business associate agreement in place.
Before The Bridge, Inc. can use or disclose any information about your health in a manner which is not described above, it must first obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing.
You have the right to request that we communicate with you by alternative means or at an alternative location. The Bridge, Inc. will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA you also have the right to inspect and copy your own health information maintained by The Bridge, Inc., except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances.
Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in The Bridge, Inc. records, and to request and receive an accounting of disclosures of your health related information made by The Bridge, Inc. during the six years prior to your request. You also have the right to receive a paper copy of this notice.
Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.
- General Information
- Your Rights
- The Bridge’s Duties
- Complaints and Reporting Violations
- Contact
- Effective Date
- General Information
The Bridge, Inc. must obtain your written consent before it can disclose information about you for payment purposes. For example, The Bridge, Inc. must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before The Bridge, Inc. can share information for treatment purposes or for health care operations. However, federal law permits to disclose information without your written permission:
1. Pursuant to an agreement with a qualified service organization/business associate;
2. For research, audit or evaluations;
3. To report a crime committed on The Bridge, Inc.’s premises or against The Bridge, Inc.’s personnel;
4. To medical personnel in a medical emergency
5. To appropriate authorities to report suspected child abuse or neglect;
6. As allowed by a court order.
For example, The Bridge, Inc. can disclose information without your consent to obtain legal or financial services, or to another medical facility to provide health care to you, as long as there is a qualified service organization/business associate agreement in place.
Before The Bridge, Inc. can use or disclose any information about your health in a manner which is not described above, it must first obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing.
- Your Rights
You have the right to request that we communicate with you by alternative means or at an alternative location. The Bridge, Inc. will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA you also have the right to inspect and copy your own health information maintained by The Bridge, Inc., except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances.
Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in The Bridge, Inc. records, and to request and receive an accounting of disclosures of your health related information made by The Bridge, Inc. during the six years prior to your request. You also have the right to receive a paper copy of this notice.
- The Bridge, Inc.’s Duties
- Complaints and Reporting Violations
Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.
- Contact