Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can gain access to this information. Please review it carefully.
Information regarding your health care, including drug and alcohol treatment, is protected by two federal laws: The Health Insurance Portability and Accountability Act (HIPAA) and the Drug and Alcohol Treatment Confidentiality Law. Under these laws, Tampa Bay DBT may not disclose any information identifying you as receiving alcohol or drug treatment, or disclose any other protected information, except as permitted by law.
This notice tells you how Tampa Bay DBT protects the confidentiality of your protected health information. Protected health information is any individually identifiable information including our name, address, telephone and/or fax number, electronic email address, social security number, or other identification number, date of birth, and dates of treatment. We follow the privacy practices that are described in this notice.
Any individual authorized to enter information into your medical records and any individual who may need access to your information must abide by this notice. All subsidiaries, business associates, sites and locations of Tampa Bay DBT may share information with each other for treatment purposes of health care operations described in this notice. Except where treatment is involved, only the minimum necessary information needed to accomplish this task will be shared.
The following categories describe different ways that Tampa Bay DBT may use and disclose medical information without your specific request or written authorization. Examples are provided for each category of uses or disclosure. Not every possible use or disclosure in a category has been listed.
1. Treatment: We may use medical information about you to provide you with medical treatment services. Examples include in treating you for a specific condition we may need to know if you have other conditions that may affect your treatment.
2. Payment: We may use and disclose medical information about you so that the treatment and services you receive from Tampa Bay DBT may be billed and payment may be collected from you. Examples include we may need to send your protected health information, such as your name, address, office visit date, and diagnostic codes to our billing service for processing.
3. Health Care Operations: We may use and disclose medical information about you to health care operations to ensure that you receive quality care. Examples include we may use medical information to review our treatment and services and evaluate the performance of our clinicians in caring for you.
The following include other ways your protected health information may be disclosed without your consent.
1. As required during an investigation by law enforcement agencies.
2. To avert a serious threat to public health or safety.
3. As required by military command authorities for their medical records.
4. To worker’s compensation or similar programs for processing claims.
5. In response to a legal proceeding.
6. To a coroner or medical examiner for identification of a body.
7. To a correctional institution or a law enforcement official where you are an inmate.
8. As required by the US Food and Drug Administration.
We may contact you to provide appointment reminder or for information about treatment alternatives or other health-related benefits and services that may be of interest to you.
The following outlines when disclosures of protected health information require your written consent.
All other uses and disclosure of protect health information not covered by this notice or the laws that apply to this practice will be made only with your written authorization. All authorizations are good for one year, unless your revoke that authorization in writing. You may revoke authorization to disclose protected health information at any time in writing. If you revoke your authorization, we will thereafter no longer use or disclose protected health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission and that we are required to maintain record of the care we have provided you.
Any individual receiving serves with Tampa Bay DBT is considered a consenting adult. Therefore, they must complete a written consent for clinicians to be able to disclose information about their treatment with family members, including adolescent parents.