Center for Change understands that your medical and health information is personal. Protecting your health information is important. We follow strict federal and state laws that require us to maintain the confidentiality of your health information.

How We Use Your Health Information

When you receive care from Center for Change, we may use your health information in providing you treatment, billing for services, and conducting our normal business (known as "health care operations"). Examples of how we may use your information include:

Treatment

We keep records of the care and services provided to you. Health care providers use these records to deliver quality care to meet your needs. For example, your therapist may share your health information with a specialist who will assist in your treatment. Some health records, including some confidential communications with a mental health professional and some substance abuse records, may have additional restrictions on their use and disclosure under state and federal laws.

Payment

We keep billing records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment from you, your insurance company, or other third party. We may also contact your insurance company to verify coverage for your care or to notify them of upcoming services that may require prior notice or approval. For example, we may disclose information about the services provided to you to claim and obtain payment from your insurance company or Medicare.

Health Care Operations

We may use or disclose your health information in order to perform the necessary administrative, educational, quality assurance, and business functions of the Center. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also use your health information to evaluate whether certain treatment or services offered by Center for Change are effective. We may also disclose your health information to other mental health professionals, physicians, nurses, technicians, or health profession students for teaching and learning purposes.

Other Services We Provide

We may also use your health information to:

• Recommend treatment alternatives
• Inform you about health services and products that may benefit you
• Share information with third parties who assist us with treatment, payment, and health care operations. Our business associates must protect your information by following our privacy practices
• Remind you of an appointment (if you do not wish to be reminded, notify a receptionist)
• Contact you for purposes of fund-raising, research, or volunteer service (if you do not wish to participate, notify the Center’s Admissions Coordinator)

We may disclose your health information to individuals, such as family members and friends, who are involved in your care or who help pay for your care. We may make such disclosures when: (a) we have your verbal agreement to do so; (b) we make such disclosures and you do not object; or (c) we can infer from the circumstances that you would not object to such disclosures. For example, if your spouse comes in to the exam room or therapy session with you, we will assume that you agree to our disclosure of your information while your spouse is present in the room. We may also disclose your health information to family members or friends in instances when you are unable to agree or object to such disclosures, provided that we feel it is in your best interests to make such disclosures and the disclosures relate directly to the family member or friend’s involvement in your care.

Sharing Your Health Information

There are limited situations when we are permitted or required to disclose health information without your signed authorization. These situations include:

• For public health purposes such as reporting communicable diseases, work-related illnesses, or other diseases and injuries permitted by law; reporting births and deaths; and reporting reactions to drugs and problems with medical devices
• To protect victims of abuse, neglect or domestic violence
• For health oversight activities such as investigations, audits, and inspections
• For law enforcement purposes
• For lawsuits and similar proceedings
• When otherwise required by law
• When requested by law enforcement as required by law or court order
• To coroners, medical examiners, and funeral directors
• For organ and tissue donation
• For research under strict federal guidelines
• To reduce or prevent a serious threat to public health and safety
• For worker’s compensation or other similar programs if you are injured at work
• For specialized government functions such as intelligence and national security

All other uses and disclosures, not described in this notice, require your signed authorization. You may revoke your authorization at any time with a written statement (with limited exceptions as provided by federal regulations).

Your Individual Rights

You have the right to:

• *Request restrictions on how we use and share your health information. We will consider all requests for restrictions carefully but are not required to agree to any restriction.
• Request that we use a specific telephone number or address to communicate with you
• *Request to inspect and copy your health information, including medical and billing records. Fees may apply. Under limited circumstances, we may deny you access to a portion of your health information and you may request a review of the denial

• *Request corrections or additions to your health information

• *Request an accounting of certain disclosures of your health information made by the Center. The accounting does not include disclosures made for treatment, payment, and health care operations and some disclosures required by law. Your request must state the period of time desired for the accounting, which must be within the six years prior to your request and exclude dates prior to April 14, 2003. The first accounting is free; however, a fee will apply if more than one request is made in a 12-month period; and
• Request a paper copy of this notice even if you agree to receive it electronically

Requests marked with a star (*) must be made in writing. Contact the Center’s Privacy Office for the appropriate form for your request.

Our Privacy Responsibilities

Center for Change is required by law to:

• Maintain the privacy of your health information
• Provide this notice describing the ways we may use and share your health information
• Follow the terms of the notice currently in effect

We reserve the right to make changes to this notice at any time and make the new privacy practices effective for all information we maintain. Current notices will be posted in our facility and on our website: www.centerforchange.com. You may also request a copy of any notice from the Center’s Privacy Office.

Our Organization

This notice describes the privacy practices of Center for Change Incorporated as well as the Center’s employees and volunteers. This notice also describes the privacy practices of affiliated providers while they are performing services at the Center, unless they provide you with a notice of their specific privacy practices. Affiliated providers are not employed by Center for Change but are authorized to provide services to patients at the Center. Affiliated providers may have different privacy practices from those described in this notice. For more information about the privacy practices of affiliated providers, please contact them directly.

Contact Us

If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision the Center made about access to your health information, contact the Center for Change Privacy Office at 1790 N State Street, Orem UT 84057.

We will investigate all complaints and will not retaliate against you for filing a complaint. You may also file a written complaint with the Office of Civil Rights of the U.S. Department of Health and Human Services.