Notice of Privacy Rights

Our practice is dedicated to maintaining the privacy of your personal health information as part of providing professional care.  We also are required by law to keep your information private.  These laws are complicated, but we must give you this important information.  This letter is a shorter version of the full, legally required Notice of Privacy Rights (NPR) and you may request a longer version by contacting us via email. 

We use your health information obtained from you or others for your treatment, payment arrangement for our services, and for other business activities which are called in the law, health care operations.   If we or you want to use or disclose your information for any other purposes, we will discuss this with you for your signature on an authorization form. 

We keep all health information private.  However, there are times when the law requires us to use or share it.  Some examples include but are not limited to:

1. When there is a serious threat to your health and safety or the health and safety of another individual or the public.  We will only share information with a person or organization that is able to help prevent or reduce the threat.
2. Some lawsuits and legal or court proceedings.
3. If a law enforcement official requires us to do so.
4. For Workers Compensation and similar benefit programs.

Your rights regarding your health information:

1. You can ask us to communicate with you about your health and related issues in particular ways or at a place that is private for you.  For example, you can ask us to call you at home rather than at work to schedule or cancel an appointment.  We will try to do our best to do as you ask.
2. You have the right to ask us to limit what we tell people involved in your care or the payment for your care, such as family members and friends.
3. You have the right to look at the health information we have about you, such as your medical and billing records.  You can get a copy of these records but we may charge your account.  Contact our Privacy Officer to arrange how to see your records.
4. If you believe the information in your records is incorrect or missing important information, you can ask us to make some kinds of changes (called amending) to your health information.  You have to make this request in writing and send it to our Privacy Officer.  You must tell must the reasons you want to make the changes.
5. You have the right to a copy of this notice.  If we change this NPR, we will post the new version in our waiting area.  You can always get a copy of the NPR from the Privacy Officer.
6. You have the right to file a complaint with our Privacy Officer and with the Secretary or the Department of Health and Human Services.  All complaints must be in writing.  Filing a complaint will not change the health care we provide you in any way. 

If you have any questions regarding this notice or our health information privacy policies, please contact our Privacy Officer via phone at (314) 577-5000 ext 101 or by email at generaluser@urbanbehav.com.

The effective date of this notice is February 17, 2006.