Informed Care: Be informed of your treatment plan and participate in the development and implementation of your plan of care. Receive a clear explanation of evaluation results; to be informed of potential or lack of potential for improvement. Be fully informed of the care and treatment that will be provided by us, the cost of care, and how payment will be handled. Be provided with services in a timely and competent manner, which includes referral to other appropriate professionals when necessary. Be told the name of your health care provider and the professional qualifications of the person providing services. Be told in a timely manner of your discharge and be involved in your discharge plan. Request or refuse treatment, and receive information regarding the consequences of refusing treatment.

Restrictions: You have the right to request restrictions on certain uses and disclosures of your health information. We will make every effort to honor reasonable restriction preferences from our clients.

Confidential Communications: Expect full consideration of your privacy and confidentiality in care discussions, evaluations, and treatments. Expect that all communications and records about your care are confidential, unless disclosure is allowed by law. You have the right to request that we communicate with you in a certain way. You may request that we only communicate your health information privately with your other family members present or through mailed communications that are sealed. We will make every effort to honor reasonable requests for confidential communications.

Inspect and Copy Your Health Information: You have the right to read, review, and copy your health information, including your complete file, and billing records. If you would like a copy of your health information, please let us know. You will be charged, according to the State regulations for duplication costs.

Amend your Health Information: You have the right to ask us to update or modify your records if you believe your health insurance records are incorrect or incomplete. We will be happy to accommodate you as long as our office maintains this information. In order to standardize the process, requests must be made in writing along with a description of the reason for the change. Your request may be denied if the health information record in question was not created by our office, is not part of our records, or if the records containing your health information are determined to be complete and accurate.

Documentation of Health Information: You have the right to ask for a description of how and where your health information was used by us for any reason other than for treatment, payment or health care operations. Please let us know in writing the time period for which you are interested. Thank you for limiting your request to no more than six years at a time. We will charge you a reasonable fee for your request.

Request a Paper Copy of this Notice: You have the right to obtain a copy of this Notice of Privacy Practices directly from us at any time. We are required by law to maintain the privacy of your health information and to provide you and your representative this Notice of Privacy Practice. We are required to practice the policies and procedure described in this notice but do reserve the right to change the terms of this Notice. If we change our privacy practices, all patients will receive a copy of the revised Notice.

Complaints: You have the right to express concerns to us, or the Secretary of Health and Human Services if you believe your privacy rights have been compromised. We encourage you to express any concerns you may have regarding the privacy of you information. Please let us know of your concerns or complaints in writing and address them to our Patient Advocate so that we may undertake the proper procedures to remedy the situation as quickly as possible.

As a patient, you have the responsibility to:

• Provide complete and accurate medical, health, and insurance carrier information.
• Remain under the care of your physician while receiving our services.
• Keep your appointments or call to reschedule with 24 hr notice: (270) 688-4889
• Accept the responsibility for any refusal of treatment.
• Ask questions when you do not understand information or instructions.
• Treat staff with courtesy and respect.
• Contact our office in the event of change of address, phone, or insurance information: (270) 688-4889