#SucessStory: Cody met his goal of brushing his teeth within 5 minutes of being cued with minimal aversions. This is awesome! Cody used to be unwilling to hold a toothbrush. He would stall and spend several moments playing in the bathroom before he would attempt to initiate the task. Lately, he has been brushing his teeth within 2 minutes of being asked, and he has shown increased skill with the task- he now covers all areas of his mouth. Keep up the good work, Cody!
New Patients
Could your child benefit from therapy? Here's what you need to know...
- Evaluations are a more formal and detailed assessments.
- Involves reviewing and studying the developmental history of the child.
- Will involve standardized testing when possible.
- Evaluations typically take an hour.
- Includes a parent interview for a comprehensive list of concerns.
- May include more detailed questionnaires about your child's abilities at home.
- Is a billable services which is covered by many health insurance plans. We accept all major commercial/private insurances, Medicaid, and MCOs.
Ready now?
Complete the information below:
#SuccessStory
Joshua graduated from occupational therapy at TheraTree! He has been working so hard with mom on moving, rolling, and tracking toys. He is having so much playing and we are so proud of all your growth!
Patient Referral
After submitting the referral form above, you can speed up your child's new patient process by completing the intake paperwork now:
Referral Process: Parents can begin the referral process by completing the patient referral (first tab) OR call us to see if your child will benefit from therapy OR requesting a referral to TheraTree from your pediatrician. We will then request a Physician order if they haven't faxed one to us yet.
Scheduling. Our patient intake specialist will schedule an evaluation with you and you may call us at (270) 688-8449. We understand you reason for getting an evaluation is important and try to schedule as little as within a week.
Paperwork. All legal guardians must complete ouromplete our intake paperwork as soon as possible. We request to have all intake information submitted at least 24 hours before the evaluation. Your information helps us prepare for you evaluation.
The day of your Evaluation:
Telehealth Evaluations:
Log into your Parent portal (or click the email link) and orient yourself 15 minutes before your appointment. For OT evaluations please have the following supplies on hand. These items help us see they way your child can use these "tools" and will enhance the quality of our evaluation. If there are any items you don't have, it's ok, we can still complete your evaluation.
- Pencil
- Paper
- Marker
- Crayons
- Scissors
- Interlocking blocks
- Stackable blocks
- Puzzle
- Favorite toy
- Small items that are smaller than the child's hand (5)
In-person Evaluations:
Arrive to your evaluation appointment at least 15 minutes early. This will allow us time to collect information such as your insurance card. If you have not completed in the evaluation packet, please arrive 30 minutes early.
Note: Please respect your scheduled appointment time. Our highly skilled therapists have busy schedules and must complete critical observations and assessments with your child, which typically take the entire allotted time. Without this, your child may not qualify for services.
If you are running late, please call us and let us know. Depending on how late you're running and our schedule, there may be a need to entirely reschedule the appointment.
If you need to cancel, please do so at least 24 hours before your appointment or with as much advanced notice as possible. Advanced notice allows us the time to see another patient during that time and help more families.
Blog: What to Expect Prior to Your Evaluation
Learn more about our clinic, why to evaluate, our intake paperwork, insurance verification, what happens when you arrive at your evaluation and about making progress!
Blog: What to Expect at Your Occupational Therapy Evaluation
Learn about our standardized assessments, observations, caregiver interview, evaluation results, plan of cares, goals, treatment, progress and success!
PRIVACY PRACTICES
Therapeutic medical treatment and quality of care is one of our highest priorities. We are committed to in the privacy rights of our patients and their families. We are required to provide you with this notice of our legal duties and privacy practices required to maintain the privacy of protected health information. We are required to abide by the terms of this notice currently in effect. We reserve the right to change the terms of our notice and to make the new notice provisions in effect for all protected health information that we maintain. If we do update our notice, we will post a revised notice on our website. You may also request a copy of any revised notice by calling the office and requesting that a revised copy be sent to you in the mail or by asking for one at your time of you next appointment.
Health Insurance Portability and Accountability Act (HIPAA): HIPAA is a federal law published by the US Department of Health and Human Services (45 CFR Part 160 and Subparts A and E of Part 164) in 1996 that sets national standards for protecting sensitive health information. It requires health care providers, including TheraTree, LLC, to safeguard patient Protected Health Information (PHI). HIPAA gives parents and guardians rights over their child’s health information, including the right to access records, request corrections, and understand how information is used or shared. TheraTree, LLC follows HIPAA regulations to keep patient health information private and secure.
Personally Identifiable Information (PII): Any information that can be used to identify your child or your family, either on its own or when combined with other information. Examples include name, address, phone number, date of birth, email address, Social Security number, or photographs and recordings that show identity.
Protected Health Information (PHI): A subcategory of PII that relates specifically to health care. PII becomes PHI when an indiviudal is identified and connected to an their health information. PHI includes any information that identifies your child and relates to their past, present, or future physical or mental health, the care they receive, or payment for health care services. Examples include medical records, therapy notes, diagnoses, test results, treatment plans, and health insurance information. Both PII and PHI are protected by federal and state privacy laws, and TheraTree, LLC safeguards this information in compliance with HIPAA and applicable regulations.
HOW YOUR HEALTH INFORMATION MAY BE USED.
PHI will be used and disclosed as part of rendering care for treatment, payment and, healthcare operations. Access to health information is limited to clinicians involved in care, authorized administrative personnel for billing and compliance, and payer or government auditors when required by law. Federal and state privacy laws permit the use or disclose your PHI without obtaining consent or without giving you a chance to object or agree with the use or disclosure in the following circumstances:
Provide Treatment: We will use your health information within our office to provide you with the best care possible. This may include administrative and clinical office procedures. Because we believe students are the future for providing quality services to our patients, student clinicians, assistants, and interns on our team will have access to your health information, observe, and/or lead treatment. Although volunteers in our volunteer program do not have direct access to health records, they are present in our facility. All students and volunteers have completed HIPAA training and signed HIPAA agreements. We may share your health information with referring physicians/pediatricians/therapists or other health care personnel providing your treatment.
Obtain Payment: We may include your health information with an invoice used to collect payment for treatment you receive in our office. We may do this with insurance forms filed for you in the mail or sent electronically. We will be sure to only work with companies with a similar commitment to the security of your health information.
Conduct Health Care Operations: It is possible that health information will be disclosed during audits by insurance companies or government appointed agencies as part of their quality assurance and compliance reviews. Your health information may be reviewed during the routine processed of certification, licensing, or credentialing activities.
Patient Communication: We may contact you to follow up on your care and inform you of treatment options or services that may be of interest to you or your family. These communications may include postcards, letters, telephone calls, voice mail, bulletins or email.
Abuse or Neglect: We will notify government authorities if we believe a patient is the victim of abuse, neglect, or domestic violence. We will make this disclosure only when we are compelled by our ethical judgment, when we believe we are specifically required or authorized by law or with the patient’s agreement.
Public Health and National Security: We may be required to disclose to Federal officials or military authorities health information necessary to complete an investigation related to public health or national security. Health information could be important when the government believes that the public safety could benefit when the information could lead to the control or the prevention of an epidemic or the understanding of a new medical device.
For Law Enforcement: As permitted or required by State or Federal Law, we may disclose your health information to a law enforcement official for certain law enforcement purposes, included (under certain limited circumstances) if you are a victim of a crime or in order to report a crime.
Family, Friends, and Caregivers: We may share your health information with those you tell us will be assisting you with your treatment or payment. We will be sure to ask your permission first. In the case of emergency, we will use our best judgment when sharing your health information.
Medical Research: Advancing medical knowledge often involved learning from the careful study of the medical histories of prior patients. Formal review and study of health histories as a part of research study will happen only under the ethical guidance, requirements and approval of an Institutional Review Board.
Uses and Disclosures of Therapy Notes: Therapy notes are recorded by a health professional documenting of currently level of functions. progress, and medical need for treatment taken during the session. We may disclosure notes taken for the following limited purposes.
For Treatment: The therapy provider that created the therapy note may use the notes for your treatment or to provide you with health care services/ For example, a physician may review her note prior to your therapy session.
For Training: We may use and disclose therapy notes for our own training programs in which student , trainees, or practitioners learn under supervision to practice to improve their skills.
Legal Action: We may use and disclose therapy notes to defend ourselves in a legal action or other proceeding. For example, we may provide therapy notes to our lawyers who are defending us in a legal case brought by you.
Coroners or Medical Examiners: We may disclose therapy notes to a coroner or medial examiner.
Required by Law: To Avert a Serious Threat to Health or Safety: We may disclose therapy notes when required to do so by law. We may use and disclose therapy notes if we believe that the use or disclosure is necessary to prevent or lesson a serious and imminent threat to the health or safety of a person of the public.
Authorization to Use or Disclose Health Information: Other than what is stated about or where Federal, State, or Local law requires us, we will not disclose your health information without your written authorization. You may revoke that authorization in writing at any time.
TECHNOLOGY
TheraTree, LLC uses audio, video, digital, and artificial intelligence (AI) technologies as part of daily clinical, administrative, and operational activities. This disclosure is intended to inform clients and families of these practices and the safeguards in place to protect Protected Health Information (PHI).
Electronic Systems and Communication: A variety of secure electronic systems are used to support client care and operations, including but not limited to: Electronic Medical Record (EMR) systems, secure patient portals, encrypted email communications, secure text messaging platforms, scheduling and appointment reminder systems, telehealth and virtual care platforms, cloud-based document storage and encrypted backup systems, data analytics tools, training and platforms, digital signature platforms for consents and forms, and online payment and billing platforms. All PHI is stored in TheraTree’s HIPAA-compliant EMR system. Paper materials are digitized for secure storage, with originals destroyed once electronic storage is verified. Records are retained for a minimum of seven (7) years after the last date of service, or longer as required by law or payer policy, after which they are securely destroyed through HIPAA-compliant methods.
Audio and Video Monitoring: Audio and video cameras are located in indoor common areas and outdoor spaces and used for safety, security, training, and quality assurance. Monitoring does not occur inside restrooms or select private therapy rooms.
Recordings and Transcriptions: Remote or in person services and consultations may use HIPAA-compliant videoconferencing platforms and/or other secure devices to facilitate therapy and consultation services. Recordings may be used for transcripts, documentation, supervision, training, quality assurance or operational decision-making.
Artificial Intelligence (AI) Tools: AI technologies are used to support clinical and administrative operations. Examples include transcription services, meeting analysis, clinical support tools, and data organization systems. These tools are implemented to improve care quality, efficiency, and safety, and are used in compliance with privacy and security requirements.
Digital Assessments and Monitoring: Tablet or computer-based testing applications, digital therapy tools, and standardized assessments administered electronically may be used for remote patient monitoring (RPM) and outcomes tracking. Remote therapeutic monitoring (RTM) devices may be incorporated such as smartphone apps or wearable devices to gather activity and/or physiological data as appropriate. RTM services may be billed to the insurance company.
Data Protection and Privacy: All technologies listed in this disclosure and data collected will be maintained in accordance with HIPAA, state and federal privacy laws, and TheraTree, LLC’s internal compliance policies. Data may become part of the patients permanent medical record and will be securely stored, retained only as long as necessary, and disposed of in accordance with applicable law and policy. Protected Health Information (PHI) is safeguarded and access is limited to authorized personnel. Technology and collected data may be reviewed at varying intervals depending upon the patients treatment plan, medical necessity, and clinician availability. Technology is not continuously monitored and should not be used to report emergencies, urgent medical concerns, or situations requiring immediate attention. Call 911 or seek appropriate emergency services as needed. Data is not used for marketing or promotional purposes without separate written consent.
PATIENTS’ RIGHTS
Patient receiving therapy services and their legal gaurdians have the following rights related to health information within the limits of the law.
Access to Care: Receive considerate, respectful, compassionate care regardless of your age, gender, race, national origin, religion, gender preference, or disability. Receive care in a safe environment free from all forms of abuse, neglect, or harassment. Have your property treated with dignity and respect. Change health care providers if dissatisfied with your care.
Informed Care: Be informed of treatment plans and participate in the development and implementation of 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 health care provider(s) and the professional qualifications of the person providing services. Be informed of discharge in a timely manner and be involved in discharge planning. Request or refuse treatment, and receive information regarding the consequences of refusing treatment.
Restrictions: Request restrictions on certain uses and disclosures of health information. We will make every effort to honor reasonable restriction preferences from clients.
Confidential Communications: Expect full consideration of patient privacy and confidentiality in care discussions, evaluations, and treatments. Expect that all communications and records about care are confidential, unless disclosure is allowed by law. Request communication in a certain way inlcuding 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: Read, review, and copy your health information, including evaluation reports, treatment records, progress notes, and billing records, as permitted by law. Portions of health records include test data (such as responses, scores, and examiner notes) and test materials (such as manuals, test questions, or scoring keys). Under Kentucky law and the American Psychological Association (APA) Code of Ethics, test materials are protected to preserve the validity and integrity of the standardized assessment(s) and cannot be released directly to clients, parents, or other unauthorized persons. Test data may only be released to another credentialed professional who has appropriate training and experience in the specialized testing and who is authorized to receive the data. Specific health information may be withheld if its’ release would pose a risk of harm or lead to misuse or misinterpretation of test results. If you would like a copy of your health information, please let us know by emailing contact@theratreepeds.com. You will be charged a reasonable fee described in the finacial responsibility agreement and in alignment with state regulations for duplication costs.
Amend your Health Information: Ask to update or modify 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. Requests 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 health information are determined to be complete and accurate.
Documentation of Health Information: Ask for a description of how and where 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 a reasonable fee for these request define in our finacial responsibility agreement.
Request a Paper Copy of this Notice: 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: Express complaints 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.
Patients and their legal gaurdians have the responsibility to:
- Provide complete and accurate medical, health, and insurance carrier information.
- Remain under the care of your physician while receiving therapy 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
Insurances We Accept:
- Aetna US Healthcare
- Anthem
- Assurant Health
- Aultra Administrative Group
- Benefit Administration Systems
- BlueCross BlueShield
- Bluegrass Family health
- CBA (Cooperative Benefit Administrators)
- Cigna
- Comprehensive Benefits
- Consecrate Group
- Coventry Cares of Kentucky
- CWI Benefits
- D H Evans & Associates
- EBC
- Ecom PPO (Cooperative Benefit Administrators)
- EPSDT
- Humana (ChoiceCare, Medicare Advantage, CareSource)
- INETICO, Inc.
- Kentucky Health Cooperative
When Maliyah first came to TheraTree she was very shy. She would provide one or two word answers during sessions when her therapist initiated the conversation, would hesitate to talk when others were around, and she would wait to ask for help until after her therapist offered. Now, when she arrives for therapy, she is excited to tell her therapist about the stuff she did during the week, reciprocates in the conversation for at least 10 minutes, and asks for help without any hesitation. Through encouragement and support, Maliyah is coming out of her shell and she is gaining more confidence every step of the way! We are so proud of you and your progress!
- Medicaid
- Mertain
- North American Administrators
- Owensboro Community Health Network
- Passport Health Plans
- Pittman & Associates
- Preferred Health Plans
- S & S Healthcare Strategies
- The Health Plan
- Tri-Care Health Net Federal Services
- United HealthCare
- WellCare of Kentucky
- Wells Fargo/HealthSmart Solutions Ins.
If you haven't met your deductible, or have other out-of-pocket expenses, we accept the #CareCredit credit card to help bridge the gap between insurance and the cost of care.
Don't see you insurance company? Don't worry! We accept many other plans and are willing to credential with new insurance companies. Call us to discuss your plan: 270-688-8449
FREE Developmental Checklist
Check now to see if your child is meeting their developmental milestones.
Use our interactive screening tool to see if your 1-6 year old is on track with their gross motor, fine motor, speech, and sensory skills.
FREE Screening
All screenings are FREE of charge and last about a fifteen minutes.
The purpose of a screening is to find out if there are areas of concern that need evaluation. If the screening identifies that your child presents with red flags that are not developmentally appropriate, it will be recommended to complete a comprehensive evaluation.
⭐️ Milestone Moment ⭐️
I started seeing Jasper on a few short weeks ago. In less than a month, I have seen so much progress! Today was the first session that his mom or grandma didn't have to stay with him longer than just to drop him off and pick him up. Jasper has struggled to play without throwing or destroying items, as well as showing variety in play. Today, Jasper independently initiated playing with 11 toys or games, and played with all of them appropriately. He had so much fun and is making so much progress in such a short time.
PATIENT RIGHTS, RESPONSIBILITIES & PRIVACY PRACTICES
This agreement explains the rights and responsibilities of patients and their legal representatives, TheraTree's privacy practices, the use of technology in providing services, and the process for submitting concerns or grievances.
PATIENT RESPONSIBILITIES
Patients receiving services and their legal guardians have the following responsibilities related to participating in care, communication, and maintaining a safe and respectful treatment environment:
Participation in Care: Participate in evaluations, treatment planning, and recommended services to the extent appropriate for the patient's abilities and agreed-upon care. Maintain appropriate medical oversight and follow mutually established plans of care, home recommendations, and clinical instructions. Ask questions when information or recommendations are unclear. Communicate concerns, preferences, or decisions to refuse treatment and understand the potential consequences of declining recommended care. Fulfill financial obligations under the Financial Responsibility Agreement and cooperate with reasonable requests necessary for authorizations, claims, and payment.
Communication & Accurate Information: Provide complete and accurate information reasonably necessary to evaluate, coordinate, document, bill, and provide services. Promptly communicate changes in health, medications, diagnoses, symptoms, behavior, functioning, insurance, contact information, custody, guardianship, or other circumstances affecting care. Immediately report known or concerns of medical risks, allergies, safety precautions, privacy, hazardous exposures, injuries, suspected abuse or neglect, unsafe supervision, or other potentially harmful circumstances that may affect patient or staff safety.
Attendance & Scheduling: Attend appointments consistently and follow TheraTree's Attendance and Scheduling Policy, including arrival, cancellation, rescheduling, and notification requirements. Arrive prepared with necessary medications, equipment, communication devices, food, supplies, forms, or records appropriate for the scheduled service.
Supervision & Transportation: Maintain appropriate supervision of patients, siblings, and other individuals requiring assistance whenever responsibility has not been expressly transferred to TheraTree staff. Do not leave children unattended in waiting areas, restrooms, vehicles, parking areas, or elsewhere on the premises. Follow established arrival, departure, and authorized pickup procedures. Ensure that individuals supervising or transporting patients are legally authorized and capable of providing safe care. Do not supervise or transport a patient while impaired by alcohol, cannabis, drugs, medications, or another condition affecting judgment, alertness, coordination, or safe caregiving. Arrange for an authorized, unimpaired caregiver or other safe transportation when necessary.
Safe & Respectful Conduct: Treat patients, families, staff, students, volunteers, and visitors with dignity and respect. Do not engage in violence, threats, harassment, intimidation, discrimination, retaliation, sexually inappropriate conduct, or substantial disruption. Do not ridicule, shame, provoke, or interfere with another person's care, privacy, supervision, or safety. Respect TheraTree property, clinical equipment, and others' belongings. Follow reasonable facility, infection control, safety, and emergency instructions.
Privacy & Confidentiality: Respect the privacy of other patients and families. Do not intentionally access, view, photograph, record, copy, remove, disclose, or distribute another person's confidential information, including records, conversations, schedules, computer screens, treatment information, diagnoses, or identifying details incidentally encountered at TheraTree. Do not photograph, audio record, video record, livestream, publicly identify, or share information about another patient, family, or private clinical interaction without appropriate authorization and legally required consent. Do not encourage or permit a child or another person in your care to record, approach, question, or interfere with another patient experiencing a private or vulnerable situation. Do not independently investigate, confront, photograph, or publicly identify another patient or family in response to a concern.
Medications: Keep prescription and over-the-counter medications, chemicals, sharps, and other potentially hazardous materials securely controlled and inaccessible to children. Medications needed during appointments must remain under appropriate adult supervision and be administered only by a legal guardian in accordance with applicable law and TheraTree procedures. Do not leave hazardous items unattended anywhere on the premises.
Weapons-Free Environment: Do not bring, carry, display, use, or possess firearms, ammunition, knives intended as weapons, stun guns, tasers, explosives, or other dangerous weapons inside TheraTree facilities or other restricted areas, regardless of whether the individual is licensed or otherwise legally authorized to carry the weapon, except as authorized law enforcement personnel acting within their official duties. Firearms and other weapons lawfully maintained inside personal vehicles are subject to applicable Kentucky law, including KRS 237.106 and KRS 527.020. Do not leave weapons accessible to children. Lawful possession of firearms or ammunition in personal vehicles remains subject to applicable Kentucky law. Immediately notify staff of observed weapons or related safety concerns.
Substance-Free Environment: Prohibited substances include tobacco, nicotine, vaping products, alcohol, cannabis (including medical cannabis), kratom, illegal drugs, and other intoxicating or mind-altering substances. Do not bring, use, smoke, vape, consume, administer, distribute, or leave prohibited substances or related paraphernalia on TheraTree premises, including buildings, entrances, parking areas, and outdoor spaces, except as permitted by applicable law. Take reasonable precautions to prevent secondhand and thirdhand substance exposure of others within the facility. Cooperate with reasonable measures to maintain a safe and healthy treatment environment.
VIOLATIONS & CONSEQUENCES
Failure to follow these responsibilities may result in action reasonably necessary to protect patients, families, staff, and the treatment environment. TheraTree may take one or more of the following actions based on the nature, severity, frequency, and immediacy of the conduct, subject to applicable legal, ethical, contractual, payer, patient rights, and continuity-of-care requirements. TheraTree may...
Immediately Intervene: Direct an individual to stop prohibited conduct, remove or safely secure prohibited items, correct unsafe conditions, separate individuals, restrict access to affected areas, or leave the premises when reasonably necessary and legally permissible. Immediate threats may require intervention without prior warning.
Corrective Notice: Provide verbal or written notice, establish expectations for future conduct, require reasonable corrective measures, request alternative waiting or supervision arrangements, or require an authorized and unimpaired caregiver for transportation. Written behavioral, safety, privacy, substance-related, or visitor agreements may be required when appropriate.
Investigate: Document and investigate incidents, preserve lawfully available evidence, including security footage and electronic communications, and request removal of unauthorized photographs, recordings, or disclosures involving other patients.
Report to Authorities: Contact emergency services, law enforcement, child protective services, licensing boards, or other authorities when required by law or warranted by the circumstances, including serious threats, dangerous weapons, suspected impaired driving, hazardous exposures, or suspected abuse or neglect. Reports will be based on applicable legal standards and available information.
Restrict or Terminate Services: Serious, repeated, threatening, unsafe, harassing, or substantially disruptive conduct may result in restrictions on an individual's presence, modified participation arrangements, or consideration of transfer, suspension, or termination of services. Such actions remain subject to applicable law, patient rights, nondiscrimination requirements, reasonable accommodations, payer obligations, professional standards, and appropriate notice and continuity-of-care procedures.
PATIENT RIGHTS
Patients receiving services and their legally authorized representatives have the following rights, subject to applicable law and any legal limitations on a representative's authority.
Access to Care: Receive considerate, respectful, compassionate care without unlawful discrimination. Receive services in an environment free from abuse, neglect, harassment, and avoidable safety hazards. Have personal property treated with dignity and respect. Receive clinically appropriate and medically necessary services, when medical necessity is required, from personnel qualified to practice within applicable professional, licensure, certification, supervision, and competency requirements. Request a change in provider or seek care elsewhere, subject to provider availability and applicable service requirements.
Nondiscrimination & Accessibility: Receive healthcare services without discrimination based on race, color, national origin, sex, age, disability, or other characteristics protected by applicable law. Receive reasonable accommodations and free language assistance or auxiliary aids and services when necessary for meaningful access and effective communication, including qualified interpreters, sign language interpreters, translated information, and accessible formats. Request assistance or report an accessibility concern to TheraTree staff or the Section 1557 Coordinator at 2605 New Hartford Rd., Owensboro, KY 42303; 270-688-8449; contact@theratreepeds.com.
Informed Care: Receive information about evaluations, diagnoses, recommendations, treatment plans, potential benefits, risks, alternatives, expected outcomes, costs, and payment arrangements. Participate in developing, reviewing, and modifying the plan of care. Receive explanations of evaluation results, progress, limitations, and discharge recommendations. Know the names and professional qualifications of treating providers. Ask questions, express preferences, request referrals when appropriate, and consent to or refuse treatment after receiving information about potential consequences. Receive reasonable notice of planned discharge and participate in discharge planning.
Access to Health Information: Inspect or obtain copies of health information in TheraTree's designated record set, including applicable evaluations, raw test data, test results, treatment records, progress notes, and billing records as permitted by HIPAA, Kentucky law, applicable professional requirements, and subject to lawful exceptions. Request electronic copies when records are maintained electronically and the requested format is readily producible. Direct certain electronic records to another person as permitted by law. TheraTree will evaluate requests individually and will not categorically restrict raw test data to credentialed professionals.Access requests will be processed within applicable legal timeframes. Reasonable cost-based fees may apply. Requests may be submitted to contact@theratreepeds.com.
Amend Health Information: Request correction or amendment of inaccurate or incomplete health information maintained in the designated record set. Requests should identify the information and explain the requested correction. TheraTree may deny requests on grounds permitted by law and will provide applicable notice and review rights.
Restrict Disclosures: Request restrictions on uses or disclosures of health information for treatment, payment, healthcare operations, or disclosure to individuals involved in care. TheraTree is not generally required to accept every requested restriction. However, TheraTree will honor qualifying requests to restrict disclosure to a health plan for payment or healthcare operations when the information relates solely to services paid in full by the patient or another person on the patient's behalf and disclosure is not otherwise required by law.
Confidential Communications: Request reasonable alternative methods or locations for receiving communications, including communications by telephone, mail, or other available methods. TheraTree will accommodate reasonable requests as required by law.
Accounting of Disclosures: Request an accounting of certain disclosures of protected health information made during the preceding six years, subject to HIPAA exceptions and applicable rules for specially protected records. Requests must identify the desired period. The first applicable accounting within a 12-month period is generally provided without charge; reasonable fees may apply to additional requests when legally permitted and disclosed in advance.
Notice of Privacy Practices: Obtain a paper or electronic copy of TheraTree's current Notice of Privacy Practices at any time, including when the individual has previously received or acknowledged the notice. Receive information about material changes in accordance with applicable law.
Privacy Breach Notification: Receive notification of breaches of unsecured protected health information when required by applicable federal or state law.
Complaints & Grievances: Express concerns or complaints about care, personnel, discrimination, privacy, safety, billing, or professional conduct without intimidation, retaliation, discrimination, or adverse treatment for exercising protected rights. Submit complaints directly to TheraTree or an appropriate external authority without first completing TheraTree's internal grievance process.
PRIVACY PRACTICES
TheraTree, LLC is required by applicable law to protect the privacy and security of protected health information, provide notice of its legal duties and privacy practices, and follow the terms of the Notice of Privacy Practices currently in effect. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Health Insurance Portability and Accountability Act (HIPAA): HIPAA is a federal law published by the US Department of Health and Human Services (45 CFR Part 160 and Subparts A and E of Part 164) in 1996 that sets national standards for protecting sensitive health information. It requires health care providers, including TheraTree, LLC, to safeguard patient Protected Health Information (PHI). HIPAA gives parents and guardians rights over their child’s health information, including the right to access records, request corrections, and understand how information is used or shared. TheraTree, LLC follows HIPAA regulations to keep patient health information private and secure.
Personally Identifiable Information (PII): Information that identifies or could reasonably identify a person, such as a name, address, telephone number, date of birth, photograph, or other identifying information. PHI is a category of identifiable information subject to healthcare-specific privacy protections.
Protected Health Information (PHI): Individually identifiable information relating to a person's past, present, or future physical or mental health, healthcare services, or payment for care. PHI includes clinical records, diagnoses, treatment plans, test results, billing information, and other information identifying a patient in connection with healthcare.
Minors and Legal Representatives: Parents and legal guardians generally may exercise privacy rights on behalf of a minor when legally authorized. However, certain services, records, communications, and treatment decisions may be subject to special confidentiality protections or limitations under federal or state law. TheraTree may request documentation of custody, guardianship, healthcare decision-making authority, or other legal status when necessary to determine access and disclosure rights. A legal representative's authority to consent to treatment does not automatically establish unrestricted access to every category of protected information. TheraTree will evaluate requests according to applicable law, court orders, and the patient's legally protected confidentiality rights.
Privacy Safeguards: TheraTree uses administrative, physical, and technical safeguards designed to protect PHI against unauthorized access, use, alteration, and disclosure. Access is limited according to job responsibilities and applicable legal requirements.
Breach Notification: TheraTree will investigate suspected privacy or security incidents and notify affected individuals and appropriate authorities when required by applicable breach notification laws.
SPECIALLY PROTECTED HEALTH INFORMATION
Psychotherapy Notes: Separately maintained notes created by a mental health professional documenting or analyzing counseling conversations receive special protection under HIPAA. These differ from ordinary treatment notes, progress notes, diagnoses, treatment plans, clinical test results, and documentation maintained in the medical record. Written authorization is generally required to disclose psychotherapy notes unless a specific legal exception applies.
Psychological Test Data & Materials: Psychological test data, including raw scores, patient responses, and certain examiner observations, may be subject to patient access rights. Proprietary test materials may receive separate legal and professional protections. Requests will be evaluated under HIPAA, Kentucky law, applicable professional requirements, and lawful exceptions.
Substance Use Disorder Records: Records created or maintained by a federally assisted substance use disorder treatment program and protected by 42 CFR Part 2 receive additional confidentiality protections. When TheraTree creates, receives, or maintains Part 2 records, it will use and disclose them in accordance with applicable Part 2 requirements, HIPAA, and any more protective law. Part 2 records generally require patient consent for treatment, payment, and healthcare operations disclosures unless an exception applies. A qualifying consent may authorize future disclosures for those purposes, subject to applicable rules. Records may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against the patient without the specific consent or court order required by Part 2. Separate protections apply to substance use disorder counseling notes. Patients may exercise applicable Part 2 rights, including requesting restrictions, accounting of disclosures, and revocation of consent as provided by law. Recipients of Part 2 information remain subject to applicable limitations on further use or disclosure.
HOW YOUR HEALTH INFORMATION MAY BE USED
TheraTree, LLC may use and disclose PHI for treatment, payment, healthcare operations, and other purposes permitted or required by law. Federal and state privacy laws permit the use or disclose your PHI without obtaining consent or without giving you a chance to object or agree with the use or disclosure in the following circumstances:
Provide Services: Use or share health information to evaluate, treat, coordinate, and manage patient care. This may include communication among treating clinicians, referring providers, physicians, authorized clinical students and trainees, and other healthcare professionals involved in treatment. Authorized personnel may access information necessary for their assigned responsibilities.
Patient Communication: Contact patients and authorized representatives regarding appointments, scheduling, referrals, treatment recommendations, follow-up care, available services, and other healthcare-related matters. Communications may occur through approved telephone, voicemail, mail, email, text, portal, or other systems, subject to applicable privacy requirements and communication preferences.
Authorized Representatives: Share information relevant to an individual's care, payment, or location with authorized representatives or persons involved in care as permitted by law. When applicable, TheraTree will provide an opportunity to agree or object, consider the patient's preferences, and use professional judgment in emergencies or when the patient cannot reasonably express a preference. Parents and legal guardians may generally act as personal representatives of minors, subject to applicable exceptions and confidentiality protections.
Healthcare Operations: Use or disclose information for quality assurance, clinical supervision, training, credentialing, licensing, audits, compliance, risk management, business administration, and evaluation of service effectiveness. Information may be disclosed to authorized contractors or business associates (including technology, billing, records management, and administrative services) performing permitted functions under required privacy safeguards.
Payment: Use or disclose information to verify insurance eligibility, obtain authorization, submit claims, determine coverage, collect payment, respond to payer inquiries, and resolve billing matters. Disclosures may involve insurers, Medicaid programs, managed care organizations, billing services, and other authorized payment entities.
Health Oversight and Legal Requirements: Disclose information for authorized audits, investigations, inspections, licensing, regulatory oversight, judicial or administrative proceedings, lawful orders, or other legally permitted purposes. Requests involving subpoenas or legal proceedings will be evaluated under applicable disclosure requirements.
Public Health and Safety: Disclose information to authorized public health agencies for legally permitted activities, including disease reporting, prevention, safety surveillance, and other public health responsibilities. Information may also be disclosed when permitted or required to prevent or lessen a serious and imminent threat to health or safety.
Abuse, Neglect, and Mandatory Reporting: Disclose information to appropriate authorities when required or permitted by law concerning suspected child abuse, neglect, dependency, or other reportable circumstances. Kentucky law requires reporting when the applicable statutory threshold is met. Such disclosures do not require patient authorization when permitted or required by law.
Law Enforcement: Disclose information to law enforcement officials only when permitted or required by applicable law, including qualifying legal process, certain criminal investigations, emergencies, or legally recognized safety circumstances.
Research: Use or disclose information for research when permitted by law, including through a valid authorization, an applicable Institutional Review Board or Privacy Board waiver, or another lawful basis. Research participation requiring consent or authorization will be addressed separately.
Marketing & Fundraising: TheraTree will not sell PHI. Marketing communications requiring HIPAA authorization will not occur without appropriate written authorization. Fundraising communications involving PHI, if conducted as permitted by law, will include an opportunity to opt out. Applicable additional restrictions and opt-out rights for records protected by 42 CFR Part 2 will be honored.
Other Legally Permitted Disclosures: Disclose information when authorized by law for workers' compensation, coroners and medical examiners, certain decedent-related functions, qualifying government functions, or other legally recognized purposes.
Authorization Required: Obtain written authorization before using or disclosing PHI for purposes requiring authorization, including most disclosures of psychotherapy notes, marketing requiring authorization, sale of PHI, and identifiable patient photographs, testimonials, or promotional materials when authorization is required. Authorization may be revoked in writing, except to the extent TheraTree has already acted in reliance upon it or another legal exception applies.
Changes to Privacy Practices: TheraTree may revise this Notice and apply revised terms to PHI it maintains, as permitted by law. The current Notice will be available at TheraTree facilities, upon request, and through applicable website posting requirements. Material changes will be communicated as required by law.
TECHNOLOGY
TheraTree uses electronic, audio, video, digital, and artificial intelligence technologies to support clinical services, communication, documentation, safety, and business operations. Technology use is subject to applicable privacy requirements, professional standards, and any separately required consent or authorization.
Electronic Systems: TheraTree may use electronic medical records, patient portals, scheduling platforms, appointment reminders, electronic forms and signatures, secure messaging, telehealth systems, billing and payment platforms, cloud storage, data analytics, and electronic backup services. PHI maintained in these systems is subject to applicable HIPAA and other legal safeguards. Authorized service providers may process or store information on TheraTree's behalf under appropriate privacy protections.
Electronic Communications: Appointment reminders, care coordination, and administrative communications may occur through approved electronic systems. Electronic communication carries risks, including unauthorized access, misdirected messages, technical failures, and transmission vulnerabilities. Reasonable safeguards are used, but no electronic communication method can be guaranteed completely risk-free. Patients may request reasonable alternative communication methods.
Emergency Limitations: Electronic messages, monitoring tools, patient portals, and digital health platforms are not continuously monitored and must not be used for emergencies or urgent medical concerns. Call 911 or seek appropriate emergency services when immediate assistance is needed.
Audio & Video Monitoring: TheraTree may use security cameras in designated indoor common areas and outdoor spaces for safety, security, incident review, and authorized operational purposes. Monitoring is not conducted in restrooms. Any audio monitoring, recording, or use of recordings for clinical training or quality assurance will comply with applicable law and consent requirements. Monitoring areas, retention, access, and disclosure will be governed by TheraTree's applicable policies.
Recordings & Transcriptions: Clinical encounters, consultations, or communications may involve recording or transcription.. Recordings may support documentation, supervision, training, clinical review, or quality assurance. Refusal of optional recording will not automatically prevent access to otherwise available medically necessary care.
Artificial Intelligence: TheraTree may use approved AI-assisted tools for transcription, documentation support, clinical information organization, administrative analysis, and operational efficiency. Such tools are intended to support, not replace, qualified professional judgment. Any use involving PHI must comply with applicable privacy and security requirements. AI-generated clinical content remains subject to appropriate professional review, verification, and correction before reliance or incorporation into patient records. Patient information will not be used for public AI model training or unrelated purposes without an appropriate legal basis and any required authorization.
Digital Assessments & Monitoring: Electronic testing, digital therapy tools, patient-reported measures, and remote monitoring technologies may be used when clinically appropriate. Remote therapeutic monitoring or other eligible services may be billed when applicable coverage, consent, documentation, and billing requirements are satisfied. Separate notices or consents will be provided when required for specific services or devices.
Data Retention & Security: Electronic and paper records are maintained, protected, and destroyed according to applicable federal and state laws, payer requirements, professional standards, and TheraTree's records retention policies. Paper records may be digitized and originals securely destroyed when legally permissible and after verification of appropriate electronic preservation. Records subject to longer retention requirements, legal holds, or special protections will be maintained accordingly.
Promotional Use: Identifiable patient information, photographs, videos, testimonials, or other media will not be used for marketing or promotional purposes without the separate authorization.
GRIEVANCES
Patients, parents, legal guardians, and authorized representatives may express concerns or submit grievances regarding TheraTree's services, personnel, professional conduct, patient rights, discrimination, accessibility, privacy, safety, billing, insurance administration, or compliance with applicable requirements.
Non-retaliation: TheraTree prohibits intimidation, coercion, discrimination, interference, or retaliation against individuals for submitting grievances, requesting accommodations, reporting concerns, exercising protected rights, or participating in investigations. Filing a grievance will not, by itself, adversely affect access to care or the quality of services provided.
Internal Grievances: Written grievances may be submitted to TheraTree's Ombudsman. Include the patient's name, relevant dates, description of the concern, and requested resolution when applicable. TheraTree may request additional information reasonably necessary for review. Internal grievances should be submitted within 30 calendar days when practical; this organizational timeframe does not eliminate legal rights or prohibit consideration of later complaints.
Grievance Response: TheraTree will ordinarily provide a written response within 30 calendar days after receiving sufficient information to evaluate the grievance. If additional investigation is necessary, TheraTree will communicate the need for additional time and provide an updated response timeframe. Applicable legal deadlines take precedence over internal targets.
Internal Appeals: Individuals dissatisfied with a written grievance decision may request reconsideration in accordance with TheraTree's Client Grievance Policy. Appeals should be submitted within 30 calendar days after receipt of the decision. TheraTree will ordinarily issue a written appeal decision within 30 calendar days after receiving the appeal, subject to applicable legal requirements.
Internal Grievance Contact: TheraTree, LLC, Attn: Ombudsman, 2605 New Hartford Rd., Owensboro, KY 42303. Phone: 270-688-8449. Email: contact@theratreepeds.com.
External Reporting Rights: Patients and representatives are not required to file an internal grievance, obtain TheraTree's permission, or complete an internal appeal before contacting a legally authorized external agency. Internal grievance procedures do not extend or shorten external legal deadlines, waive available remedies, or prevent mandatory reporting.
Civil Rights & Accessibility: Individuals who believe they have experienced discrimination, denial of required language assistance, failure to provide effective communication, or another civil rights violation may contact TheraTree's Section 1557 Coordinator or the U.S. Department of Health and Human Services, Office for Civil Rights. Federal civil rights complaints generally must be filed within 180 days of the alleged violation, although extensions may be available for good cause.
Federal Privacy and Civil Rights: Complaints may be submitted to the U.S. Department of Health and Human Services, Office for Civil Rights, through https://ocrportal.hhs.gov/ or by contacting HHS OCR at 1-800-368-1019 or TDD 1-800-537-7697. Written complaints may be mailed to U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201. Individuals may also submit complaints concerning records protected by 42 CFR Part 2 when applicable.
Kentucky Health & Family Services: Concerns within the jurisdiction of the Kentucky Cabinet for Health and Family Services may be submitted to the Cabinet's Office of the Ombudsman and Administrative Review. Phone: 1-800-372-2973. TTY: 1-800-627-4702.
Insurance: Concerns involving coverage, claims, authorizations, benefits, network participation, cost sharing, or payer decisions may be submitted to the applicable insurance company, Medicaid managed care organization, government healthcare program, or other oversight authority.
Professional Licensure & Certification: Concerns regarding professional conduct, licensure, credentials, supervision, competency, or ethical responsibilities may be submitted directly to the appropriate Kentucky professional licensing board or certification organization:
- Kentucky Board of Licensure for Occupational Therapy | bot.ky.gov | 502-782-8807 | OT@ky.gov
- National Board for Certification in Occupational Therapy (NBCOT) | nbcot.org | 301-990-7979
- Kentucky Board of Speech-Language Pathology and Audiology | slp.ky.gov | 502-782-8801 | SLPA@ky.gov
- American Speech-Language-Hearing Association (ASHA) | asha.org | ethics@asha.org
- Kentucky Board of Physical Therapy | pt.ky.gov
- American Physical Therapy Association (APTA) | apta.org | spec-cert@apta.org
- Kentucky Applied Behavior Analysis Licensing Board | aba.ky.gov | 502-892-4249 | ABA@ky.gov
- Behavior Analyst Certification Board (BACB) | bacb.com
- Kentucky Board of Examiners of Psychology | psy.ky.gov | 502-782-8812 | PSY@ky.gov
- American Board of Professional Psychology (ABPP) | abpp.org | office@abpp.org
- Kentucky Board of Licensed Professional Counselors | lpc.ky.gov | LPC@ky.gov
- National Board for Certified Counselors (NBCC) | nbcc.org | 336-547-0607 | ethics@nbcc.org
- Kentucky Board of Social Work | bsw.ky.gov | 502-564-2350
- National Association of Social Workers (NASW) | socialworkers.org
- Kentucky Board of Licensure for Marriage and Family Therapists | mft.ky.gov | 502-782-8809 | MFT@ky.gov
- American Association for Marriage and Family Therapy (AAMFT) | aamft.org | 703-838-9808
Rev. 4/1/18, 2/15/19, 11,15/21, 11/1/22, 11/14/23, 3/6/25, 9/23/26, 10/20/26, 11/2/26