Information We Collect Automatically
If you visit our website to browse, read, or download information:
* Your web browser automatically sends us (and we may retain) information such as the:
o Internet domain through which you access the Internet (e.g., yourServiceProvider.com if you use a commercial Internet service provider, or yourSchool.edu if you use an Internet account from your school);
o type of browser software and operating system you are using;
o date and time you access our site; and
o the Internet address of the site from which you linked directly to our site.
* We will use this information as aggregate data to help us maintain this site, e.g., to determine the number of visitors to different sections of our site, to ensure the site is working properly, and to help us make our site more accessible and useful.
* We will not use this information to identify individuals, except for site security or law enforcement purposes.
* We will not obtain personally-identifying information about you when you visit our site, unless you choose to provide such information.
Other Information We Collect
If you choose to identify yourself (or otherwise provide us with personal information) when you use our online forms:
* We will collect (and may retain) any personally identifying information, such as your name, street address, email address, and phone number, and any other information you provide. We will use this information to try to fulfill your request and may use it provide you with additional information at a later time.
* If your communication relates to a law enforcement matter, we may disclose the information to law enforcement agencies that we deem appropriate.
How Long We May Keep Information
We may keep information that we collect for an unlimited period of time.
Please note that electronic communication, particularly email, is not necessarily secure against interception. Please do not send sensitive data (e.g., private health information, Social Security numbers, bank account or credit card information) by email or web form.
HIPPA Notice of Privacy Practices
Your Information. Your Rights. Our Responsibilities.
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.
*The terms of this notice apply to all records containing you and your child’s individually identifiable health information that are created, received, used, disclosed and/or retained by our practice. For purposes of this Notice, the terms “my,” “you” and “your” may also mean “my child,” “your child” or individual that you are enrolling in Blue Bird Day, LLC.
You have the right to:
* Get a copy of your paper or electronic medical record
* Correct your paper or electronic medical record
* Request confidential communication
* Ask us to limit the information we share
* Get a list of those with whom we’ve shared your information
* Get a copy of this Privacy Notice
* Choose someone to act for you
* File a complaint if you believe your privacy rights have been violated
You have some choices in the way that we use and share information as we:
* Tell family and friends about your condition
* Provide disaster relief
* Provide mental health care
* Market our services
* Raise funds
Our Uses and Disclosures
We may use and share your information as we:
* Provide treatment
* Run our organization
* Bill for your services
* Help with public health and safety issues
* Do research
* Comply with the law
* Respond to organ and tissue donation requests
* Work with a medical examiner or funeral director
* Address law enforcement, and other government requests
* Respond to lawsuits and legal actions
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
* You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. All requests must be made in writing.
* We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your health information
* You can ask us to correct health information about you that you think is incorrect or incomplete. All requests must be made in writing.
* We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
* You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a certain address, by making a written request to us.
* Your written request must be addressed to the Blue Bird Day, LLC Privacy Official listed at the end of this Privacy Notice, and it must specify how or where you would like us to contact you. We will say “yes” to all reasonable requests.
* We may deny a request if you have not explained how payment will be handled (if applicable), or if you have not specified an alternative address or method of contact.
Ask us to limit what we use or share
* You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your therapy.
* If you pay for a service out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
* You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
* We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
* You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
* If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
* Before we take any action, we will make sure the person has this authority and can act for you.
File a complaint if you feel your rights are violated
* You can complain if you feel we have violated your rights by contacting our Privacy Official at the address and phone number listed at the end of this Privacy Notice.
* You can file a complaint with the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
* We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to:
* Share information with your family, close friends, or others involved with the treatment
* Share information in a disaster relief situation
* Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
* Marketing purposes
* Sale of your information
* Most sharing of psychotherapy notes
In the case of fundraising:
* We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways:
We can use your health information and share it with other professionals who are treating you.
Example: We may disclose health information to doctors, nurses, or other therapist(s), including people outside of our office who are involved in your child’s treatment and need the information to provide your child with appropriate services.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We may use and disclose health information about you to manage and improve our services and treatment.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We may use and share your information for billing and payment from you, an insurance company, Early Intervention Central Billing Office or other third party.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html
Help with public health and safety issues
We can share health information about you for certain situations such as:
* Preventing disease
* Helping with product recalls
* Reporting adverse reactions to medications
* Reporting suspected abuse, neglect, or domestic violence
* Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with HHS if it wants to see that we’re complying with federal privacy law.
Address law enforcement and other government requests
We can use or share health information about you:
* For law enforcement purposes or with a law enforcement official
* With health oversight agencies for activities authorized by law
* For government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
* We are required by law to maintain the privacy and security of your protected health information.
* We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
* We must follow any state or federal law that contains greater privacy protections than HIPAA. For example, Blue Bird Day, LLC follows the Illinois Mental Health and Developmental Disabilities Confidentiality Act concerning mental health records.
* We must follow the duties and privacy practices in this notice and give you a copy of it.
* We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office and on our web site. If you have any questions, please contact our Privacy Official:
310 N. Loomis St.
Chicago, IL 60607
Phone: (312) 243-8487
* Blue Bird Day, LLC is equipped with security cameras to promote health and safety during treatment. The footage will be accessed by authorized professionals.
* We will never share any substance abuse treatment records without your written permission.
* We will never market or sell your personal information.