Skyward Speech Therapy LLC
Notice of Privacy Practices 

Effective date: February 9, 2024 

This notice tells you how your medical record may be used  and shared and how you may get this information. Please read it carefully. 

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential.  This Act gives you, the patient, significant new rights to understand and control how your health information is used. We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information. HIPAA provides penalties for covered entities that misuse personal health information.

As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

Our Pledge To You

Your health information is something that Skyward Speech Therapy LLC has always worked  to keep private. We are ethically and legally obligated to keep it confidential under  state and federal laws.  

What Is This Document?

This document, called a Notice of Privacy Practices, tells you how we may use and  share your health information. This includes using and sharing it so that we may  provide you with health care and be paid for it, and so that we may run our business  and follow state and federal legal rules. We must follow the terms of this notice. 

Who Is Covered In This Notice?

The following people must adhere to the rules in this notice:

• All speech-language pathologists working at Skyward Speech Therapy LLC

• Anyone who is allowed to add health information to your file, including students and other staff

• Any volunteers who may help you while you are in this clinic

Ways We May Use And Share Your Health Information  Without Your Permission 

• Treatment. We may share information with doctors and other health care providers who care for you. For example, if your doctor orders speech therapy, we will share the results of our treatment with that doctor.

• Payment. We may use and share information about the treatment you receive with your insurance company or other payer to receive payment for services. This may include sharing important medical information. We may share information for any of the following reasons:

  • To get the insurance company’s permission to start treatment

  • To get permission for more treatment

  • To get paid for the treatment you receive

• Health Care Operations. We may use and share your health information to run the clinic and be sure that all patients receive good care. For example, we may use your health information to

  • see how well our services are working; 

  • see how well our staff is doing;

  • see how we compare to other clinics;

  • make our services better; and/or

  • help others study health care services.

Your Health Information May Also Be Used or Shared Without Your Permission for:

• Abuse and Neglect. We may share your health information with government agencies when there is evidence of abuse, neglect, or domestic violence. 

• Appointment Reminders. We will use your information to remind you of upcoming appointments. Reminders may be sent in the mail, by email, or by phone call or voice mail message. If you do not wish to get reminders, please tell your speech-language pathologist.

• As Required by Law. We will share your information when we are told to do so by federal, state, or local law. We will also share information if we are asked by the police or courts.

• Government Functions. Your information may be shared for national security or military purposes. If you are a veteran, your information may be shared with the U.S. Department of Veterans Affairs. 

• Information About a Person Who Has Died. We may share information with the coroner, the medical examiner, or a funeral director, as needed.

• Public Health Risks. We may report information to public health agencies as required by law. This may be done to help prevent disease, injury, or disability. It may also be done to report medical device safety issues to the Food and Drug Administration and to report diseases and infections.

• Regulatory Oversight. We may use or share your information with agencies overseeing health care. This may include sharing information for audits, licensure, and inspections.

• Research. We may share your health information with researchers to be included in their research project. Information will be shared only for projects that have been through a special approval process. These projects also have rules to protect your privacy, and your permission may be sought separately by project coordinators for this purpose.

• Threats to Health and Safety. Your health information may be shared if we believe that it will prevent a threat to your health and safety or the health and safety of others.

• Workers’ Compensation. We will share your information with the U.S. Department of Labor’s Office of Workers’ Compensation Programs (OWCP) if your case is being considered as a work-related injury or illness.

When Your Permission Is Needed To Use or Share Your Health Information

You must give us permission to use or share your health information for any situation that is not listed in this notice. You will be asked to sign a form, called an authorization, to allow us to use or share your information. You are allowed to take back this authorization—called revoking authorization—at any time. We will not be able to get back the information that we had originally shared with your permission. We may (only with your permission) use your information to let you know of other services that might be of interest to you.

Your Privacy Rights

You have the right to do the following:

• Ask us not to share your information. You can ask us not to use or share your information for treatment, payment, or health care operations. You can also ask us not to share information with people involved in your care, such as family members or friends. You must ask for limits in writing. We must share information when required by law. We do not have to agree to what you ask.

• Ask us to contact you privately. You can ask us to contact you only in a certain way or at a certain place. For example, you may want us to call you but not to e-mail you. Or you may want us to call you at work but not at home. You must ask us in writing. We will make every effort to comply with your request.

• See and get a copy of your health information. You have the right to see your health information and to get a copy of that information. You have a right to see treatment, medical, and billing information. You may not be able to see or copy information put together for a court case, certain lab results, and copyrighted materials, such as test protocols.

• Ask for changes to your health information. You can ask us to change information that you think is wrong. You can also ask that we add information that is missing. You must ask us in writing and give us a reason for the change. We do not have to make the change.

• Get a report of how and when your information was used or shared. You can ask us to tell you when your information was shared and who we shared it with. There are some rules about this:

  • You need to ask us in writing. 

  • You must tell us the dates you are asking about and if you want a paper or electronic copy.

  • You may get information going back 6 years, but it cannot be for earlier than
    April 14, 2003. This is the date when the government privacy rules took effect. 

• Get a paper copy of this privacy notice. You can get a paper copy of this notice at any time. You can get a copy even if you have already signed the form saying you have seen this notice.

• File complaints. You can file a complaint with us or with the U.S. Office of Civil Rights if you think that

  • your information was used or shared in a way that is not allowed;

  • you were not allowed to look at or get a copy of your information; or

  • any of your rights were denied.

Your Rights Regarding Your Health Information 

You have certain rights regarding your health information, described below. These rights apply to the health information we keep. You must submit a written request to use any of these rights. You can send your written request to Skyward Speech Therapy LLC at the address given at the end of this notice. 

• Right to Request Special Communications. You have the right to ask us to contact you about medical matters in a certain way or at a certain place. We will follow all reasonable requests. Your request must tell us how you wish to be contacted.  

• Right to Inspect and Copy. You have the right to read or get a copy of your health  information, with some exceptions. We may turn down your request under certain  circumstances. If we do so, you may ask for a licensed health-care professional chosen by us to review why we turned you down. We will follow the reviewer’s decision.  

• Right to Request Changes. If you believe the health information that we created is wrong or incomplete, you may ask us to change it. You must provide a reason why you want the change. We cannot take out or destroy any information already in your medical record. We also are not required to agree to make the change. If we do not agree to the change, you can write a letter about the changes. We will send  you one back saying why we will not make the changes. You may then send another disagreeing with us. It will be attached to the information you wanted changed or  corrected.  

• Right to an Accounting of Disclosures. We are required to track who we share your health information with under certain circumstances. You have the right to ask for a copy of this list. We do not have to track every time we share your health  information with others. Your request must give a time period, which may not be longer than 6 years and may not include dates before April 14, 2003.  

• Right to Request Restrictions. You have the right to ask for a restriction or limitation on the medical information we use or share about you for payment, treatment, or health-care operations and the information we may share with your  family, friends, or others involved in your care. We are not required to agree to your  request. If we agree, we will follow your request unless the information is needed to provide you with emergency treatment. You must tell us the type of restriction you want and to whom it applies.  

• Right to a Paper Copy of This Notice. You have the right to a paper copy of this  notice. Copies of this notice will be posted and available at www.skywardspeech.com.  

Other Uses And Sharing Of Your Health Information 

All other uses and sharing of your health information will be done only with your  written permission.  

Changes To This Notice 

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for your health information we already have as well as any we get in the future. Any changes in this notice are posted on our website at www.skywardspeech.com. The revised notice also will be emailed to you when the updates are made.

What If I Have Questions Or Need To Report A Problem?

If you have any questions about this notice or about how your health information is used or shared by us please contact Skyward Speech Therapy LLC by e-mail at mayderry@skywardspeech.com or by calling (316)-210-3709. If you believe your privacy rights were violated, you may file a complaint with us. We will not retaliate against you for filing a complaint. Please give as much information as possible so that the complaint can be properly investigated.  

You may also file a complaint to your regional office of the U.S. Office of Civil Rights. To find out more about filing complaints, go to www.hhs.gov/hipaa/filing-a-complaint.