This Notice of Privacy Practices (“Notice”) describes how medical information about you may be used and disclosed, and how you can access this information. Please review it carefully.

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Our Legal Duty

Kinetic Performance Physical Therapy (“the Practice”) is committed to protecting the privacy of your Protected Health Information (“PHI”). We are required by law to:

    •    Maintain the privacy and security of your PHI under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and Florida Statutes §456.057.

    •    Provide you with this Notice explaining our duties and privacy practices.

    •    Notify you in the event of a breach of your unsecured PHI.

    •    Abide by the terms of this Notice.

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How We May Use and Disclose Your Information

We may use or disclose your PHI without your written authorization for the following purposes:

Treatment

To provide, coordinate, or manage your healthcare and related services. For example, we may share information with your physician or other healthcare providers involved in your care.

Payment

To bill and collect payment from you, your insurance company, or a third-party payer for the services you receive.

Healthcare Operations

For activities that support our practice operations, such as quality assessment, staff training, compliance programs, or accreditation.

As Required by Law

We may disclose PHI when required by federal, state, or local law. Examples include:

    •    Public health reporting

    •    Health oversight activities (audits, investigations, inspections)

    •    Judicial or administrative proceedings

    •    Law enforcement purposes

    •    Workers’ compensation claims

    •    National security or protective services

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Other Uses Requiring Authorization

We will obtain your written authorization for:

    •    Most uses and disclosures of psychotherapy notes

    •    Marketing communications not otherwise permitted by law

    •    The sale of your PHI

You may revoke an authorization at any time in writing, except where we have already relied on it.

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Your Rights

You have the following rights regarding your PHI:

    •    Access: You may inspect or obtain a copy of your medical records.

    •    Amendment: You may request corrections if your records are incomplete or inaccurate.

    •    Accounting of Disclosures: You may request a list of disclosures of your PHI made by the Practice.

    •    Restrictions: You may request limitations on how we use or disclose your PHI. We are not required to agree to all requests unless required by law.

    •    Confidential Communications: You may request that we communicate with you in a certain way (e.g., by phone, mail, or email).

    •    Paper Copy: You may request a paper copy of this Notice, even if you receive it electronically.

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Florida-Specific Protections

Florida law provides additional privacy protections. For example, records related to mental health, substance abuse, HIV/AIDS, and genetic information are subject to heightened protection and cannot be disclosed without your written consent, except as required or permitted by law.

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Breach Notification

If a breach occurs involving your unsecured PHI, we will notify you in compliance with both HIPAA and Florida law.

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Complaints

If you believe your privacy rights have been violated, you may file a complaint with any of the following:

The Practice:

Kinetic Performance Physical Therapy

753 Shotgun Road

Sunrise, FL, 33326

Phone: 732-991-2031

Email: info@kineticperformancept.org

Florida Agency for Health Care Administration (AHCA):

HIPAA Privacy Officer

2727 Mahan Drive, Mail Stop #6

Tallahassee, FL 32308

Phone: (888) 419-3456

Website: https://ahca.myflorida.com

U.S. Department of Health and Human Services, Office for Civil Rights

200 Independence Avenue, S.W.

Washington, D.C. 20201

Phone: (800) 368-1019

TDD: (800) 537-7697

Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not face retaliation for filing a complaint.

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Contact Information

For more information about this Notice or to exercise your privacy rights, please contact:

Kinetic Performance Physical Therapy

753 Shotgun Road

Sunrise, FL, 33326

Phone: 732-991-2031

Email: info@kineticperformancept.org