Summary of Notice of Privacy Practices

What Health Information Is

Whenever an ATC provider treats you, health information is created.  Health Information may be written (e.g., an entry into the data book or treatment plan), spoken (discussion amongst therapists and/or doctors), or electronic (bills saved onto a computer).

The law permits ATC to use or disclose Health Information for these routine activities:

  • For Treatment
  • For Payment
  • For Health Care Operations
  • For Appointment Reminders/Communication

Other examples of permitted uses and disclosures of Health Information:

  • Uses and disclosures permitted or required by law
  • Some research activities
  • Some marketing activities
  • Public health activities

Activities you can object to

In many circumstances, you may have the right to object before we disclose certain information

Activities that require your written permission (authorization)

If ATC needs to use or disclose your health information for other purposes, we must first receive your written authorization.

Your Patient Privacy Rights

You have the right to:

  • Request how we contact you
  • Inspect, and receive a copy of, your medical and billing records
  • Request corrections to your medical and billing records
  • Receive an accounting (list) of certain disclosures
  • Receive a copy of ATC’s Notice of Privacy Practices.  You can get a current notice form upon request at any time.
  • Request restrictions on uses and disclosures of your health information.  (We may not be able to grant requests beyond what the law requires).

Please contact Kim Bingen-Ward, MSW, CAPSW, at (414) 475-1896 if you have questions or concerns regarding privacy practices.

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