Mobile Therapy Centers of America, LLC (MTC) Notice of Patient Information Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO INFORMATION.

Mobile Therapy Centers of America’s Legal Duty
Mobile Therapy Centers of America, LLC (MTC) is required by the Health Insurance Portability Accountability Act of 1996 (HIPAA) to protect the privacy of your personal health information, provide this notice about our information practices, and follow the information practices that are described herein.

Uses And Disclosures Of Health Information

MTC uses your personal health information primarily for treatment, obtaining payment for treatment, conducting internal administrative activities, and evaluating the quality of care we provide. For example, MTC may use your personal health information to contact you to provide appointment reminders, to provide information about treatment alternatives, or any other health related benefits that could be of interest to you.

MTC may also use or disclose your personal health information without prior authorization for public health purposes, auditing purposes, or for emergencies. We may provide de-identified information for research studies. We also provide information when required by law.

In any other situation, MTC will obtain your written authorization before disclosing your personal health information. If you provide us with a written authorization to release your information for any reason, you may later revoke that authorization to stop future disclosures at any time.

MTC may change its policy at any time. When changes are made, a new Notice of Information Practices will be posted in a common area of the clinic, designated child care center, or otherwise provided to you. You may also request an updated copy of our Notice of Patient Information Practices at any time.

PATIENT’S INDIVIDUAL RIGHTS

You have the right to review or obtain a copy of your personal health information at any time. You have the right to request that we correct any inaccurate or incomplete information in your records. You also have the right to request a list of instances where we have disclosed your personal health information for reasons other than treatment, payment, or other related administrative purposes.

You may also request in writing that we not use or disclose your personal health information for treatment, payment, and administrative purposes except when specifically authorized by you, when required by law, or in emergency situations. MTC will consider all such requests on a case-by-case basis, but are not legally required to accept them.

If you have any questions about this privacy statement, the practices of this site, or your dealings with this Web site, please contact us at info@mtcus.com.

Management

Mobile Therapy Centers of America, LLC
1870 W. Winchester Road
Suite 203
Libertyville, IL 60048
Phone: .847-816-7200
Fax: 847-816-7210
Email: info@mtcus.com