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Akron Physician Wellness Initiative Privacy Information 

  • Our office location is private and discreet.
  • Services are free of charge. We do not bill your insurance company.
  • We do not document in CarePath, Epic, eClinicalWorks, or any other shared electronic health record.
  • Our focus is on wellness and performance enhancement, not illness.
  • All visits and presenting concerns are kept strictly confidential. The only exceptions are if the individual is a danger to oneself or others, or if there is knowledge of child or elder abuse or neglect in accordance with mandated reporting laws.
  • We do not share any information with residency programs or medical departments. The only exception is if the individual is, or appears to be, having problems that may impair patient safety or is demonstrating behavior that may be a risk to patients, they will be referred for a “fitness for duty” evaluation. We do not conduct these evaluations.

 

CLIENT RIGHTS AND NOTICE OF PRIVACY PRACTICES

The following privacy practices will be adhered to by all healthcare professionals and employees. APWI is required by law to maintain the privacy of our clients’ personal health information. We reserve the right to change the terms of these practices as necessary and to make the new practice effective for all personal health information maintained by us.

USES AND DISCLOSURES OF YOUR PERSONAL HEALTH INFORMATION

Your Authorization. Except as outlined below, we will not use or disclose your personal health information for any purpose unless you have signed a form authorizing the use or disclosure. You have the right to revoke that authorization in writing unless we have taken any action in reliance on the authorization.

Your Treatment. We will only use and disclose your personal health information as necessary for your treatment. The psychologist, psychiatrist (if applicable), and medical director involved in your care will use information in your record and information that you provide about yourself to plan a course of treatment for you. We WILL NOT release your personal health information to another healthcare facility or professional without your written consent.

Insurance Company. APWI does not bill your health insurance company. Therefore, no information regarding your treatment with us will be disclosed to your insurance company.

Health Information Exchanges. APWI does NOT participate in any electronic Health Information Exchanges. No information regarding your treatment at APWI will be available in your general medical record (such as that maintained by CliniSync or the Ohio Health Information Partnership).

Family and Friends Involved in Your Care. We will not disclose your personal health information to family, friends, supervisors, coworkers, or any other person without your prior written authorization. If you are facing an emergency medical situation and we determine that a limited disclosure may be in your best interest, we may share limited personal health information with such individuals without your approval (see “Other Uses and Disclosures” below).

Appointments and Services. You have the right to request, and we accommodate reasonable requests, to receive communications regarding your personal health information by alternative means or at alternative locations. For instance, you may not want appointment information left on voicemail or sent to a particular address and we will accommodate reasonable requests. You may request such confidential communication on our intake form, or in writing at any time.

Other Uses and Disclosures. We are permitted or required by law to make certain other uses and disclosures of your personal health information without your authorization. We may release your personal health information:

  • for any purpose required by law;
  • as required by law if we suspect child abuse or neglect or if we believe you to be a victim of abuse, neglect, or domestic violence;
  • to protect you or someone else against a clear and substantial risk of imminent serious harm being inflicted;
  • if required by law to a government oversight agency conducting audits, investigations, or civil or criminal proceedings;
  • if required to do so by court or administrative ordered subpoena or discovery request; in most cases you will have notice of such release;
  • if you are a member of the military as required by armed forces services; we may also release your personal health information if necessary for national security or intelligence activities; to workers’ compensation agencies if necessary for your workers’ compensation benefit determination.

YOUR RIGHTS

Access to Your Personal Health Information. You have the right to receive a copy and/or inspect much of the personal health information that we retain on your behalf. All requests for access must be made in writing and signed by you or your authorized or legal representative. We may charge you a reasonable fee if you request a copy of the information. We may also charge for postage if you request a mailed copy. Clients or their authorized or legal representatives may request access to their personal health information by completing the Authorization for Release of Information Form, which is available upon request in our office.

Complaints. If you believe your privacy rights have been violated, you can file a complaint with the APWI Medical Director.

Statement of Non-Discrimination. APWI complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, sex, gender identity, sexual orientation, age, or disability.

FOR MORE INFORMATION

If you have any questions or need further assistance regarding these practices, you may contact us by phone at 330.217.6331, or by U.S. Mail at 47 N. Main St., Suite 138, Akron OH 44308. You have the right to a paper copy of these practices, even if you have requested such copy by other means.

EFFECTIVE February 1, 2021.