Rights and Privacy | Akron Physician Well

Akron Physician Wellness Initiative (APWI)

PATIENT RIGHTS AND NOTICE OF PRIVACY PRACTICES

The following privacy practices will be adhered to by all Akron Physician Wellness Initiative healthcare professionals and employees (referred to as “APWI” or “we”). APWI is required by law to maintain the privacy of our patients’ personal protected health information. We will abide by the terms of this notice for as long as it remains in effect. We reserve the right to change the terms of these practices as necessary and to make the new practices 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 and/or psychiatrist 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 non-APWI affiliated professional without your written consent.

Payment. We may use and disclose your personal, protected health information as necessary to prepare a bill to send to you. This bill is only for the payment purposes of those who have provided services to you. APWI does not bill your health insurance company. Therefore, no information regarding your treatment with APWI will be disclosed to your insurance company.

Healthcare Operations. We may use and disclose your personal, protected health information as necessary and as permitted by law, for our healthcare operations that include clinical improvement, professional peer review, business management, etc. In these cases, disclosure must always be limited to the minimum necessary information for the purpose intended.

Health Information Exchanges. APWI as an entity does NOT participate in any electronic Health Information Exchanges (HIE; such as that maintained by the Ohio Health Information Partnership). Some pharmacies where you choose to fill a prescription may participate in an HIE. This means that if you fill a prescription given to you by an APWI provider at a pharmacy that uses an HIE, information regarding this medication may be available to other healthcare providers or systems that participate in the same HIE as the rendering pharmacy. All HIEs maintain appropriate administrative, physical, and technical safeguards to protect the privacy and security of protected health information. Only authorized individuals may access and use PHI from HIEs. If you have questions or concerns about the use of HIEs, we recommend contacting your preferred pharmacy.

Business Associates. Certain components of our services are performed through contracts with outside organizations such as our telehealth platform, e-prescribing platform, legal services, etc. At times it may be necessary for us to provide some of your personal, protected health information to one or more of these outside persons or organizations who assist us with our healthcare operations. In all cases, we require these business associates to appropriately safeguard the privacy of your information.

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. 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. Patients 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.

Amendments to Your Personal, Protected Health Information. You have the right to request in writing that personal, protected health information we maintain about you be amended or corrected. We are not obligated to make all requested amendments but will give each request careful consideration. All amendment requests, in order to be considered by us, must be in writing, signed by you or your representative, and must state the reasons for the amendment/correction request. If we make an amendment or correction that you request, we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary.

Accounting for Disclosures of Your Personal, Protected Health Information. You have the right to receive an accounting of certain disclosures made by us of your personal, protected health information. Requests must be made in writing and signed by you or your representative. The first accounting in any 12-month period is free; you may be charged a reasonable fee for each subsequent accounting you request within the same 12-month period.

Restrictions on Use and Disclosure of Your Personal, Protected Health Information. You have the right to request restrictions on certain uses and disclosures of your personal, protected health information for treatment or healthcare operations by contacting the Clinical Director. We are not required to agree to your restriction request but will attempt to accommodate reasonable requests when appropriate. We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction by sending such termination notice to the Clinical Director.

Notice of Breach. You will receive notification if there has been an impermissible use or disclosure resulting in the compromise of your unencrypted personal health information.

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.

REVISED September 22, 2023; June 12, 2025.