The Maryland Therapy Network
Speech-Language Therapy
Physical Therapy * Occupational Therapy

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The Maryland Therapy Network Inc. has implemented the following policies and procedures so that the confidentiality of your personal and/or medical information remains confident.

Your physician(s) and all other employees working in the practice will keep any information related to you (medical and/or non-medical) in a confidential manner. However, so that we may provide you with appropriate medical care for general practice operations and/or for the purposes of obtaining payment, we will, at our discretion, provide information pertaining to the treatment you received in this practice, the charges for this treatment and related information to other healthcare-related entities. This information will be submitted through the following mechanisms: U.S. Postal Service, facsimile, internet, voice/mail and/or personal communications. The following is a list of the most common types of entities to whom we most typically would provide personal health-related information. This list is not all-inclusive. Other entities may be added in the future.

Physicians and non-physician providers who work outside of this practice.
Medical facilities (i.e., hospitals, surgery centers, nursing homes).
Laboratories for the purpose of running medical tests.
Other healthcare providers, such as ambulance services, clinical research organizations, county health departments, and hospitals.
Insurance companies (or third party administrators) for the purpose of obtaining payments, reviewing medical necessity and/or general case management.
State or Federal agencies that require the submission of specific health related information.
Non-healthcare providers, such as public education systems.
Lawsuits and similar proceedings in response to a court or administrative order.

We may mail the following to you: new patient forms, appointment correspondence, account statements, brochures, etc. In addition, we may need to contact you by phone to discuss your office appointments, test results, treatments, referrals, account balances and/or to return your phone calls. We will first attempt to contact you at home, however, if you are not available and you provide us with your work number, we will attempt to contact you at work. If you are not available, we will leave a message for you to either call the office or to remind you of your appointment time.

In the event you do not pay all of your charges in full at the time of your visit, we will mail a statement to your home. Depending on your specific situation, we may mail correspondence to your home noting that you need to contact the office to schedule an appointment. Periodically, we may mail test result information to your home. We will use the home address you provided us with at the time you register with the practice.

We may contact your insurance company to determine your coverage, eligibility, deductible status and/or your co-insurance and co-pay requirements.

We will do our best to see you promptly. However, there may be times when your provider is running behind schedule and you will need to wait in the waiting room.

If you would like copies of your medical records and/or information sent to another physician or medical facility, you must authorize the release of this information in writing (we will provide you with the necessary form to complete). You must also provide written authorization for the release of information to your life insurance carrier, disability insurer or other entity.

Please provide us with current information regarding your phone numbers (home and work) and home billing address. This will allow us to make the correct contact when trying to reach you.

You may authorize The Maryland Therapy Network Inc. to use photographs, videotapes and/or new articles for the purpose of internal and/or external publicity. You grant freely and without expectation of any compensation, monetary or otherwise, permission to release these photographs, videotapes and/or news articles to the news media with pertinent information relating to the programs and activities of The Maryland Therapy Network Inc.

When necessary, these policies will be modified with the policies to ensure compliance with practice operations and with State and Federal Privacy regulations.

If you have any questions or concerns with the policies and/or procedures noted above, or wish to request any modification to our privacy statement, please contact our practice administrator at 410-569-0990 to discuss them. We trust that you are comfortable with our sincere efforts to maintain the confidentiality of the information related to your medical care.

A Team Approach to Habilitative and Rehabilitative Care
Children's Medical Services Provider since 1987 through DHMH