Patient Privacy

Notice of Privacy Practices

Insurance Verification:

The first major step in admitting a patient into our facilities is to verify a candidate’s medical coverage – if available. Once the insurance coverage is confirmed, an assessment and evaluation are done. Both of these easy steps can usually be completed right over the phone. Once approved and scheduled, we arrange to pick up arriving patients right at the airport for your convenience.

Why you are receiving a notice from your doctors and health plan:

Your health care provider and health plan must give you a notice that tells you how they may use and share your health information and how you can exercise your health privacy rights. In most cases, you should get this notice on your first visit to a provider or in the mail from your health insurer, and you can ask for a copy at any time. The provider or health plan cannot use or disclose information in a way that is not consistent with their notice.

Why you are asked to sign a form:

The law requires your doctor, hospital, or any other health care provider you see in person to ask you to state in writing that you received the notice. Often, that means the doctor will ask you to sign a form stating that you received the notice that day.

  • The law does not require you to sign the acknowledgment of receipt of the notice.
  • Signing does not mean that you have agreed to any special uses or disclosures of your health records.
  • Refusing to sign the acknowledgment does not prevent the entity from using or disclosing health information as the rule permits it to do.
  • If you refuse to sign the acknowledgment, the provider must keep a record that they failed to obtain your acknowledgment.

What is in the Notice?

The notice must describe:

  • The ways that the Privacy Rule allows the covered entity to use and disclose protected health information. It must also explain that the entity will get your permission, or authorization, before using your health records for any other reason.
  • The covered entity’s duties are to protect health information privacy.
  • Your privacy rights, including the right to complain to HHS and to the covered entity if you believe your privacy rights have been violated.
  • How to contact the entity for more information and to make a complaint.

When and how you can receive a Notice of Privacy Practices:

  • Most covered health care providers must give notice to their patients at the patient’s first service encounter (usually your first appointment). In emergency treatment situations, the provider must give the patient the notice as soon as possible after the emergency. It must also post the notice in a clear and easy-to-find location where patients are able to read it.
  • A health plan must give its notice to each new enrollee at enrollment, and send a reminder to every enrollee at least once every three years that the notice is available upon request. A health plan can give the notice to the named insurer, that is, the subscriber for coverage. It does not also have to give separate notices to any covered spouses and dependents.
  • A covered entity must give a copy of the notice to anyone who asks for one. If a covered entity has a website for customers, it must post its notice in an obvious spot there.



This notice is effective as of July 20, 2016



Behavioral Health of the Palm Beaches, Inc. uses and discloses your protected health information for treatment, payment, and health care operations. Some examples of when our office may use or disclose your health care information for these purposes include:

Sharing test results with other health care providers for confirmation of a diagnosis;
Providing your diagnosis or other information about your health to your insurance provider or our billing service to obtain payment for the health care services we provide;
Reviewing information as part of our quality improvement program.


Behavioral Health of the Palm Beaches, Inc. may also use or disclose your protected health information, in compliance with guidelines outlined by law, for the following purposes:

Providing you with information related to your health;
Contacting you regarding appointments, information about Behavioral Health of the Palm Beaches, Inc., or other health related services;
Incidental uses or disclosures (e.g., listing your name on a sign-in sheet, etc.); Compliance with all laws (including reports of suspected abuse, neglect or violence); Providing certain specified information to law enforcement or correctional institutions;
Providing information to a coroner, medical examiner, funeral director or organ procurement organization;
Public health activities when requested by a public health authority or the FDA. Responding to health oversight agencies;
Responding to court or administrative tribunal orders, subpoenas, discovery requests, or other lawful process;
Research activities;
When necessary to avert a serious threat to health or safety;
Military affairs, veterans affairs, national security, intelligence, Department of State, or presidential protective service activities;
Providing information regarding your location, general condition, or death, to public or private disaster relief agencies; or
Providing information to a family member, other relative, or close personal friend, relative to your location, general condition, or death;
To assist in your health care (e.g. pick-up prescriptions or other documents, note follow-up care instructions, etc.)


Behavioral Health of the Palm Beaches, Inc. will make other uses and disclosure of your protected health information only after obtaining your written authorization. If you authorize a use not contained in this notice, you may revoke your authorization at any time by notifying us in writing that you wish to revoke your authorization.


Subject to limitations outlined by law, you have certain rights related to use and disclosure of your protected health information, including the right to:

Request restrictions on certain uses and disclosures. However, Behavioral Health of the Palm Beaches, Inc. is not obligated to agree to requested restrictions.
Receive confidential communications (e.g., home phone, work phone, etc.) or protected health information. We will comply with reasonable requests.
Request to see or receive an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or summary of your health information, in most instances, within 30 days. If we are unable to provide the requested information within 30 days, we will give you an explanation as to why not.

Inspect and copy your protected health information, with some limited exceptions,
Request that we amend or correct your private health information. We may deny your request, but we will notify you why within sixty (60) days.
Receive an accounting of disclosures of your health information, for a period of six (6) years after your discharge, except for disclosures made at your request, or relative to your treatment, payment, or our company operations.
Request that someone act on your behalf, for example, by giving someone medical power of attorney, or by appointing someone as your legal guardian.
Obtain a copy of this notice. We will provide you with a paper copy of the notice promptly upon your request.


Subject to limitations outlined by law, Behavioral Health of the Palm Beaches, Inc. has certain duties related to your protected health information, including:
Behavioral Health of the Palm Beaches, Inc is required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.
Behavioral Health of the Palm Beaches, Inc. is required to abide by the terms of the privacy notice that is currently in effect.
Behavioral Health of the Palm Beaches, Inc. reserves the right to change a privacy practice described in this notice and to make such change effective for all protected health information. Revised notices will be posted in our offices, on our website, and available upon request.
Behavioral Health of the Palm Beaches, Inc. is required by law to let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
Behavioral Health of the Palm Beaches, Inc. will not use your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

If you believe your privacy rights have been violated, you may make a complaint by contacting: Ariana Raub, Patient Advocate, Behavioral Health of the Palm Beaches, 2976 South Military Trail, West Palm Beach, FL 33415, (561) 465-1443, or to:

Timothy Noonan
Regional Manager Office for Civil Rights, U.S. Department of Health and Human Services
Sam Nunn Atlanta Federal Center
Suite 16T701 Forsyth Street, S.W.
Atlanta, GA 30303-8909
Voice Phone (800) 368-1019
FAX (404) 562-7881
TDD (800) 537-7697

No individual will be retaliated against for filing a complaint.