HIPAA NOTICE OF PRIVACY PRACTICE

Notice of Privacy Practices

Effective Date: 11/01/2025

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

Our Responsibilities

Essence Physical Therapy is required by law to:

• Maintain the privacy of your Protected Health Information (PHI)

• Provide you with this Notice of Privacy Practices

• Follow the terms of this notice

How We May Use and Disclose Your Health Information

We may use and disclose your PHI for the following purposes:

Treatment
To provide, coordinate, or manage your physical therapy care, including communication with other healthcare providers involved in your treatment.

Payment
To obtain payment for services, including billing Medicare or providing documentation for reimbursement.

Healthcare Operations
To support practice operations such as quality improvement, scheduling, documentation, and compliance activities.

Other Uses Permitted or Required by Law

We may disclose PHI without your authorization for:

• Public health and safety requirements

• Legal proceedings

• Health oversight activities

• Abuse or neglect reporting

• Workers’ compensation claims

• Law enforcement or national security purposes

  Uses Requiring Authorization

Any use or disclosure not listed above will be made only with your written authorization. You may revoke authorization in writing at any time, except where action has already been taken.

Your Rights

You have the right to:

• Inspect and obtain a copy of your health records

• Request corrections to your records

• Request restrictions on certain uses or disclosures

• Request confidential communications

• Receive an accounting of disclosures

• Obtain a paper copy of this notice

We are not required to agree to all requested restrictions.

Changes to This Notice

We reserve the right to change this notice and make the new notice effective for all PHI we maintain. Updated notices will be available upon request and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate for filing a complaint.

Contact Information / Privacy Officer

Privacy Officer: Dr. Neeraja Suryawanshi, PT,DPT
Practice: Essence Physical Therapy
📞 Phone: 516-395-1674
📧 Email: NS@ESSENCEREHAB.COM