Elite Sports Physical Therapy (ESPT)

Notice of Privacy Practices (NPP)

This Notice describes how your medical information may be used and disclosed, and how you can access this information. Please review it carefully.

Our Commitment to Your Privacy

At ESPT, we are committed to protecting your personal health information (PHI). Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), we are required by law to maintain the privacy of your PHI, provide you with this Notice, and abide by the terms of this Notice.

How We May Use and Disclose Your Health Information

For Treatment

We may use and share your PHI with healthcare providers involved in your care, such as physicians, specialists, physical therapy students, or other clinicians.

For Payment

We may use and share your PHI to bill and collect payment from you, your insurance company, or a third-party payer. For example, information about your diagnosis, treatment, and progress may be sent to your health plan to confirm medical necessity or obtain prior authorization.

For Healthcare Operations

We may use and share your PHI to support clinic operations, quality assessment, training, accreditation, compliance audits, and staff education. For example, student physical therapists may access your records under PT supervision as part of clinical training.

Other Permitted Uses and Disclosures

We may use and disclose your PHI without your authorization when required or permitted by law, including:

  • Public health activities (disease prevention, reporting adverse events)
  • Regulatory oversight (licensing, inspections, audits)
  • Worker’s Compensation claims
  • Legal proceedings, subpoenas, or court orders
  • Law enforcement purposes
  • To prevent serious threats to health or safety

Uses and Disclosures Requiring Your Authorization

We will not use or disclose your PHI for purposes other than those described above without your written authorization. This includes most uses of psychotherapy notes, marketing, or the sale of PHI. You may revoke an authorization at any time in writing.

Your Rights as a Patient

You have the right to:

    • Access and Copies: Inspect and obtain a copy of your medical records. A reasonable fee may apply.
    • Amendment: Request corrections to your records if you believe information is incomplete or inaccurate.
  • Restrictions: Request limits on how we use or disclose your PHI. While we will consider your request, we are not required to agree to all restrictions.
  • Confidential Communications: Request that we contact you in a specific way (e.g., by mail, email, or phone) or at a specific address.
  • Accounting of Disclosures: Request a list of certain disclosures we have made of your PHI for purposes other than treatment, payment, or operations.
  • Paper Copy: Request a paper copy of this Notice at any time, even if you agreed to receive it electronically.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your PHI.
  • We will notify you promptly if a breach occurs that may compromise the privacy or security of your information.
  • We must follow the duties and privacy practices described in this Notice.
  • We will not use or share your PHI other than as described here unless you provide written authorization.

Complaints and Concerns

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, Office for Civil Rights (OCR).

You will not be retaliated against for filing a complaint.

To file a complaint with ESPT, contact:
 Privacy Officer: Dr. Kimberly Huey
Elite Sports Physical Therapy
194 Francisco Lane, Suite 104
Fremont, CA 94539
Phone: 510-656-3777
Email: kim.espt@gmail.com

To file a complaint with HHS OCR, contact:
 Office for Civil Rights
U.S. Department of Health & Human Services
200 Independence Avenue SW, Washington, DC 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy

Changes to This Notice

We reserve the right to change this Notice at any time. Changes will apply to all PHI we maintain. The revised Notice will be available in our clinic and posted on our website.

Acknowledgment of Receipt

You will be asked to sign a separate form acknowledging that you received this Notice.