Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. We are not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, we are required to honor your request for a restriction.
Appears in 7 contracts
Samples: Client Financial Responsibility Agreement, Therapist Client Agreement, Medicare Opt Out Contract Agreement
Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. We are not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, we are required to honor your request for a restrictionrequest.
Appears in 3 contracts
Samples: Interlocal Agreement, Client Therapist Service Agreement, Confidential Fee Agreement
Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, payment or health care operations. We are I am not required to agree to with your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, we are required to honor your request for a restrictionrequest.
Appears in 2 contracts
Samples: Client Disclosure Agreement, Privacy Practices Notification, and Consent for Treatment, Client Disclosure Agreement, Privacy Practices Notification, and Consent for Treatment
Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. We are I am not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In Right to Request Confidential Communication. You have the right to request that case, we are required to honor your request for I communicate with you about treatment matters in a restrictioncertain way or at a certain location.
Appears in 1 contract
Samples: Client Agreement/Informed Consent
Right to Request Restrictions. You have the right to request a restriction or limitation on the PHI we use or disclosure of your PHI disclose about you for treatment, payment, payment or health care operations, or that wedisclose to someone who may be involved in you care of payment for you care, like a family member or friend. We While we will consider your request, we are not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, we are required to honor your request for a restrictionit.
Appears in 1 contract
Samples: Informed Consent & Client Agreement
Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. We are I am not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, we are I am required to honor your request for a restriction.
Appears in 1 contract
