privacy (hipaa) information

HIPPA Stack Of Forms

HIPAA Compliance

Last updated: February 2018

Concentra makes all reasonable efforts to comply with HIPAA — the Health Insurance Portability and Accountability Act of 1996 – and privacy regulations and State privacy laws and regulations. We take these matters very seriously and have instituted numerous internal and external measures to maximize compliance. The following related pages detail our full HIPAA and privacy program:

  • HIPAA Information — General discussion about protected health information (PHI) and Concentra’s role in protecting it 
  • Notice of Privacy Practices — Describes your guaranteed rights under HIPAA and how Concentra can user your protected health information (PHI)
  • Confidentiality Statement — Detailed, legal description of the requirements protecting the privacy of our patients’ health information 
  • Internet Privacy Policy — Our company’s specific statement on protecting personally identifiable information (PII) that's communicated through this medium
    Privacy Concerns Woman Typing Records

    Privacy (HIPAA) Concerns

    For HIPAA-related issues or questions, please contact us at 800.819.5571.

      Forms for Patient Rights

      The following forms are to be used in connection with patient's guaranteed rights under HIPAA:

      • Access Records Request— This form is used to access a patient’s record. Please note: The Concentra Privacy Office does not process/fulfill Access Requests. Completed Access Request forms should be submitted to the Medical Records Custodian for the center where the patient was seen. Please use our Location Finder tool for center contact information (phone, mailing address, fax).
      • Amend Records Request — This form is used to request a modification to a patient's information that was created by Concentra because the patient feels that the information is inaccurate or incomplete. This does not include clerical corrections, such as address, date of birth, employer, etc.
      • *Confidential Handling Request — This form is used to request an alternate method of communication (i.e. a different email, cellphone, or address) than what is on file for confidentiality reasons. This form should not be used for requesting a patient’s medical record. Please use the form linked under the header Access Records Request if the intended goal is to obtain patient medical records.
      • *Restriction Request — This form is used to request a limitation or restriction of disclosure of patient PHI to a health plan or carrier when a private pay patient has paid in full. The form is also used to request a limitation or restriction of disclosure of patient’s PHI to others such as a family member physician or employer (this does not apply to workers compensation).
      • Complaint Form — This form may be used for a patient to submit a HIPAA complaint or report an alleged privacy violation to the Concentra Privacy Office. You may also submit a complaint directly to center leadership where you were seen, or via our HIPAA Hotline at 1-800-819-5571.
      • Disclosure Accounting  Request — This form is used to request a list of disclosures to governmental agencies, research groups, law enforcement, etc., when the patient’s authorization is not required under HIPAA.

      *These rights may be limited for certain services, such as workers compensation.