privacy (hipaa) information

HIPPA Stack Of Forms

HIPAA Compliance

Last updated: October 2015

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 — This form is used to request access to a patient's record. The records can be provided in person by mail, email or fax.
      • Amend — 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 — This form is used for a patient to request alternate methods of communication, such as email, cell phone, or a different address than the home address on file.
      • *Restrictions — 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 Forms — This form may be used for a patient to submit a HIPAA complaint or report an alleged privacy violation to the Privacy Office.
      • Account 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.