🏅 CQL Person-Centered Excellence Accredited
Indiana Medicaid Waiver Provider
✓ Humana · Anthem · UnitedHealthcare
19 Indiana Counties
- (574) 387-4049
- Mon–Fri 8am–5pm
- After Hours: (574) 250-6306
Legal
HIPAA Notice Of Privacy Practices — Cti Developmental Rehabilitative Services
Effective Date: [DATE BEFORE LAUNCH]
Last Updated: [DATE]
THIS NOTICE DESCRIBES HOW MEDICAL AND PERSONAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
WHO WE ARE
CTI Developmental Rehabilitative Services (CTI) is a Medicaid waiver provider providing home and community-based services to individuals with disabilities and older adults in Indiana. As a covered entity under HIPAA, we are required to maintain the privacy of your protected health information (PHI) and to provide you with this Notice.
YOUR PHI RIGHTS
You have the right to: (1) Request a restriction on how we use or disclose your PHI; (2) Receive confidential communications; (3) Inspect and obtain a copy of your PHI; (4) Request that we amend your PHI; (5) Receive a list of disclosures; (6) Receive a paper copy of this Notice. To exercise these rights, contact our Privacy Officer at (574) 387-4049 or info@childrensti.com.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with CTI's Privacy Officer at (574) 387-4049 or info@childrensti.com, or with the U.S. Department of Health and Human Services Office for Civil Rights at www.hhs.gov/ocr.
CONTACT
Privacy Officer, CTI Developmental Rehabilitative Services | 2012 Ironwood Circle, Suite 230, South Bend, IN 46635 | (574) 387-4049 | info@childrensti.com