EMPLOYEE CONFIDENTIALITY AGREEMENT
AS REQUIRED BY
PORTABILITY AND ACCOUNTABILITY ACT
As an employee with Elm City Center
you will have access to information related to our consumers and the
business of Elm City Center. Illinois and U.S. law mandates that personal
health information be kept confidential except under specific circumstances.
Personal health information includes demographic, billing, and medical
information about the consumer. The fact that someone is receiving care is
also to be kept confidential. This information cannot be shared with others
except for the purposes of treatment, payment, and health care operations or
with the consent of the consumer or as provided by law.
Information related to the business
of our practice is also confidential and proprietary.
This includes billing and
employment information, business plans, and any information on the
day-to-day operations of Elm City Center. This information may only be
shared in the context of your work responsibilities.
As an employee, you agree that you
will keep confidential the personal health information of our consumers and
our business information. You understand that breaching confidentiality of
the consumerís personal health information is a violation of law, and could
result in legal action. Additionally, breaching consumer confidentiality or
the confidentiality of our business information may subject you to
discipline, up to and including termination.
Your duty to keep confidential
consumer and business information remains even after you are no longer
employed by Elm City Center.
I acknowledge that as part of my
training on confidentiality I was trained regarding Elm City Centerís
policies and procedures related to Health Insurance Portability And
Accountability Act (HIPAA).
I have read and understand the
above Confidentiality Policy and recognize that a breach of the
confidentiality of consumer or business information may result in
discipline, up to and including, termination of employment.
Name of Employee