<b>Case Management Disclosure</b>

DISCLOSURE OF INFORMATION

Case Management Relationship

First Rehabilitation Resources, Inc. (FRR) is a privately owned and operated organization. A third party has requested that FRR provide case management services on your behalf, and have agreed to pay for the requested case management services

You have been assigned a FRR Case Manager to assist you throughout the rehabilitation process, and should refer to the FRR website, www.1strehab.com, tab Rehab Participants to learn more about the role of a Case Manager. If you are unable to access the FRR website, your FRR Case Manager can provide the information via paper documents upon request

FRR does not compensate Case Managers based on utilization of services or vendors, and your FRR Case Manager will remain an objective party throughout the rehabilitation process

Although a third party has hired FRR to provide services, you are your FRR Case Manager’s consumer. Your FRR Case Manager must provide services that at all times respect your needs and ensure that your needs are addressed, within the limits of what the third party payer has authorized

Disclosure of Information to Third Parties/Confidentiality

In the event that your Attorney does not allow your FRR Case Manager to have direct communication with you, such will be coordinated through your Attorney’s office

Otherwise, throughout the course of your rehabilitation services you will likely maintain regular telephonic and/or in-person contact with your FRR Case Manager. Summaries of said contacts/meetings will be forwarded to both the third party payer, and your Attorney's office if you are represented by an Attorney

These summaries may include updates regarding rehabilitation progress, significant developments that occurred during the interaction or since the previous update, observations made by the FRR Case Manager, issues encountered during the rehabilitation process, or any other information that currently impacts or may begin to impact the rehabilitation process

Your FRR Case Manager will do his/her best to refrain from sharing personal information that does not impact your rehabilitation

During the course of service provision, all records will be kept private except as follows:

If a third party (i.e. insurance carrier, attorney, etc.) is paying for services, records will be provided to that party

If your FRR Case Manager believes you are going to harm or endanger yourself or others, he/she is required to notify the endangered individual(s), the proper authorities and/or officials

If your FRR Case Manager believes you are going to harm or endanger or abuse children or the elderly, he/she must report this to state or local authorities

If your FRR Case Manager or this agency is sued or court ordered and a properly issued subpoena is received, then information in your file may be released

If you are a minor or not your own legal guardian, then the information in your file may be available to your legal guardian or advocate

Notification of Case Management Actions and Recommendations

As you, the consumer, are continuously involved in your ongoing case management activities, you may request information about your consumer-centered Case Management plan at any time and will be verbally provided with such by your FRR Case Manager

Written or electronic notification of case management actions/recommendations may occur if this is a commonly used method of contact between yourself and your FRR Case Manager. However, if the actions/recommendations are discussed verbally, written or electronic notification is not necessary or required

A Case Manager may choose to notify you of case management actions/recommendations in writing if it is his/her preference to do so, or if specifically asked to do so by the third party payer or a Supervisor

Upon case closure, you and your Attorney, if you are represented, will receive written notification of such via regular mail within two days of the FRR Case Manager receiving a case closure request from the third party payer