
Notice of Privacy Practices as Required by the
Privacy Regulations Promulgated Pursuant to the Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
This notice describes how health information about you may be used and
disclosed, and how you can get access to your identification health information.
• Our Commitment to Your Privacy
Our organization is dedicated to maintaining the privacy of your identifiable
health information. In conducting our business, we will create records regarding
you and the treatment and services we provide to you. We are required by law to
maintain the confidentiality of health information that identifies you. We also
are required by law to provide you with this notice of our legal duties and
privacy practices concerning your identifiable health information. By law, we
must follow the terms of the notice of privacy practices that we have in effect
at the time.
To summarize, this notice provides you with the following important information:
How we may use and disclose your identifiable health information.
Your privacy rights in your identifiable health information.
Our obligations concerning the use and disclosure of your identifiable health
information.
The terms of this notice apply to all records containing your identifiable
health information that are created or retained by our practice. We reserve the
right to revise or amend our notice of privacy practices. Any revision or
amendment to this notice will be effective for all of your records our practice
has created or maintained in the past, and for any of your records we may create
or maintain in the future. Our organization will post a copy of our current
notice in our offices in a prominent location, and you may request a copy of our
most current notice during any home visit.
If you have any questions about this notice, please contact The Administrator of
Advance MedeQuip at (407) 323-5093 or (866) 404-6633.
• We May Use and Disclose Your Health Information in the Following Ways:
The following categories describe the different ways in which we may use and
disclose your identifiable health information.
A. Treatment. Our organization may use your identifiable health information to
treat you. After we receive an order/prescription to deliver equipment/supplies
to you we may inform you that laboratory testing may need to be performed to
establish a proper diagnosis appropriate for the services/equipment rendered if
testing information was not available at the time services were requested, If
testing information is available through an independent laboratory or a hospital
it may need to be forward to us to establish qualifying results and diagnosis.
May of the people who work for our organization may use or disclose your
identifiable health information in order to treat you or to assist others in
your treatment. Additionally, we may disclose your identifiable health
information to others that may assist in your care, such as your physician,
therapists, spouse, children, or parents.
B. Payment. Our organization may use and disclose your identifiable health
information in order to bill and collect payment for the services and items you
may receive from us. For example, we may contact your health insurer to certify
that you are eligible for benefits (and for what range of benefits), and we may
provide your insurer with details regarding your treatment to determine if your
insurer will cover, or pay for your treatment. We also may use and disclose your
identifiable health information to obtain payment from third parties that may be
responsible for such costs, such as family members. Also, we may use your
identifiable health information to bill you directly for services and items.
C. Health Care Operations. Our organization may use and disclose your
identifiable health information to operate our business. As examples of the ways
in which we may use and disclose your information for our operations, our
organization may use your health information to evaluate the quality of care you
received from us, or to conduct cost-management and business planning activities
for our practice.
D. Appointment Reminders. Our organization may use and disclose your
identifiable health information to contact you and remind you of
visits/deliveries.
E. Release of Information to Family/Friends. Our organization may release your
identifiable health information to a friend or family member that is helping you
pay for your health care, or who assists in taking care of you.
F. Disclosures Required by Law. Our organization will use and disclose your
identifiable health information when we are required to do so by federal, state,
or local law.
• Use and disclosure of Your Identifiable Health Information in Certain Special
Circumstances
The following categories describe unique scenarios in which we may use or
disclose your identifiable health information.
A. Public Health Risks. Our organization may disclose your identifiable health
information to public health authorities that are authorized by law to collect
information for the purpose of:
Maintain vital records, such as births and deaths
Reporting child abuse or neglect
Preventing or controlling disease, injury, or disability
Notifying a person regarding potential exposure to a communicable disease
Notifying a person regarding a potential risk for spreading or contracting a
disease or condition
Reporting reactions to drugs or problems with products or devices
Notifying appropriate government agency(ies) and authority(ies) regarding the
potential abuse or neglect of an adult patient (including domestic violence);
however, we will only disclose this information if the patient agrees or we are
required or authorized by law to disclose this information.
Notifying your employer under limited circumstances related primarily to a
workplace injury or illness or medical surveillance.
B. Health Oversight Activities. Our organization may disclose your identifiable
health information to a health oversight agency for activities authorized by
law. Oversight activities can include, for example, investigations, inspections,
audits, surveys, licensure and disciplinary actions; civil, administrative, and
criminal procedures or action; or other activities necessary for the government
to monitor government programs, compliance with civil rights laws and the health
care system in general.
C. Lawsuits and Similar Proceedings. Our organization may use and disclose your
identifiable health information in response to a court or administrative, if you
are involved in a lawsuit or similar proceeding. We also may disclose your
identifiable health information in response to a discovery requires, subpoena,
or other lawful process by another party involved in the dispute, but only if we
have made an effort to inform you of the request or to obtain an order
protecting the information the party has requested.
D. Law Enforcement. We may release identifiable health information if asked to
do so by law enforcement official.
Regarding a crime victim in certain situations, if we are unable to obtain the
person’s agreement.
Concerning a death we believe might have resulted from criminal conduct.
Regarding criminal conduct at our offices.
In response to a warrant, summons court order, subpoena or similar legal
process.
To identify/locate a suspect, material witnesses fugitive or missing person.
In an emergency, to report a crime (including the location or victim of the
crime, or the description, identity or location of the perpetrator.)
E. Serious Threats to Health and Safety. Our organization may use and disclose
your identifiable health information when necessary to reduce or prevent a
serious threat to your health and safety or the health and safety of another
individual or the public. Under these circumstances, we will only make
disclosure to a person or organization able to help prevent the threat.
F. Military. Our organization may disclose your identifiable health information
if you are a member of US or foreign military forces (including veterans) and if
required by the appropriate military command authorities.
G. National Security. Our organization may disclose your identifiable health
information to federal officials for intelligence and national security
activities authorized by law. We also may disclose your identifiable health
information to federal officials in order to protect the President, other
officials or foreign heads of state, or to conduct investigations.
H. Inmates. Our organization may disclose your identifiable health information
to correctional institutions or law enforcement officials if you are an inmate
or under the custody of a law enforcement official, Disclosure for these
purposes would be necessary: (a) or the institution to provide health care
services to you, (b) for the safety and security of the institution, and/or (c)
to protect your health and safety or the health and safety of similar programs.
I. Worker’s Compensation. Our organization may release your identifiable health
information for workers’ compensation and similar programs.
• Your Rights Regarding Your Identifiable Health Information
A. Confidential Communications. You have the right to request that our
organization communicate with you about you and your health and related issues
in a particular manner or at a certain location. For instance, you may ask that
we contact you at home, rather than work. In order to request a type of
confidential communication, you must make a written request to the administrator
or office to contact for further information specifying the requested method of
contact, or the location where you wish to be contacted. Our organization will
accommodate reasonable requests. You do not need to give a reason for your
request.
B. Requesting Restrictions. You have the right to request a restriction in our
use or disclosure of your identifiable health information for treatment, payment
or health care operations. Additionally, you have the right to request that we
limit our disclosure of your identifiable health information to individuals
involved in your care or the payment for your care, such a family member or
friends. We are not required to agree to your request; however if we do agree we
are bound by our agreement except when otherwise required by law, in
emergencies, or when the information is necessary to treat to you. In order to
request a restriction in our use or disclosure of your identifiable health
information, you must make your request in writing to the Administrator of
Advance MedeQuip at (407) 323-5093 or (866) 404-6633. Your request must describe in a clear and concise
fashion: (a) the information you wish restricted; (b) whether you are requesting
to limit our practices use, disclosure or both; and (c) to whom you want the
limits to apply.
C. Inspection and Copies. You have the right to inspect and obtain a copy of the
identifiable health information that may be used to make decisions about you,
including patient medical records and billing records, but not including
psychotherapy notes. You must submit your request in writing to the
administrator of Advance MedeQuip at (407) 323-5093 or (866)
404-6633. in order to inspect and/or obtain a
copy of your identifiable health information. Our organization may charge a fee
for the costs of copying, mailing, labor and supplies associated with your
request. Our practice may deny your request to inspect and/or copy in certain
limited circumstance; however, you may request a review of our denial. Reviews
will be conducted by another licensed health care professional chosen by us.
D. Amendment. You may ask us to amend your health information if you believe it
is incorrect or incomplete, and you may request an amendment for as long as the
information is kept by or for our organization. To request an amendment, your
request must be made in writing and submitted to the administrator of Advance MedeQuip at (407) 323-5093 or (866) 404-6633. You must provide us with a reason that supports
your request for amendment. Our organization will deny your request if you fail
to submit your request (and the reason supporting your request) in writing.
Also, we may deny your request if you ask us to amend information that is (a)
accurate and complete; (b) not part of the identifiable health information kept
by or for the organization; (c) not part of the identifiable health information
which you would be permitted to inspect and copy; or (d) not created by our
organization, unless the individual or entity that created the information is
not available to amend the information.
E. Accounting of Disclosures. All of our patients have the right to request an
“accounting of disclosures”. An “accounting of disclosures” is a list of certain
disclosures our organization is made of your identifiable health information. In
order to obtain an accounting of disclosures, you must submit your request in
writing to the administrator of Advance MedeQuip at (407) 323-5093
or (866) 404-6633. All
requests for an “accounting of disclosure” must state a time period that may not
be longer than six years and may not include dates of service before April 14,
2003. The first list you request within a 12-month period is free of charge, but
our practice may charge you for additional lists within the same 12-month
period. Our organization will notify you of the costs involved with additional
requests, and you may withdraw your request before you incur any costs.
F. Right to a Paper Copy of This Notice. You are entitled to receive a paper
copy of our notice of privacy practices. You may ask us to give you a copy of
this notice at any time. To obtain a paper coy of this notice, contact the
administrator of Advance MedeQuip at (407) 323-5093 or (866)
404-6633 for further
information.
G. Right To File a Complaint. If you believe your privacy rights have been
violated, you may file a complaint with our organization or with the Secretary
of the Department of Health and Human Services. To file a complaint with our
organization, contact the Administrator of Advance MedeQuipMedeQuip at (407)
323-5093 or (866) 404-6633. You will not be penalized for filing a complaint. All complaints
must be submitted in writing.
H. Right to provide an authorization for other uses and disclosures. Our
organization will obtain your written authorization for uses and disclosures
that are not identified by these notices or permitted by applicable law. Any
authorization you provide to us regarding the use and disclosure of your
identifiable health information may be revoked at any time in writing. After you
revoke your authorization, we will no longer use or disclose your identifiable
health information for the reasons described in the authorization. Please not,
we are required to retain records of your care.
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