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Attleboro
Area Medical Equipment Company
Privacy Policy
Notice of Privacy Practices
This notice describes
how protected health information about you may be used and disclosed
and how you can get access to this information. Please review it
carefully.
Our company is dedicated
to maintaining the privacy of your identifiable health information.
In conducting our business, we will create records regarding you and
the services we provide to you. This Notice tells you about the
ways in which Attleboro Area Medical Equipment Co. (referred to as
“we”) may collect, use, and disclose your protected health
information and your rights concerning your protected health
information. “Protected health information” is information about
you that can reasonably be used to serve you and that relates to
you, or the payment for that care.
We are required by law
to maintain the confidentiality of health information that
identifies you; as well as by federal and state laws to provide you
with this Notice about your rights and our legal duties and privacy
practices with respect to your protected health information. We
must follow the terms of this Notice while it is in effect. Some of
the uses and disclosures described in this Notice may be limited in
certain cases by applicable state laws that are more stringent than
the federal standards.
If you have questions
about this notice, please contact the Privacy Officer at Attleboro
Area Medical Equipment Co. at (508) 222-9146 for further information.
The terms of this notice
apply to all records containing your health information that are
created or retained by our organization. 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 office in
a prominent location, and you may request a copy of our most current
notice by calling us.
HOW WE MAY USE AND DISCLOSE YOUR
PROTECTED HEALTH INFORMATION
We may use and disclose
your protected health information for different purposes.
The examples below are
provided to illustrate the types of uses and disclosures we may make
without your authorization for payment, home care operations, and
treatment.
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Payment. We
use and disclose your protected health information in order 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 we may provide
your insurer with details regarding your treatment to determine
if your insurer will cover, or pay for, your equipment. We
also may use and disclose your health information to obtain
payment from third parties that may be responsible for such
costs, such as family members. Also, we may use your health
information to bill you directly or services and items.
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Home Care
Operations. We use and disclose your protected health
information in order to perform our home care activities, such
as providing equipment appropriate to your needs, or
administrative activities, including data management or quality
assessment activities.
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Treatment.
We may use and disclose your protected health information to
coordinate services with other health care providers involved in
your care. For example, we may perform an oximetry test to
evaluate the appropriateness of oxygen equipment; collect
measurements to identify appropriate seating and mobility
system(s). We may obtain and disclose information on
Arterial Blood Gases, oxygen
saturation results, CPT diagnosis codes, diagnosis and
prognosis, functional limitations, pre-existing health
conditions, hospitalizations, prior use of equipment, and
information specific to qualifying the patient as dictated by
CMN / detailed written order forms.
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Appointment
Reminders. We may use and disclose your health information
to contact you and remind you of visits / deliveries.
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Health-related
Benefits and Services. We may use and disclose your health
information to inform you of health-related benefits or services
that may be of interest to you.
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Release of
information to Family / friends. We may release your health
information to a friend or family member that is helping you to
pay for your health care, or who assists in taking care of you.
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Disclosures
Required by Law. We will use and disclose your health
information when we are required to do so by federal, state or
local law.
OTHER PERMITTED OR REQUIRED
DISCLOSURES
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As Required by
Law. We must disclose protected health information about you
when required to do so by law.
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Public Health
Activities. We may disclose protected health information to
public health agencies for reasons such as preventing or
controlling disease, injury, or disability.
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Victims of Abuse,
Neglect or Domestic Violence. We may disclose protected
health information to government agencies about abuse, neglect,
or domestic violence.
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Health Oversight
Activities. We may disclose protected health information to
government oversight agencies. Oversight activities can
include, for example, investigations, inspections, audits,
surveys, licensure and disciplinary actions; civil,
administrative, and criminal procedures or actions; or other
activities necessary for the government to monitor government
programs, compliance with civil rights laws and the health care
system in general.
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Judicial and
Administrative Proceedings. We may disclose protected health
information in response to a court or administrative order. We
may also disclose protected health information about you in
certain cases in response to a subpoena, discovery request, or
other lawful process.
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Law Enforcement.
We may disclose protected health information under limited
circumstances to a law enforcement official in response to a
warrant or similar process; to identify or locate a suspect; or
to provide information about the victim of a crime.
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To Avert a
Serious Threat to Health or Safety. We may disclose
protected health information about you, with some limitations,
when necessary to prevent a serious threat to your health and
safety or the health and safety of the public or another person.
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Special
Government Functions. We may disclose information as
required by military authorities or to authorized federal
officials for national security and intelligence activities.
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Workers
Compensation. We may disclose protected health information
to the extent necessary to comply with state law for workers’
compensation programs.
YOUR RIGHTS REGARDING YOUR
PROTECTED HEALTH INFORMATION.
You
have certain rights regarding protected health information that the
Plan maintains about you.
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Right to Access Your
Protected Health Information.
You have the right to review or obtain copies of your protected
health information records, with some limited exceptions.
Usually the records include referral information, delivery
forms, billing, claims payment, and medical management records.
Your request to review and/or obtain a copy of your protected
health information records must be made in writing. We may
charge a fee for the costs of producing, copying, and mailing
your requested information, but we will tell you the
cost in advance.
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Right to Amend Your
Protected Health Information.
If you feel that protected health information maintained by us
is incorrect or incomplete, you may request that we amend the
information. Your request must be made in writing and must
include the reason you are seeking a change. We may deny your
request if, for example, you ask us to amend information that
was not created by us, or you ask to amend a record that is
already accurate and complete. If we deny your request to
amend, we will notify you in writing. You then have the right to
submit to us a written statement of disagreement with our
decision and we have the right to rebut that statement.
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Right to an Accounting of
Disclosures. You
have the right to request an accounting of disclosures we have
made of your protected health information. The list will not
include our disclosures related to your treatment, our payment
or health care operations, or disclosures made to you or with
your authorization. The list may also exclude certain other
disclosures, such as for national security purposes. Your
request for an accounting of disclosures must be made in writing
and must state a time period for which you want an accounting.
This time period may not be longer than six years and may not
include dates before April 14, 2003. Your request should
indicate in what form you want the list (for example, on paper
or electronically). The first accounting that you request within
a 12-month period will be free. For additional lists within the
same time period, we may charge for providing the accounting,
but we will tell you the cost in advance.
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Right to Request
Restrictions on the Use and Disclosure of Your Protected Health
Information. You
have the right to request that we restrict or limit how we use
or disclose your protected health information for services,
payment, or health care operations. We may not agree to your
request. If we do agree, we will comply with your request
unless the information is needed for an emergency. Your request
for a restriction must be made in writing. In your request, you
must tell us (1) what information you want to limit; (2) whether
you want to limit how we use or disclose your information, or
both; and (3) to whom you want the restrictions to apply.
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Right to Receive
Confidential Communications.
You have the right to request that we use a certain method to
communicate with you or that we send information to a certain
location. For example, you may ask that we contact you at work
rather than at home. Your request to receive confidential
communications must be made in writing.. We will accommodate all
reasonable requests. Your request must specify how or where you
wish to be contacted.
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Right to a Paper Copy of
This Notice. You
have a right at any time to request a paper copy of this
Notice. You may ask us to give you a copy of this notice at any
time.
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Contact Information for
Exercising Your Rights.
You may exercise any of the rights described above by contacting
our privacy Office.
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Complaints. If
you believe that your privacy rights have been violated, you may
file a complaint with us and/or with the Secretary of the
Department of Health and Human Services. All complaints must be
submitted in writing. You will not be penalized for filing a
complaint.
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