DARAH MEDICAL EQUIPMENT AND SUPPLIES LLC 09/01/2013 HIPAA 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 Darah Medical Equipment (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. If you have any questions about this policy, please contact the Privacy Officer at 855-293-5011. We will post a copy of our current notice in our office in a prominent location and will provide a copy online. WE ARE REQUIRED BY LAW TO: Maintain the privacy of protected health information Give you this notice of our legal duties and privacy practices regarding health information about you, and
Follow the terms of this notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION The following describes the ways we may use and disclose health information 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 obtain and disclose information on 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. 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. 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. Appointment Reminders. We may use and disclose your health information to contact you and remind you of visits / deliveries. 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. 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. Research. Under certain circumstances, we may use and disclose Health Information for research. Before we use or disclose Health Information for research, the project will go through a special approval process. Even without special approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information. OTHER PERMITTED OR REQUIRED DISCLOSURESAs Required by Law. We must disclose protected health information about you when required to do so by law. Public Health Activities. We may disclose protected health information to public health agencies for reasons such as preventing or controlling disease, injury, or disability. Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. Organ and Tissue Donation. If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation. Military and Veterans. If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military. Victims of Abuse, Neglect, or Domestic Violence. We may disclose protected health information to government agencies about abuse, neglect, or domestic violence. Public Health Risks. We may disclose protected health information about you for public health activities. Examples of theseinclude notification for product recalls or reporting problems about product. 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. Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information. Lawsuits, Disputes and Court 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. 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. This may also include: intelligence, counterintelligence and other national security activities authorized by law, to authorized federal officials so they may provide protection to the President or other authorized persons or heads of state or to correctional institutions or law enforcement officials. Workers Compensation. We may disclose protected health information to the extent necessary to comply with state law for workers’ compensation programs. OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRING YOUR AUTHORIZATION Marketing. We must obtain your permission prior to using your Protected Health Information for purposes that are considered marketing under the HIPAA privacy rules. For example, and except as described above, where we receive financial remuneration from third parties in exchange for communicating with your about certain products, services, treatments, therapies, health care providers, settings of care, case management, and care coordination, with your permission, we may use your protected health information to provide you with these communications. Sale of Protected Health Information. We will not make any disclosure of Protected Health Information that is a sale of Protected Health Information without your written authorization. Psychotherapy Notes. We will not use or disclose psychotherapy notes about you without your authorization except for use by the mental health professional who created the notes to provide treatment to you or to defend ourselves in a legal action or other proceeding brought by you. Other uses and disclosures of Protected Health Information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you do give us an authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer and we will not longer disclose Protected Health Information under the authorization. We are unable to take back any disclosures that we have already made with your authorization or pursuant to this Notice of Privacy Practices. YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION 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. This includes medical and billing records, other than psychotherapy notes. Your request to review and/or obtain a copy of your protected health information records must be made in writing to Darah Medical Equipment, Attn: Privacy Officer, 1197 Farnsworth Rd. Ste D, Waterville, Ohio, 43566. We have up to 30 days to make your Protected Health Information available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state of federal needs-based benefit program. We may deny your request in certain limited circumstances. If we do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review. Right to an Electronic Copy of Electronic Medical Records. If your Protected Health Information is maintained in an electronic format, you have the right to request that an electronic copy of your records be given to you or transmitted to another individual or entity. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record. Right to get notice of a breach: You have the right to be notified upon a breach of any of your unsecured Protected Health Information. 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. The request can be sent to Darah Medical Equipment, Attn: Privacy Officer, 1197 Farnsworth Rd. Ste D,Waterville, Ohio, 43566.
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. An request must be made in writing to Darah Medical Equipment, Attn: Privacy Officer, 1197 Farnsworth Rd. Ste D, Waterville, Ohio, 43566 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 to Darah Medical Equipment, Attn: Privacy Officer, 1197 Farnsworth Rd. Ste D, Waterville, Ohio, 43566. 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. 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 to Darah Medical Equipment, Attn: Privacy Officer, 1197 Farnsworth Rd. Ste D, Waterville, Ohio, 43566, We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. 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. You may obtain a copy of this notice at our web site, www.darahmedical.com. Right to file a complaint about our privacy practices: If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies or procedures, you may file a complaint with the Privacy Officer at Darah Medical Equipment, Attn: Privacy Officer, 1197 Farnsworth Rd. Ste D, Waterville, Ohio, 43566. All complaints must be made in writing. You will not be penalized for filing a complaint. CHANGES TO THIS NOTICE We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office. The notice will contain the effective date on the first page, in the top left hand corner. Acknowledge receipt of this notice of privacy practices on the patient agreement form.