Notice of Privacy Practices
This Notice describes how medical information about you may be used and disclosed and how you can get access to this information
Please review it carefully
If you have any questions about this notice, please contact Candy Gott or Paula Tabor of our office at 407/849-6455. 915 S. Orange Avenue, Orlando, FL. 32806.
WHO WILL FOLLOW THIS NOTICE
This Notice describes the information privacy practices followed by our employees, staff and other office personnel.
YOUR HEALTH INFOMATION
This notice applies to the information and records we have about your health, health status, and the health care and services you receive at Colonial Medial Supplies.
We are required by law to give you this notice. It will tell you about the ways in which we may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of that information.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
We may request your written, signed Consent to use and disclose health information for the following purposes:
For service/equipment/treatment: We may use health information about you to provide you with service, equipment or treatment. We may disclose health information about you to doctors, therapists, technicians, office staff or other personnel who are involved in taking care of you and your health.
For example, information obtained by a respiratory therapist will be recorded in your record. Family members and other health care providers may be part of your medical care outside this office and may require information about you that we have.
For payment: We may use and disclose health information about you so that the treatment and services you receive at Colonial Medical Supplies may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about a service you received here so your health plan will pay us or reimburse you for the service. We may also tell your health plan about service, equipment or treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the service, equipment or treatment.
For company operations: We may use and disclose health information (without divulging your personal identity) in order to run the office and make sure that you and our other patients receive quality service. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also use health information about all or many of our patients to help us decide what additional services we should offer, and how we can become more efficient.
We May use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations:
To avert a serious threat to health or safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Required by law: We will disclose health information about you when required to do so by federal, state, or local laws.
Military, Veterans, National Security and Intelligence: If you are or were a member of the armed forces, or part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military authority.
Worker's Compensation: We may release health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public health risks: We may disclose health information about you for public health reasons in order to prevent or control disease, injury or disability or report deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products.
Health oversight activities: We may disclose health information to health oversight agency for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the health care system, government programs, and compliance with civil rights laws. For example: Medicare or Medicaid.
Lawsuits and disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in a response to a subpoena.
Law enforcement: We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements.
Information not personally identifiable: We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Family and Friends: We may disclose information about you to your family members or friends if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may also disclose health information to your family or friends if we can infer from the circumstances, based on our professional judgment that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse when you bring your spouse with you to Colonial Medical Supplies for service, equipment or treatment.
In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person's involvement in your care. We may use our professional judgment and experience to make reasonable inferences that it is in your best interest to allow another person to at on your behalf to pick up, for example, supplies.
Other uses and disclosures of health information
We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written Authorization. We must obtain your Authorization separate from any Consent we may have obtained from you. If you give us Authorization to use or disclose health information about you, you may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization, but we cannot take back any uses or disclosures already made with your permission.
You would complete an Authorization telling us to release your information to a specific entity, for example, your employer.
If we have HIV or substance abuse information about you, we cannot release that information without a special signed, written authorization (different than the Authorization and Consent mentioned above) from you. In order to disclose these types of records for purposes of treatment, payment or health care operations, we will have to have both your signed Consent and a special written Authorization that compliance with the law governing HIV or substance abuse records.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
You have the following rights regarding health information we maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy your health information, such as medical and billing records. You must submit a written request to Paula Tabor, our designated HIPAA Officer, in order to inspect and /or copy your health information. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other associated supplies.
Right to Amend: If you believe health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment as long as the information is kept by this office.
To request an amendment, complete and submit a Medical Record Amendment/Correction Form to Paula Tabor, our designated privacy official contact. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
a) We did not create, unless the person or entity that created the information is no longer available to make the amendment.
b) Is not part of the health information that we keep.
c) Is accurate and complete.
Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures.” This is a list of the disclosures made of medical information about you for purposes other than treatment, payment and health care operations. Colonial Medical Supplies does not participate in disclosures for purposes other than treatment, payment and health care operations. However you may still make a request, in writing, to Paula Tabor, our designated privacy official contact. It must state a time period, which 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, electronically). We may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred.
Right Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for it, like a family member or friend. For example, you could ask that we not use or disclose information about an orthosis you received.
We are not required to agree to your request: If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you may complete and submit the request for Restriction On Use/Disclosure of Medical Information to Paula Tabor, our designated privacy official contact.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a coy of this notice at any time. Even if you have agreed to receive it electronically, you are still entitled to a paper copy. To obtain such a copy, contact Paula Tabor, our designated privacy official contact, or stop in our store and request a copy.
CHANGES TO THIS NOTICE
We reserve the right to change this notice, and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a summary of the current notice in the office with its effective date in the top right hand corner. You are entitled to a copy of the notice currently in effect.
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of The Department of Health and Human Services. To file a complaint with our office, contact Paula Tabor, HIPAA Privacy Officer, 407/849-6455.
You will not be penalized for filing a complaint.