Note: You will need Acrobat Reader to view these files.
| NOTICE OF PRIVACY PRACTICES
Confidentiality of Your Health Care Information
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 questions about this notice, please contact the PrivacyOfficer at (805) 684-3304. This notice describes InHealth Technologies, A Division of Helix Medical,LLC, privacy practices and that of: -
All employees, and office personnel. -
Any intern(s), volunteer(s) or student(s) that we allow to input or maintain patient data files. -
All internal departments and units of InHealth Technologies, A Division of Helix Medical, LLC. -
All entities, sites and locations owned by InHealth Technologies, A Division of Helix Medical, LLC. Our Commitment to Your Privacy
We have always had stringent safeguards to protect private health information (PHI), however, because of a new law some changes are necessary to assure you we are dedicated to maintaining the privacy of your health information. In conducting our business, we may receive, create, use, or disclose individually protected health information regarding you and the treatments and services we provide you. We are required by law to provide you with this notice of our legal duties and privacy practices concerning your PHI.
By law we must follow the terms of the notice of privacy practicesthat we have in effect at the time.
Health Information Security
InHealth Technologies, A Division of Helix Medical, LLC, requiresits employees to follow security policies and procedures that limitaccess to those employees who need it to perform their job responsibilities.In addition, we maintain physical, administrative and technical measuresto safeguard your PHI.
Understanding your medical record Information
We create a record of the care and services you receive from InHealth.This record may contain your prescription information, Medicare orother insurance and/or correspondence from your doctor, speech pathologistor other health care providers. All the information wehave about you is called PHI. PHI means health information, includingyour demographic information, collected from you or received fromyour physician, another health care provider, a health plan and/ora health care clearinghouse.
To summarize, this notice provides you with the following importantinformation: -
How we use and disclose your PHI. -
Your privacy rights in your PHI. -
Our obligations concerning the use and disclosure of your PHI. How We May Use and Disclose Medical Information About You
For Treatment: We may use health information about you to provide you with medical treatment or services. We may disclose health information about you to doctors, nurses, technicians, office staff or other personnel who are involved in taking care of you and your health.
For example, different personnel in our office may share informationabout you and disclose information to people who do not work in ouroffice in order to coordinate your care. Family members and otherhealth care providers may be part of your medical care outside thisoffice and may require information about you that we have.
For Payment:
We may use and disclose health information aboutyou so that the treatment and services you receive at this officemay be billed to and payment may be collected from you, an insurancecompany 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 reimburse you for the service.
For Health Care Operations:
We may use and disclose your protectedhealth information in order to perform our daily business activities,which may include data management, customer service, complying withlaws and quality.
For example, we may use your health information to evaluate theperformance of our staff in caring for you. We may also use healthinformation about all or many of our patients to help us decide whatadditional services we should offer or how we can become more efficient.
Health-Related Products and Services:
We may tell you about health-relatedproducts or services that may be of interest to you.
Affiliates:
If you choose to participate in the optional MedicAlert® programas a member of our INHEALTH Speakers Club, we will disclose your name,address, telephone number and E-mail address to the MedicAlert Foundation.MedicAlert Foundation is a nonprofit membership organization thatkeeps a confidential, computerized medical file on every member toprovide assistance in a medical emergency. We do not disclose to themany of your health information.InHealth Technologies, A Division ofHelix Medical, LLC, does not sell protected health information tooutside organizations and takes steps to ensure that only authorizedbusiness associates, who need to know, see your health information.
As Required by Law
We will disclose health information about you whenrequired to do so by federal, state, or local law.
To Avert a Serious Threat to Health or Safety
We may use and disclose health information about you when necessaryto prevent a serious threat to your health and safety or the healthand safety of the public or another person. Any disclosure would beto someone able to help stop or reduce the threat.
Research
We may use and disclose health information about you for researchprojects that are subject to a special approval process. We will askyou for your permission if the researcher will have access to yourname, address or other information that reveals who you are, or willbe involved in your care at the office.
Military
If you are, or were, a member of the armed forces, we may releasemedical information about you as required by military command authorities. Wemay also release information about foreign military personnel to theappropriate foreign military authority.
Workers’ Compensation
We may release health information about you for workers’ compensationor similar programs. These programs provide benefits for work-relatedinjuries or illness.
Public Health Risks
We may disclose health information about you for public health activities.
These activities generally include, but are not limited to the following: -
To prevent or control disease, injury or disability. -
To report births, deaths. -
To regulate products subject to FDA regulations. -
To notify a person who might have been exposed to a disease or might be a risk for getting or spreading a disease or condition. -
To report child abuse or neglect. -
To notify the appropriate government agency if we think a patient has been the victim of abuse, neglect, or domestic violence. Health Oversight Activities
We may disclose health information to a health oversight agency for audits, investigations, inspections, accrediting 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.
Judicial and Administrative Proceedings
If you are involved in a lawsuit or a dispute, we may disclose healthinformation about you in response to a court or administrative order.Subject to all applicable legal requirements, we may also disclosehealth information about you in response to a subpoena.
Law Enforcement
We may release health information if asked to do so by a law enforcementofficial in response to a court order, subpoena, warrant, summonsor similar process, subject to all applicable legal requirements.
Coroners, Medical Examiners and Funeral Directors
We may release health information to a coroner or medical examiner.This may be necessary, for example, to identify a deceased personor determine the cause of death or as necessary to carry out theirduties.
Information Not Personally Identifiable
We may use or disclose health information about you in a way thatdoes not personally identify you or reveal who you are.
Individuals Involved in the Treatment or Payment of Your Care
We may disclose health information about you to your family membersor friends if we obtain your verbal agreement to do so, or if we giveyou an opportunity to object to such a disclosure and you do not raisean objection. We may also disclose health information to your familyor friends if we can infer from the circumstances, based on our professionaljudgment, that you would not object.
Consent
You may revoke your Consent at any time by giving us written notice.Your revocation will be effective when we receive it, but will notapply to any uses and disclosures which occurred before that time.Ifyou do revoke your Consent, we will not be permitted to use or discloseinformation for purposes of treatment, payment or health care operations,and we may therefore choose to discontinue providing you with healthcare treatment and services.
Your Rights Regarding Health Information About You
You have the following rights regarding health information we maintainabout you: -
Right to Inspect and Copy
You have the right to inspect and request a copy of certain health information we have on file. Usually, this includes medical and billing records.
To inspect and request a copy of health information on file aboutyou, you must submit a written request by US mail to the Privacy Officerc/o Customer Service Department, 1110 Mark Ave., Carpinteria, CA 93013. Ifyou request a copy of your health information, we may charge a feefor the costs of copying, mailing, or other associated supplies.
We may deny your request to inspect or receive a copy in certain limitedcases. If we deny your request, you may ask for a review of the denial.The person who conducts the review will not be the person who deniedthe request. We will comply with the outcome of the review. -
Right to Request an Amendment
If you believe medical 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 originates at InHealth Technologies, A Division of Helix Medical, LLC.
You must request an amendment in writing and submit it to the PrivacyOfficer c/o Customer Service Department. You must also tell us thereason for your request. The request to amend your record may be denied,in which case you have the right to enter a statement into your recordsaying that you disagree with the decision. -
Right to an Accounting of Disclosures
You have the right to request an “accounting of disclosures.” Thisis a list of the disclosures we made of medical information aboutyou for purposes other than treatment, payment and health care operations.To obtain this list, you must submit your request in writing to thePrivacy Officer c/o Customer Service Department. It must state a timeperiod, which may not be longer than six years and may not includedates before April 14, 2003. Your request should indicate in whatform you want the list (for example, on paper, electronically). Wemay charge you for the costs of providing the list. We will notifyyou of the cost involved and you may choose to withdraw or modifyyour request at that time before any costs are incurred. -
Right to 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 a surgery you may have had.
We are not required to agree to your request, but, if we do agree,we will comply with your request unless the information is neededto provide you emergency treatment.
You must submit your request for restrictions in writing to the PrivacyOfficer c/o Customer Service Department. In your request, you musttell us:
-
What information you want to restrict. -
Whether you want to limit our use, disclosure, or both. -
To whom you want the restrictions to apply, such as your spouse or another relative.
The Privacy Officer will inform you if InHealth Technologies, A Divisionof Helix Medical, LLC, can comply with your requested restrictions.
-
Right to Request Confidential Communications
You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
You must submit your request for confidential communication in writing. Yourrequest must specify how or where we should contact you. When appropriate,we might ask you how payment will be handled, but we will not askthe reason for the request. We will try to accommodate all reasonablerequests. -
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 copy of this notice at any time. To get a paper copy of this notice, contact the Privacy Officer c/o Customer Service Department. This notice is also available on our website, www.inhealth.com. Other Uses of Medical Information
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will only be made with your written permission or after you have had an opportunity to agree to object. If you provide us with permission to use or share your medical information, you may revoke that permission, in writing, at any time. If you revoke, or take away, your permission, we will no longer use or share your health information for the reasons in your written authorization. We will not be able to take back any information that we have already shared.
Changes to this Notice
We reserve the right to change this notice. We reserve the right tomake the revised or changed notice effective for medical informationwe already have, as well as information we receive in the future.We will post copies of the current notice. The notice will containthe effective date of the notice in the top right-hand corner of thefirst page.
For More Information or to Report a Problem
If you believe your privacy rights have been violated, you may filea complaint with our office or with the Secretary of the Departmentof Health and Human Services.
To file a complaint with our office contact:
Privacy Officer
InHealth Technologies
A Division of Helix Medical, LLC
1110 Mark AvenueCarpinteria, CA 93013
All complaints must be in writing. There will be no retaliation forfiling a complaint. |
