| 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.
Direct
Healthcare Supply (DHS) is a health care product provider subject
to the Health Insurance Portability and Accountability Act of
1996, as amended ("HIPAA"). We have always been committed
to protecting the information you share with us and are required
by law to:
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Maintain
the privacy of your protected health information; electronic/computer
information, telephone & cell phone communications,
verbal or faxed information
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Provide
this Notice of our legal duties and privacy practices with
respect to protected health information to any customer
who requests it;
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Abide by the terms of this Notice until adoption of a new
one; and
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To
post this notice on our website: www.directhealthcaresupply.com.
"We"
and "us" in this document refers to any individual
employed by DHS. All employees are authorized to release your
protected health information for the reasons listed below.
Uses
and Disclosures for Payment, Treatment or Healthcare Operations:
Under HIPAA, we may use, receive or disclose your protected
health information for payment, treatment or healthcare operations
without obtaining a written authorization from you. Examples
of this use include but are not limited to:
Payment:
We may use and disclose your protected health information
to receive payment for the products and services we provide.
Payment activities may include sending claims to your health
insurance carrier or medical plan, reviewing the medical necessity
of the services rendered with your physician, and coordinating
the payment of benefits between medical plans.
Treatment:
We may disclose protected health information to your medical
care providers for management or coordination of that care.
Healthcare
Operations: We may use and disclose your protected
health information for our business planning and operational
purposes. For example, we may use or disclose your protected
health information for activities such as verification of eligibility
for benefits with your health insurance carrier or for training
and quality control purposes within our organization. Your protected
health information is stored in locked file cabinets.
Business
Associates: We may contract with other businesses for
certain services. These businesses may require access to your
personal health information in order to perform a payment or
healthcare operations for us. These Business Associates must
agree in writing that they will follow these privacy practices
and will protect the privacy of your health information.
Unless
you authorize us otherwise, your protected health information
will be available only to the individuals who need the information
to conduct payment, treatment or healthcare operations activities.
Other Uses and Disclosures: Other
disclosures DHS may make:
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To
comply with legal proceedings, court or administrative order
or subpoena;
To law enforcement officials for limited law enforcement
purposes;
To public Health Authorities for certain required public
health activities;
To avert a serious threat to the health or safety of you
or any other person;
To comply with laws and regulations related to workers’
compensation or similar programs;
To a coroner, medical examiner or funeral director for purposes
of carrying out his or her duties;
To federal officials for lawful intelligence activities
or if you are imprisoned;
To your personal representative appointed by you or designated
by law;
When otherwise required by law; and
To inform you of other products and services that may be
of interest to you.
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These uses and disclosures may be subject to
special rules under HIPAA or other laws.
Limitations on Use and Disclosure: If a use
or disclosure of your protected health information identified
in this Notice is subject to a law more stringent than HIPAA,
the more stringent law will apply. If you have a question about
your rights under any particular federal or state law, please
write to the DHS Privacy Contact.
Authorizations Required for all Other Uses and Disclosures:
Any other use or disclosure of your protected health information
not identified within this Notice will be made only with your
written authorization. You have the right to limit the type
of information and the persons to whom it should be disclosed.
You may revoke your written authorization at any time, and the
revocation will be followed to the extent action on the authorization
has not yet been taken.
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Direct Healthcare
Supply
PO Box 309
Hudson, OH 44236
Attention: Privacy Contact |
YOUR RIGHTS:
Below are your privacy and confidentiality rights as
a customer of Direct Healthcare Supply. Please note that all
requests must be made in writing.
| • |
You
may request that DHS places a restriction on certain uses
and disclosures of your protected health information.
We are not required to agree to a requested restriction.
To request a restriction, please write to our Privacy
Contact and provide specific information as to the disclosures
that you wish to restrict and the reasons for your request.
We will respond in writing. |
| • |
You
may request that our confidential communications of your
protected health information be sent to alternative locations
or by alternative communicative means. For example, you
may ask that we send information or products to your office
rather than your home address. We are not required to accommodate
your request unless the request is reasonable. |
| • |
You
may make a written request to inspect and obtain a copy
of the protected health information that may be used by
DHS to make decisions about your care or treatment. Be specific
as to the information requested. A reasonable fee may be
imposed for copying and mailing the requested information. |
| • |
You
may request that DHS amend your protected health information
or record if you believe that information is incorrect or
incomplete. DHS cannot amend information it did not create
and will refer you to the provider of service if you are
requesting amendment to diagnosis or treatment information. |
| • |
You may receive an accounting
of certain disclosures of your protected health information
made by DHS for purposes other than treatment, payment or
healthcare operations in the six years prior to the date
of the request; but not for disclosures made prior to April
14, 2003; |
| • |
Request and obtain a paper copy
of this Notice at any time, even if you have agreed to receive
it electronically. |
To exercise any of these rights, please write
to the address listed at the end of this Notice. There are circumstances
where DHS is allowed to deny or limit your request. In such
event you may have the right to object and obtain a review of
our decision. We will provide you with further information about
those rights at that time. If you would like more specific information
about these matters, contact the DHS Privacy Contact.
Changes to this Notice: DHS reserves
the right to change the terms of this Notice and its privacy
practices and to make the new provisions effective for all protected
health information it maintains. Any amended Notice will be
made available to you in the same way that this Notice is available
to you.
Complaints and Privacy Contact:
You may file a complaint with our Privacy Contact and with the
Secretary of the Department of Health and Human Services if
you believe your privacy rights have been violated. Their addresses
are available under contact information below. All complaints
must be filed in writing. Federal law prohibits retaliation
against you for filing a complaint.
Privacy Contact Information:
If you have any questions about this Notice write to:
Direct Healthcare Supply
PO Box 309
Hudson, OH 44236
Attention: Privacy Contact
To contact the Secretary of Health and
Human Services, write to:
U.S. Department of Health and Human Services
Hubert Humphrey Building
200 Independence Avenue, S.W.
Washington, D.C. 20201
Effective Date of Notice: April
14, 2003. DHS is required to follow the terms of this notice
until it is replaced. DHS reserves the right to change this
Privacy Statement at any time as allowed by law and will notify
you of any changes as required by law. DHS reserves the right
to make the changes apply to all information DHS maintains. |
