Patient Privacy Notice
This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
OUR LEGAL DUTY: The privacy of your health information is important to us. We are required by Federal law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We are required by federal law to abide by the terms of this Notice currently in effect. This notice takes effect September 23, 2013.
We reserve the right to change the terms of this Notice at any time. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for health information that we maintain, including health information we created or received before we made the changes. Should we make such a change, you may obtain a revised Notice by requesting a copy from the Privacy Officer at the telephone number or address listed below.
USES AND DISCLOSURES OF HEALTH INFORMATION: The following categories describe different ways that we use and disclose health information. Treatment: We may use and disclose your health information for treatment purposes. For example, we may disclose your health information to a physician or other healthcare provider providing treatment to you in order to provide you with durable medical equipment and/or supplies.
Payment: We may use and disclose your health information to obtain payment for services we provide to you. For example, we may disclose your health information to your health insurance plan so it will pay for your services.
Health Care Operations: We may use or disclose your health information in order to support our business activities. For example, we may use your health information to evaluate the quality of care you receive from us, to conduct cost management assessments, and to plan business activities.
National Security: We may disclose your health information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Law Enforcement: We may disclose your health information, so long as applicable legal requirement are met, for law enforcement purposes.
Workers’ Compensation: We may disclose your health information for workers’ compensation or similar programs. Judicial and Administrative Proceedings: We may disclose your health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. Required by Law: We may use or disclose your health information to the extent such use or disclosure is otherwise required by federal, state or local law. Public Health and Safety: We may disclose your health information for certain situations such as preventing disease, helping with product recalls, reporting suspected abuse, neglect, or domestic violence, or preventing or reducing a serious threat to anyone’s health or safety.
Research: We may use or disclose your health information for research purposes.
Business Associates: We may disclose your health information to persons who perform functions, activities or services for us or on our behalf that require the use or disclosure of your health information. To protect your health information, we require the business associate to appropriately safeguard your information. Involvement in Your Care: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, orally or in writing, your health information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose your health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location or general condition.
Marketing: We must obtain your written authorization to use and disclose your health information for most marketing purposes.
Sale of PHI: We must obtain your written authorization for any disclosure of your health information which constitutes a sale of health information.
Other Uses: Other uses and disclosures not described above will be made only with your written authorization (unless otherwise permitted or required by law). You may revoke your authorization, at any time, in writing, except to the extent that we have taken action in reliance on the authorization.
PATIENT RIGHTS: Access: You have the right to inspect and obtain an electronic or paper copy of your health information. This includes medical and billing records. To inspect and/or get a copy your health information you must submit your request in writing to the Privacy Officer. We may charge a reasonable costbased fee for copies of your health information.
Right to Amend: You have the right to request that we amend your health information that you think is incorrect or incomplete. Your request must be made in writing and submitted to the Privacy Officer. Your request must provide a reason that supports your amendment request. We may deny your request, but we will tell you why in writing.
Disclosure Accounting: You have the right to receive a list of disclosures we have made of your health information for the last 6 years. If you request this accounting more than once in a 12 month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. You must submit your request in writing to the Privacy Officer.
Restriction: You have the right to request a restriction or limitation on our use or disclose of your health information for treatment, payment or health care operations. You must submit your request in writing to the Privacy Officer. 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 your care, such as a family member or friend. We are not required to agree to your request, except we must agree not to disclose your health information to your health plan where the disclosure (1) is for payment or health care operations and is not otherwise required by law, and (2) pertains to a healthcare item or service for which you (or someone on your behalf other than your health plan) have already paid in full. If we do agree, we will abide by our agreement (except in an emergency).
Breaches: You have the right to receive notifications of breaches of unsecured protected health information.
Paper Copy: You have the right to obtain a paper copy of this Notice from us, even if you have already agreed to receive the notice electronically.
Confidential Communications: You have the right to request that we communicate with you in a certain way or at a certain location. We will accommodate all reasonable requests. We may condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact.
Fundraising Communications: We may contact you for fundraising purposes. You have the right to opt out of receiving these communications.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. We will not retaliate in any way for filing a complaint. To file a complaint with our office, please submit it in writing to the address as follows:
Mary Beste Gateway Medical Equipment, LLC 181 Chesterfield Business Pkwy.
Chesterfield, MO 63005-1233
Phone: (636) 536-5337Fax: (636) 489-1564 Email: firstname.lastname@example.org