Notice of
Health Information Privacy Practices
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
CAREFULLY.
Introduction
At, { Hearing Aids Help }, we are committed to treating
and using protected health information about you responsibly. This Notice
of Health Information Privacy Practices describes the personal information
we collect, and how and when we use or disclose that information. It also
describes your rights as they relate to your protected health information.
This Notice is effective April 11, 2014, and applies to all protected
health information as defined by federal regulations.
Understanding Your Health Record/Information
Each time you visit, { Hearing Aids Help }, a record of
your visit is made. Typically, this record contains your symptoms,
examination and test results, treatment, and a plan for future
care or treatment. This information, often referred to as your health or
medical record, serves as a:
• Basis for planning your care and treatment,
• Means of communication among the many health professionals who
contribute to your care,
• Legal document describing the care you received,
• Means by which you or a third-party payer can verify that services
billed were actually provided,
• A tool in educating heath professionals,
• A source of data for medical research,
• A source of information for public health officials charged with
improving the health of this state and the nation,
• A source of data for our planning and marketing,
• A tool with which we can assess and continually work to improve the care
we render and the outcomes we achieve.
Understanding what is in your record and how your health information is
used helps you to: ensure its accuracy, better understand who, what, when,
where, and why others may access your health information, and make more
informed decisions when authorizing disclosure to others.
Your Health Information Rights
Although your health record is the physical property of, { Hearing Aids
Help }, the information belongs to you. You have the
right to:
• Obtain a paper copy of this notice of information practices upon
request,
• Inspect and copy your health record as provided for in 45 CFR 164.524,
• Amend your health record as provided in 45 CFR 164.528,
• Obtain an accounting of disclosures of your health information as
provided in 45 CFR 164.528,
• Request communications of your health information by alternative means
or at alternative locations,
• Request a restriction on certain uses and disclosures of your
information as provided by 45 CFR 164.522, and
• Revoke your authorization to use or disclose health information except
to the extent that action has already been taken.
Our Responsibilities
{ Hearing Aids Help, 'our business office or offices' }, are required to:
• Maintain the privacy of your health information,
• Provide you with this notice as to our legal duties and privacy
practices with respect to information we collect and maintain about you,
• Abide by the terms of this notice,
• Notify you if we are unable to agree to a requested restriction, and
• Accommodate reasonable requests you may have to communicate health
information by alternative means or at alternative locations.
We reserve the right to change our practices and to make the new
provisions effective for all protected health information we maintain.
Should our privacy practices change it will be posted on our website, you
can request that we mail you a revised notice to the address you’ve
supplied us, or if you agree, we will email the revised notice to you.
We will not use or disclose your health information without your
authorization, except as described in this notice. We will also
discontinue using or disclosing your health information after we have
received a written revocation of the authorization according to the
procedures included in the authorization.
For More Information or to Report a Problem
If have questions and would like additional information, you may contact
the practice’s Privacy Officer, William Jackson at 916-475-5509.
If you believe your privacy rights have been violated, you can file a
complaint with the practice’s Privacy Officer, or with the Office for
Civil Rights, U.S. Department of Health and Human Services. There will be
no retaliation for filing a complaint with either the Privacy Officer or
the Office for Civil Rights. The address for the OCR is listed below:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
Examples of Disclosures for Treatment, Payment and Health
Operations
We will use your health information for treatment.
For example: Information obtained by the, Hearing Instruments Specialist, hearing aid
dispenser or other member of your health care team will be recorded in
your record and used to determine the course of treatment that should work
best for you. Your, Hearing Instruments Specialist, will document in your record his or her
expectations of the members of your health care team. Members of your
health care team will then record the actions they took and their
observations. In that way, the, Hearing Instruments Specialist, will know how you are
responding to treatment.
We will also be pleased to provide your physician or a subsequent health care provider
with copies of various reports that should assist him or her in treating
you.
We will use your health information for payment.
For example: A bill may be sent to you or a third-party payer. The
information on or accompanying the bill may include information that
identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health operations.
For example: Members of the medical staff, the risk or quality improvement
manager, or members of the quality improvement team may use information in
your health record to assess the care and outcomes in your case and others
like it. This information will then be used in an effort to continually
improve the quality and effectiveness of the healthcare and service we
provide.
Business associates: There are some services provided in our organization
through contacts with business associates. Examples include hearing aid
manufacturers, hearing aid repair labs, earmold manufacturers, and billing
services. When these services are contracted, we may disclose your health
information to our business associate so that they can perform the job
we’ve asked them to do and bill you or your third-party payer for services
rendered. To protect your health information, however, we require the
business associate to appropriately safeguard your information.
Communication with family: Health professionals, using their best
judgment, may disclose to a family member, other relative, close personal
friend or any other person you identify, health information relevant to
that person’s involvement in your care or payment related to your care.
Marketing: We may contact you to provide appointment reminders,
information about hearing aid warranty status, new technology, treatment
alternatives or other health-related benefits and services that may be of
interest to you.
Fund raising: We may contact you as part of a fund-raising effort.
Food and Drug Administration (FDA): We may disclose to the FDA health
information relative to adverse events with respect to food, supplements,
product and product defects, or post marketing surveillance information to
enable product recalls, repairs, or replacement.
Workers compensation: We may disclose health information to the extent
authorized by and to the extent necessary to comply with laws relating to
workers compensation or other similar programs established by law.
Public health: As required by law, we may disclose your health information
to public health or legal authorities charged with preventing or
controlling disease, injury, or disability.
Correctional institution: Should you be an inmate of a correctional
institution, we may disclose to the institution or agents thereof health
information necessary for your health and the health and safety of other
individuals.
Law enforcement: We may disclose health information for law enforcement
purposes as required by law or in response to a valid subpoena.
Federal law makes provision for your health information to be released to
an appropriate health oversight agency, public health authority or
attorney, provided that a work force member or business associate believes
in good faith that we have engaged in unlawful conduct or have otherwise
violated professional or clinical standards and are potentially
endangering one or more patients, workers or the public.