HIPAA Privacy Policy
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.
The Health Insurance Portability & Accountability Act of 1996 (“HIPAA”)
is a federal program that requires that all medical records and other
individually identifiable health information used or disclosed by us
in any form, whether electronically, on paper or orally, are kept properly
confidential. This Act gives you, the patient, significant new rights
to understand and control how your health information is used. “HIPAA” provides
penalties for covered entities that misuse personal health information.
Uses and Disclosures
Treatment. Your health information may be used by staff members or disclosed
to other health care professionals for the purpose of evaluating your
health, diagnosing medical conditions, and providing treatment. For example,
results of tests and procedures will be available in your medical record
to all health professionals who may provide treatment or who may be consulted
by staff members.
Payment. Your health information may be used to seek payment from your
health plan, from other sources of coverage such as an automobile insurer,
or from credit card companies that you may use to pay for services. For
example, your health plan may request and receive information on dates
of service, the services provided, and the medical condition being treated.
Health care operations. Your health information may be used, as necessary,
to support the day-to-day activities and management of Monroe Wheelchair & Affiliates.
For example, information on the services you received that may be used
to support budgeting and financial reporting, and activities to evaluate
and promote quality.
Business Associates. Your health information may be disclosed to our
business associates, such as subcontractors, so they can perform the
jobs we have asked them to do. To protect your health information, we
require the business associate to appropriately safeguard your health
information.
Law enforcement. Your health information may be disclosed to law enforcement
agencies to support government audits and inspections, to facilitate
law-enforcement investigations, and to comply with government-mandated
reporting.
Worker's Compensation. Your health information may be disclosed to comply
with worker’s compensation laws and other similar programs that
provide benefits for work-related injuries or illnesses.
Other uses and disclosures require your authorization. Disclosure of
your health information or its use for any purpose other than those listed
above requires your specific written authorization. If you change your
mind after authorizing a use or disclosure of your information, you may
submit a written revocation of the authorization. However, your decision
to revoke the authorization will not affect or undo any use or disclosure
of information that occurred before you notified us of your decision
to revoke your authorization.
Individual Rights
You have certain rights under the federal privacy standards. These
include:
1. The right to request restrictions on the use and disclosure of your protected
health information
2. The right to receive confidential communications concerning your medical
condition and treatment
3. The right to inspect and copy your protected health information
4. The right to amend or submit corrections to your protected health information
5. The right to receive an accounting of how and to whom your protected health
information has been disclosed
6. The right to receive a printed copy of this notice
Monroe Wheelchair & Affiliates Duties
We are required by law to maintain the privacy of your protected health
information and to provide you with this notice of privacy practices.
We also are required to abide by the privacy policies and practices
that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy
policies and practices. These changes in our policies and practices may
be required by changes in federal and state laws and regulations. Upon
request, we will provide you with the most recently revised notice on
any office visit. The revised policies and practices will be applied
to all protected health information we maintain.
Requests to Inspect Protected Health Information
You may generally inspect or copy the protected health information
that we maintain. As permitted by federal regulation, we require that
requests to inspect or copy protected health information be submitted
in writing. You may obtain a form to request access to your records by
contacting Customer Service or the Privacy Officer. Your request will
be reviewed and will generally be approved unless there are legal or
medical reasons to deny the request.
Complaints\Contact Person
If you would like to submit a comment or complaint about our privacy
practices, you can do so by sending a letter outlining your concerns
to:
Privacy Officer
Monroe Wheelchair
295 Monroe Ave.
Rochester, NY 14607
(585) 546.8595
If you believe that your privacy rights have been violated, you should
call the matter to our attention by sending a letter describing the cause
of your concern to the same address.
You will not be penalized or otherwise retaliated against for filing
a complaint.
You may also use the above name and address to contact us for further
information concerning our privacy practices.
Effective Date
This notice is effective on or after April 14, 2003.
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