Effective: July 28, 2005 RESP-I-CARE, INC. 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 any questions about this Notice or wish to obtain any of the forms addressed in this Notice, please contact our Privacy Officer at (423)349-9000 in our RESP-I-CARE corporate office. This "Notice of Privacy Practices" describes how we may utilize and disclose your protected health information to administer treatment, obtain payment or manage health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information that may identify you and relates to your past, present or future physical or mental health or condition and related health care services. We are required by law to provide this notice and abide by the terms of this "Notice of Privacy Practices" in order to maintain the privacy of your protected health information. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. We will provide you with any revised Notice of Privacy Practices when calling the office and requesting that a revised copy be sent to you in the mail, asking for one at the time of your next appointment or accessing our website at respicare@usa.com. UNDERSTANDING YOUR HEALTH INFORMATION RECORDS
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU For Treatment: We may use health information about you to provide your medical treatment or services. We may disclose your health information to doctors, therapists, technicians, nurses, office staff or other personnel who are involved in your care. Different personnel in our office may share information about you and disclose information to people who do not work in our office in order to coordinate your care, such as ordering special supplies for you from vendors and for obtaining information from a previous provider. Family members and other health care providers may be part of your medical care outside this office and may require your information. For example, information obtained by a respiratory therapist or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. We may provide your physician or a subsequent healthcare provider with copies of various reports so they can help determine the most appropriate care for you. For Payment: We may utilize and disclose health information about you so that the treatment and services you receive from RESP-I-CARE may be billed to and payment may be collected from you, your insurance company, or a third party payer. For example, we may need to provide your health plan information regarding a service you received, so that your health plan will pay us or reimburse you for the service. We may also tell your health plan about a treatment you are going to receive in order to obtain prior approval, or to determine whether your plan will cover the treatment. Information identifying you may include, but is not limited to, your diagnosis, procedures and the supplies used. For Health Care Operations: We may utilize and disclose health information about you in order to efficiently provide our services and make sure that you and our other patients receive quality care. For example, we may review your health information to evaluate the performance of our staff in caring for you. We may also use health data about our patients to help decide what additional services we should offer, how we can become more efficient, or whether or not certain new treatments are effective. Business Associates: Some services are provided by our organization through contracts with professional associates. When services are contracted, we may disclose your information to our business associates so that they can perform the job we've asked them to do. To protect your health information, we require the business associate to appropriately safeguard your information. For example, we may submit information to an independent agency to obtain required statistical data in relation to the home health care field. Appointment Reminders/Scheduling of Appointments: We may contact you by phone (including leaving a message on your answering machine) or by mail to schedule an appointment for services or as a reminder that you have an appointment for services at our office or at your home. Treatment Alternatives: We may tell you about or recommend possible treatment options or alternatives that may be of interest to you. Health-Related Products and Services: We may tell you about health-related products or services that may be of interest to you. Please notify us if you do not wish to be contacted for appointment reminders, or if you do not wish to receive communications about treatment alternatives or health-related products and services. If you advise us in writing that you do not wish to receive such communications, we will not utilize or disclose your information for these purposes. You may revoke your Consent at any time by giving us written notice. Send written requests to: RESP-I-CARE (Attn: Privacy Officer), 648 Eastern Star Road, Kingsport, TN 37663. Your revocation will be effective when we receive it, but it will not apply to any uses and disclosures that occurred before that time. If you do revoke your Consent, we will not be permitted to use or disclose information for purposes of treatment, payment or health care operations, and we may therefore choose to discontinue providing your health care treatment and services. SPECIAL SITUATIONS Required By Law: We will disclose health information about you when required to do so by federal, state or local law. Research: We may use and disclose health information about you for research projects that are approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information. We will ask for permission if the researcher will have access to your name, address or other information that reveals who you are, or who will be involved in your care at the office. Organ and Tissue Donation: Consistent with applicable law, if you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary, to facilitate such donation and transplantation. Military, Veterans, National security and Intelligence: If you are or were a member of the armed forces, or part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military authority. Food and Drug Administration: We may disclose health information to the FDA 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 release health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness. Public Health Risks: We may disclose health information about you for public health reasons in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products. Health Oversight Activities: We may disclose health information to a health oversight agency for audits, investigations, inspections, 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. Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena. Law Enforcement: We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements. Correctional Institution: Should you be an inmate of a correctional institution, we may disclose to the institution, or agents thereof, information necessary for your health and the health and safety of other individuals. Coroners, Medical Examiners and Funeral Directors: We may release health information to a coroner, medical examiner, or funeral director consistent with applicable law to carry out their duties. This may be necessary, for example, to identify a deceased person or determine the cause of death. Information Not Personally Identifiable: We may use or disclose health information about you in a way that does not personally identify you or reveal who you are. Family and Friends: Health professionals, using their best judgment, may disclose health information about you to your family members or friends, or any other person you identify in which that person's involvement is relevant to your care or payment related to your care. In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person's involvement in your care. We may use our professional judgment and experience to make reasonable inferences that it is in your best interest to allow another person to act on your behalf. For example, we may assume you agree to our disclosure of your personal health information to your spouse when your spouse is present during equipment set-up or a routine equipment check, or to a friend that you have sent to pickup supplies for you. OTHER USES AND DISCLOSURES OF HEALTH INFORMATION YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION Right to Inspect and Copy: You have the right to inspect and copy your health information, such as medical and billing records, that we use to make decisions about your care. You must submit a written request to our Privacy Officer in order to inspect and/or copy your health information. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other associated supplies. We may deny your request to inspect and/or copy in certain limited circumstances. If you are denied access to your health information, you may ask that the denial be reviewed. If such a review is required by law, we will select a licensed health care professional to review your request and our denial. The person conducting the review will not be the person who denied your request, and we will comply with the outcome of the review. Right to Amend: If you believe health 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 is maintained by this office. To request an amendment, contact our Privacy Officer to obtain a Medical Record Amendment/Correction Form. This form must be completed and submitted to our Privacy Officer for review. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
Right to Accounting of Disclosures: You have the right to request an "accounting of disclosures". This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment and health care operations. To obtain this list, you must submit your request in writing to our Privacy Officer. It must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically, etc.). We may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your 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 specific medical supply you received. We are not Required to Agree to your Request: If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. We will notify you if we are unable to agree with your restriction request. To request restrictions, you may complete and submit the Request For Restriction on use/Disclosure of Medical Information to our Privacy Officer. Right to Request Confidential Communications: You have the right to request that we communicate with you about medical 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. We will make our best effort to accommodate any reasonable requests to communicate health information by alternative means or at alternative locations. To request confidential communications, you may complete and submit the Request for Restriction on Use/Disclosure of Medical Information and/or Confidential Communication to our Privacy Officer. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. 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. Even if you have agreed to receive it electronically, you are still entitled to a paper copy. To obtain such a copy, contact our Privacy Officer. CHANGES TO THIS NOTICE COMPLAINTS |