CHME INC. 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.
We are required by law to maintain the privacy of your health information (“Protected Health Information” or “PHI”) and to provide you with this Notice of our legal duties and privacy practices concerning your Protected Health Information. When we use or disclose your Protected Health Information, we must abide by the terms of this Notice (or other Notice in effect at the time of the use or disclosure).
Uses and Disclosures:
Treatment. Your PHI may be used by staff members or disclosed to other healthcare professionals to evaluate your health, diagnose medical conditions, and provide treatment. For example, test and procedure results 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 PHI may be used to seek payment from your health plan, other coverage sources such as an automobile insurer, or 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 PHI may be used, as necessary, to support the day-to-day activities and management of Home Medical Equipment & Supplies & Affiliates. For example, information on the services you received may be used to support budgeting, financial reporting, and activities to evaluate and promote quality.
Business Associates. Your PHI 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 PHI, we require the business associate to safeguard your health information appropriately.
Law Enforcement. Your PHI may be disclosed to law enforcement agencies to support government audits and inspections, facilitate law-enforcement investigations, and comply with government-mandated reporting.
Worker’s Compensation. Your PHI 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 PHI or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing the use or disclosure of your PHI, 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 PHI 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:
The right to request restrictions on the use and disclosure of your PHI,
The right to receive confidential communications concerning your medical condition and treatment,
The right to inspect and copy your PHI,
The right to amend or submit corrections to your PHI,
The right to receive an accounting of how and to whom your PHI has been disclosed,
The right to receive a printed copy of this Notice.
Home Medical Equipment & Supplies & Affiliates Duties:
We are required by law to maintain your PHI’s privacy and provide you with this Notice of privacy practices. We must also abide by the privacy policies and practices 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 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 PHI we maintain.
Requests to Inspect PHI:
You may generally inspect or copy the PHI that we maintain. As permitted by federal regulation, we require that requests to inspect or copy PHI be submitted in writing. You may obtain a form requesting access to your records by contacting Customer Service. Your request will be reviewed and generally approved unless there are legal or medical reasons to deny the request.
Complaints:
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:
CHME Inc.
289 Foster City Blvd Suite A
Foster City, CA 94404
(650) 357-8550
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 as of April 14, 2003.