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, please contact our Privacy Compliance Officer at 800.456.3500 or e-mail us at privacy@choice-med.com.
Please click here to print an acknowledgment that you have received this Notice of Privacy Practices.
Adobe® Acrobat Reader® Required
About this Notice
Choice Medical Supplies is required by law to maintain the privacy of your health information, to provide you with a notice of its legal duties and privacy practices, and to follow the information practices that are described in this notice.
This notice explains how your health information may be used and disclosed. You have a right to request and receive a paper copy of this notice. Choice Medical Supplies will not use or disclose your health information except as described in this notice.
This notice applies to all the health information obtained by Choice Medical Supplies and kept in your Customer Account file. We share your information only as necessary to perform treatment, payment, or operational activities.
Understanding Your Health Record and Personal Health Information
Each time you, or someone else on your behalf, orders supplies from us and we submit a claim for payment (either to you or to Choice Medical Supplies), a medical record is made. Typically, this record contains a list of your supplies, a prescription for your supplies, and your name, address, phone number, date of birth, social security number, insurance information, evaluations, test results, diagnoses, and prognoses.
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 services you received
- Means by which you or a third-party payer can verify that services billed were actually ordered and provided
- Source of information for public health officials charged with improving the health of the nation
- Source of data for facility planning and marketing
- Tool with which we can assess and continually work to improve the service we render and the outcomes we achieve
- Means of communication among the many health professionals who contribute to your care
- Legal document describing the services you received
- Means by which you or a third-party payer can verify that services billed were actually ordered and provided
- Source of information for public health officials charged with improving the health of the nation
- Source of data for facility planning and marketing
- Tool with which we can assess and continually work to improve the service 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
- Make more informed decisions when authorizing disclosure to others
For example: Information provided by your physician or other member of your health care team will be recorded in your record and used to determine the supplies or services that should work best for you. We may provide your physician or a subsequent health care provider with copies of protected health information that should assist him or her in making decisions regarding your care.
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.
For example: We may contact you to assure the quality of our service, to verify your order, and to inform you of any issues relating to your order or services requested.
All other uses and disclosures will be made only with your written authorization, which you have the right in most cases to revoke.
- Better understand who, what, when, where, and why others may access your health information
- Make more informed decisions when authorizing disclosure to others
Examples of Uses and Disclosures for Treatment, Payment and Health Operations
The following categories describe the ways we may use and disclose your health information.
Treatment
We may use health information about you to provide you with medical treatment or services. We may disclose health information about you to doctors, nurses, technicians, office staff or other personnel who are involved in your care or health care decisions.
For example: Information provided by your physician or other member of your health care team will be recorded in your record and used to determine the supplies or services that should work best for you. We may provide your physician or a subsequent health care provider with copies of protected health information that should assist him or her in making decisions regarding your care.
Payment
We may use and disclose health information about you so that the treatment and services you receive at this office may be billed to and payment may be collected from you, an insurance company or a third party.
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.
Regular health operations
We may use and disclose health information about you in order to run the office and make sure that you and our other customers receive quality care. We also may contact you as part of our efforts to assess and continually work to improve services we render and the outcomes we are reaching to achieve.
For example: We may contact you to assure the quality of our service, to verify your order, and to inform you of any issues relating to your order or services requested.
Other Uses and Disclosures
We also may use and disclose your health information without your consent to meet special reporting requirements to facilitate continuity of care or for other purposes. Such uses and disclosures include:
- Family and friends who are involved in your medical care.
- Business associates of ours, with whom we contract for services. Examples of Business Associates include
- Data for health oversight activities, such as auditing and licensing.
- Reports on communicable diseases.
- Reports to employers for work-related illness or injuries.
- Reports on abuse, neglect, or domestic violence
- To avert a serious threat to public health or safety or to prevent serious harm to an individual
- As required by law, such as for law enforcement or in response to a subpoena or court order.
- Coroners and medical examiners, as necessary, to carry out their duties.
- Organ procurement organizations, to the extent allowed by law.
- Research projects that are subject to a special approval process. Your permission is required if the researcher will have
- Workers compensation
- Marketing. We may provide you with information about product alternatives or other services that may be of interest to
- Business associates of ours, with whom we contract for services. Examples of Business Associates include
consultants, accountants, lawyers, entities that ship orders on our behalf, custom fitting manufacturers, and third-party billing companies. We require these Business Associates to protect the confidentiality of your health information
- The Food and Drug Administration, such as to report adverse events.
- Data for health oversight activities, such as auditing and licensing.
- Reports on communicable diseases.
- Reports to employers for work-related illness or injuries.
- Reports on abuse, neglect, or domestic violence
- To avert a serious threat to public health or safety or to prevent serious harm to an individual
- As required by law, such as for law enforcement or in response to a subpoena or court order.
- Coroners and medical examiners, as necessary, to carry out their duties.
- Organ procurement organizations, to the extent allowed by law.
- Research projects that are subject to a special approval process. Your permission is required if the researcher will have
access to your name, address, or other information that reveals who you are.
- Specialized government functions; for example, as required by military authorities.
- Workers compensation
- Marketing. We may provide you with information about product alternatives or other services that may be of interest to
you.
- If you are an inmate, your health information may be released to the correctional facility or agents.
All other uses and disclosures will be made only with your written authorization, which you have the right in most cases to revoke.
Special Authorizations
There are federal and state laws that provide special protection for certain kinds of personal health information, such as information about sexually transmitted and other communicable diseases, drug and alcohol abuse, and certain mental health services. These laws may require specific authorizations from you to disclose this information. In such cases, to comply with these laws, we will contact you to request the necessary authorizations.
Your Rights
You have individual rights over the use and disclosure of your personal health information, including the rights listed below. You may exercise any of these rights by contacting our Privacy Officer at 1.800.456.3500.
Restrict use
You may request, in writing, restrictions on certain uses and disclosure of your information. We will consider your request but are not legally required to accept it. After careful review of your request, we will notify you of our determination in writing.
Serving Our Valued Customers For More Than 65 years
Copyright 2004 Choice Medical Supplies