Provider notice of privacy practices
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OnlineMedSupplies.com, a division of Centreville Medical Arts
DME has developed this
Policy for the benefit of each user of this
website to demonstrate our serious commitment to protecting your
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.
Uses and Disclosures: We use health information about
you for providing durable medical equipment (DME), to obtain payment for
DME, for administrative purposes, and to evaluate the quality of service
that we provide. Continuity of care is part of treatment and your
records may be shared with other providers to whom you are referred. We
may use or disclose identifiable health information about you without
your authorization in several situations, but beyond those situations,
we will ask for your written authorization before using or disclosing
any identifiable health information about you. See details below for
examples of information uses.
Your rights: In most cases, you have the right to
look at or get a copy of health information about you. If you request
copies, we will charge you only normal photocopy fees. You also have the
right to receive a list of certain types of disclosures of your
information that we made. If you believe that information in your record
is incorrect, you have the right to request that we correct the existing
Our legal duty: We are required by law to protect the
privacy of your information, provide this notice about our information
practices, follow the information practices that are described in this
notice, and seek your acknowledgement of receipt of this notice.
Before we make a significant change in our policies,
we will change our notice and post the new notice in our office and on
our web site. You can also request a copy of our notice at any time or
download a copy from our web site. For more information about our
privacy practices, contact the person listed below.
Complaints: If you are concerned that we have
violated your privacy rights, or you disagree with a decision we made
about access to your records, you may contact the person listed below.
You also may send a written complaint to the U.S. Department of Health
and Human Services. The contact information listed below can provide you
with the appropriate address upon request. If you have any questions or
complaints, please call:
Centreville Medical Arts DME
Lafayette Center Drive, Chantilly, VA 20151
Your protected health information will be used, as needed, in activities
related to obtaining payment for durable medical equipment. For example,
obtaining approval for an accessory for your communication device may
require that your relevant protected health information be disclosed to
your Health Insurance Company or governmental plan to obtain approval
for the equipment.
Healthcare Operations: We may use or disclose, as-needed, your protected
health information in order to support our business activities. For
example, when we review employee performance, we may need to look at
what an employee has documented in your medical record.
Business Associates: We may share your protected
health information with a third party ‘business associate’ that performs
various activities (e.g., billing, outside sales). Whenever an
arrangement between us and a business associate involves the use or
disclosure of your protected health information, we will have a written
contract that contains terms that will protect the privacy of your
protected health information.
Marketing: We may use or disclose certain health
information in the course of providing you with information about
equipment alternatives, health-related services, or fund-raising
activities. You may contact us to request that these materials not be
sent to you.
Opportunity to Object
We may use and disclose
your protected health information in the following instances. You have
the opportunity to object. If you are not present or able to object,
then your provider may, using professional judgment, determine whether
the disclosure is in your best interest.
Others Involved in Your Healthcare: Unless you
object, we may disclose to a member of your family, a relative, a close
friend or any other person you identify, your protected health
information that directly relates to that person’s involvement in your
Emergencies: In an emergency treatment situation, we
will provide you a Notice of Privacy Practices as soon as reasonably
practicable after the delivery of treatment.
We may use and disclose your protected health information if we have
attempted to obtain acknowledgement from you of our Notice of Privacy
Practices but have been unable to do so due to substantial communication
barriers and we determine, using professional judgment, that you would
Without Opportunity to Object
We may use or disclose your protected health information in the
following situations without your authorization or opportunity to
Public Health: For public health purposes to a public
health authority or to a person who is at risk of contracting or
spreading your disease.
Health Oversight: To a health oversight agency for
activities authorized by law, such as audits, investigations, and
Abuse or Neglect: To an appropriate authority to
report child abuse or neglect, if we believe that you have been a victim
of abuse, neglect, or domestic violence.
Food and Drug Administration: As required by the Food
and Drug Administration to track products.
Legal Proceedings: In the course of legal proceedings.
Law Enforcement: For law enforcement purposes, such
as pertaining to victims of a crime or to prevent a crime.
Research: To researchers when their research has been
approved by an Institutional Review Board or Privacy Board.
Soldiers, Inmates, and National Security: To military
supervisors of Armed Forces personnel or to custodians of inmates, as
necessary. Preserving national security may also necessitate disclosure
of protected health information.
Workers’ Compensation: To comply with workers’
Compliance: To the Department of Health and Human Services to
investigate our compliance.
In general, we may use or disclose your protected health information as
required by law and limited to the relevant requirements of the law.
You have the right to:
Inspect and copy your protected health information: However, we may
refuse to provide access to certain psychotherapy notes or information
for a civil or criminal proceeding.
Request a restriction of your protected health
information: You may ask us not to use or disclose certain parts of your
protected health information for treatment, payment or healthcare
operations. You may also request that information not be disclosed to
family members or friends who may be involved in your care. Your request
must state the specific restriction requested and to whom you want the
restriction to apply. We are not required to agree to a restriction that
you may request, but if we do agree, then we must act accordingly.
Request to receive confidential communications from us by alternative
means or at an alternative location: We will accommodate reasonable
requests. We may also condition this accommodation by asking you for
information as to how payment will be handled or specification of an
alternative address or other method of contact. We will not request an
explanation from you as to the basis for the request.
Ask us to amend your protected health information:
You may request an amendment of protected health information about you.
If we deny your request for amendment, you have the right to file a
statement of disagreement with us, and your medical record will note the
Receive an accounting of certain disclosures we may
have made: This right applies to disclosures for purposes other than
treatment, payment or healthcare operations. It excludes disclosures we
may have made to you, for a facility directory, to family members or
friends involved in your care, or for notification purposes. You have
the right to receive specific information regarding these disclosures.
The right to receive this information is subject to certain exceptions,
restrictions and limitations.
Obtain a paper copy of this notice from us: Upon
request, even if you have agreed to accept this notice electronically.
*Generally, you pay 20%
of the Medicare-approved amount after you pay your Medicare Part B
deductible for the year ($162 in 2011). Medicare pays the other 80%. The
Medicare-approved amount is the lower of the actual charge for the item
or the fee Medicare sets for the item. However, the amount you pay may
vary because Medicare pays for different kinds of durable medical
equipment in different ways. You may be able to rent or buy the