| Emergency Services Available 24 Hours, 7 Days a Week. |
35 Welby Rd. New Bedford, MA 02745 (508) 992-2146 1 (800) 473-4669 Fax: (508) 999-2724 |
Our company is dedicated to maintaining the privacy of your identifiable health information. In
conducting our business, we will create records regarding you and the service we provide to you. This
notice tells you about the way in which Enos Home Respiratory (referred to as "we" or Enos Home
Respiratory) may collect, use, ans disclose your protected health information. "protected health
information" is information about you that can reasonably be used to service you and that relates to
you, or the payment of that care.
We are required by law to maintain the confidentiality of health information that identifies you
with this Notice about your rights and our legal duties and privacy practices with respect to your
protected health information. We must follow the terms of this Notice while it is in effect. Some of
the uses and disclosures described in this Notice may be limited in certain cases by applicable state
laws that are more stringent than the federal standards.
If you have any questions about this notice, please contact the Privacy Officer at Enos Home
Respiratory at 800-473-4669 for further information.
The terms of this notice apply to all records cintaining your health information that are created
or retained by our organization. We reserve the right to revise or amend our notice of privacy
practices. Any revisions or amendments to this notice will be effective for all of your records our
practice has created or maintained in the past, and for any of your records we may create or maintain
in the future. Our organization will post a copy or our current notice in our office in a prominent
location, and you may request a copy of our most current notice by calling us.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
OTHER PERMITTED OF REQUIRED DISCLOSURES
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
conducting our business, we will create records regarding you and the service we provide to you. This
notice tells you about the way in which Enos Home Respiratory (referred to as "we" or Enos Home
Respiratory) may collect, use, ans disclose your protected health information. "protected health
information" is information about you that can reasonably be used to service you and that relates to
you, or the payment of that care.
We are required by law to maintain the confidentiality of health information that identifies you
with this Notice about your rights and our legal duties and privacy practices with respect to your
protected health information. We must follow the terms of this Notice while it is in effect. Some of
the uses and disclosures described in this Notice may be limited in certain cases by applicable state
laws that are more stringent than the federal standards.
If you have any questions about this notice, please contact the Privacy Officer at Enos Home
Respiratory at 800-473-4669 for further information.
The terms of this notice apply to all records cintaining your health information that are created
or retained by our organization. We reserve the right to revise or amend our notice of privacy
practices. Any revisions or amendments to this notice will be effective for all of your records our
practice has created or maintained in the past, and for any of your records we may create or maintain
in the future. Our organization will post a copy or our current notice in our office in a prominent
location, and you may request a copy of our most current notice by calling us.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
- We may use and disclose your protected health information for different purposes. The
examples below are provided to illustrate the types of uses and disclosures we may without
your authorization for payment, home care operations, and treatment. - Payment. We use and disclose your protected health information in order to bill and collect
your payment for the services and items you may recieve from us. For example, we may
contact your health insurer to certify that you are eligable for benefits and we may provide
your insurer with details regarding your treatment to determine if your insurer will cover, or
pay for, your equipment. We may also use and disclose your health information to obtain
payment from third parties that may be responsible for such costs, such as family members.
Also, we may use your health information to bill you directly for services and items. - Home Care Operations. We use and disclose your protected health information in order to
perform our home care activities, such as providing equipment appropriate to your needs, or
administrative activities, including data management or quality assessment activities. - Treatment. We may use and disclose your protected health information to coordinate services
with our health care providers invilved in your care. For example, we may provide an oximetry
test to evaluate the appropriatenedd of oxygen equipment; collect measurements to identify
appropriate seating and mobility system(s). We may obtain and disclose information on
Arterial Blood Gases, oxygen saturation results. CPT diangosis codes, diagnosis and prognosis,
functional limitations, pre-existing health condidtions, hospitalizations, prior use of equipment,
and information specific to qualifying the patient as dictated by CMN / detailed written order
forms. - Appropriate Reminders. We may use and disclose your health information to contact you and
remind you of visits / deliveries. - Health-related Benefits and Services. We may use and disclose your health information to
inform you of health-related benefits to services that may be of interest to you. - Release of information to Family / Friends. We may release your health information to a
friend or family member that is helping you to pay for your health care, or who assists in
taking care of you. - Disclosures Required by Law. We will use and disclose your health information when we are
required to do so by federa, state, and local law.
OTHER PERMITTED OF REQUIRED DISCLOSURES
- As Required by Law. We must disclose protected health information about you when required
to do so by law. - Public Health Activities. We may disclose protected health information to public health
agencies for reasons such as preventing or controlling disease, injurs, or disabilities. - Victims of Abuse. Neglect, or Domestic Violence. We may disclose protected health
information to government agencies about abuse, neglect, or domestic violence. - Health Oversight Activities. We may disclose protected health information to government
oversight agencies. Oversight activities can include, for example, investigations, inspections,
audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal
procedures or actions; or other activities necessary for the government to monitor government
programs, compliance with civil rights laws and the health care system in general. - Judicial and Administrative Proceedings. We may disclose protected health information in
response to a court or administrative order. We may also disclose protected health information
about you in certain cases in response to a subpoena, discovery request, or other lawful process. - Law Enforcement. We may disclose protected health information under limited circumstances
to a law enforcement official in response to a warrent or similar process; to identify or locate a
suspect; or to provide information about the victim of a crime. - To Avert a Seriour Threar to Health or Safety. We may disclose protected health information
about you, with some limitations, when necessary to prevent a serious threat to your health
and safety or the health and safety of the public or another person. - Special Government Functions. We may disclose information as required by military
authorities or to authorized federal officials for national security and intelligence activities. - Workers Compensation. We may disclose protected health information to the extent necessary
to comply with state law for workers' compensation programs.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
- You have cartain rights regarding protected health information that the Plan maintains about
you. - Right to Access Your Protected Health Information. You have the right to review or obtain
copies of your protected health information records, with some limited exceptions. Usually the
records include referral information, delivery forms, billing claims payment, and medical
management records. Your request to review and/or obtain a copy of your protected health
information records must be made in writing. We may charge a fee for the costs of producing,
copying, and mailing your requested information, but we will tell you the cost in advance. - Right to Amend Your Protected Health Information. If you feel that protected health
information maintained by us is incorrect or incomplete, you may request that we amend the
information. Your request must be made in writing and must include the reason you are
seeking a change. We may deny your request if, for example, you ask us to amend information
that was not created by us, or you ask to amend a record that is already accurate and complete.
If we deny your request to amend, we will notify you in writing. You then have the right to
submit to us a written statement of disagreement with our decision and we have the right to
rebut the statement. - Right to an Accounting of Disclosures. You have the right to request an accounting of
disclosures we have made of your protected health information. This list will not include our
disclosures related to your treatement, our payment or health care operations, or disclosures
made to you or with your authorization. The list may also exclude certain other disclosures,
such as for national security purposes. Your request for an accounting of disclosures must be
made in writing and must state a time period for which you want an accounting. This time
period may not be longer than 6 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 or electronically).
The first accounting that you request within a 12-month period will be free. For additional lists
within the same time period, we may change for providing the accounting, but we will tell you
the cost in advance. - Right to Recieve Confidential Communications. You have the right to request that we use a
certain method to communicate with you or that we send information to a certain location. For
example, you may ask that we contact you at work rather that at home. Your request to
recieve confidential communications must be made in writing. We will accommodate all
reasonable requests. Your request must specify how or where you wish to be contacted. - Right to a Paper Copy of this Notice. You have the right at any time to request a paper copy of
this Notice. You may ask us to give you a copy of this notice at any time. - Contact Information for Excersising Your Rights. You may excersise any of the rights
described above by contacting our privacy office. - Complaints. If you believe that your privacy rights have been violated, you may file a
complaint with us and/or with the Secretary of the Department of Health and Human Services.
All complaints must be sumbitted in writing. You will not be penalised for filing a complaint.
| Copyright © 2007 Enos Home Oxygen & Medical Supply, Inc. All rights reserved. |
| Notice of Privacy Practices (Effective April 14, 2003) |