NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED, DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
During your treatment at Mobile Hearing Aids, members of its staff may gather information about your medical history and your current health. This notice explains how that information may be used and shared with others. It also explains your privacy rights regarding this information. The terms of this notice apply to health information created or received by Mobile Hearing Aids. We are required, by law, to: make sure that medical information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; and follow the terms of this notice that is currently in effect.
Your Medical information may be used and disclosed for the following purposes:
- Treatment: We may use your information to provide, coordinate, and manage your care and treatment. For example, a Mobile Hearing Aids staff member may share your medical information with another health care provider for a consultation or a referral.
- Payment: We may use and disclose medical information about you so that the treatment and services you receive may be billed to, and payment may be collected from you, an insurance company, or another third party. For example, we may need to give your health insurance information about treatment you received at Mobile Hearing Aids so your health insurance will pay us or reimburse you for the treatment.
- Health Care Operations: We may use and disclose medical information about you for Mobile Hearing Aids health care operations. Health care operations are the uses and disclosures of information that are necessary to run Mobile Hearing Aids and to make sure that all of our customers receive quality care. For example, we may use medical information to evaluate the performance of our staff in caring for you.
- Appointment Reminders and Other Health Information: We may use your medical information to send you reminders about future appointments. We may also contact you with information about new or alternative treatments or other health care services.
- To People Assisting in Your Care: Mobile Hearing Aids will only disclose medical information to those taking care of you, helping you to pay your bills, or other close family members or friends (only if they need to know this information to help you), and then only to the extent permitted by law. We may, for example, provide limited medical information to allow a family member to pick up a hearing device for you. If you are able to make your own health care decisions; Mobile Hearing Aids will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, Mobile Hearing Aids will disclose relevant medical information to family members or other responsible people, if we feel it is in your best interest to do so, including in an emergency situation.
- Research: Federal law permits Mobile Hearing Aids to use and disclose medical information about you for research purposes, either with your written authorization or, where allowed by the state, when an Institutional Review Board or Privacy Board has reviewed the study for privacy protection before the research begins.
- To Business Associates: Some services are provided by or to Mobile Hearing Aids through contracts with business associates. Examples include Mobile Hearing Aids’ attorneys, consultants, collection agencies, and accreditation organizations. We may disclose information about you to our business associates so that they can perform the job we have contracted with them to do.
In all of the situations described above, where required to do so by law, Mobile Hearing Aids will obtain your written permission prior to disclosing your health information. Your medical information may be released in the following special situations.
We may also use or disclose your information without your permission for the following purposes to the extent permitted or required by law:
- Under emergency conditions, to government or other group assisting in emergencies or disasters
- When required by law
- For public health activities, including and without limitation to, reporting disease and vital statistics, child abuse, and adult abuse/domestic violence or neglect
- For health oversight activities, such as activities of state licensing and peer review authorities, and fraud prevention enforcement agencies
- For judicial and administrative proceedings
- To avert a serious threat to health or safety
- To law enforcement officials with regard to crime victims, crimes on our premises, crime reporting in emergencies, and identifying and locating suspects or other persons.
- For certain specialized government functions, such as military discharge
- To the military, to federal officials for lawful intelligence, counterintelligence, national security activities, and to correctional institutions and law enforcement regarding persons in lawful custody
- As authorized by the state’s worker’s compensation laws.
You have the following rights regarding your medical information that we maintain:
- Right to inspect and copy: You have the right to inspect and receive a copy of your medical information that is used to make decisions about your care. Usually, this includes medical and billing records maintained by Mobile Hearing Aids. If you wish to inspect and copy medical information, you must submit a written request. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request, to the extent permitted by state and federal law. We may deny your request to inspect and copy your information in certain, very limited circumstances. For example, we may deny access if your physician believes it will be harmful to your health, or could cause a threat to others. If you are denied access to medical information, you may request that the denial be reviewed. Another health care provider chosen by Mobile Hearing Aids will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
- Right to Request Amendment: If you believe that medical information, we have about you is incorrect or incomplete, you have the right to ask us to change the information. You have to right to request an amendment for as long as the information is kept by or for Mobile Hearing Aids. To request a change to your information, you must complete and return a Request for Amendment Form (a copy of which is available upon request). In addition, you must provide a reason that supports your request. Mobile Hearing Aids may deny your request for 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: Was not created by Mobile Hearing Aids, unless the person or entity that create the information is no longer available to make the amendment Is not part of the medical information kept by or for Mobile Hearing Aids Is not part of the information which you would be permitted to inspect and copy or is accurate and complete
- Right to an 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. This list will not include disclosures for treatment, payment, and health care operations; disclosures that you have authorized or that have been made to you; disclosures for the facility directories; disclosures for a national security or intelligence purposes; and disclosures to correctional institutions or law enforcement with custody of you. To request this list of disclosures, you must state a time period for which you would like the accounting. The accounting period may not go back further than six years from the date of request.
- Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you. For example, you could ask that we not use or disclose information about treatment that you received to other health care providers or to your insurance company. 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.
- 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 contact you only at work or by mail. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted, and we may require you to provide information about how payment will be handled.
- Right to Paper Copy of this Notice: You have the right to receive a paper copy of this notice. You may ask us to give you a copy at any time.
Changes to this Notice We reserve the right to change this notice.
We reserve the right to make the revised or changed notice effective for medical information we already have about you, as well as any information we receive in the future. If the terms of this notice are changed, Mobile Hearing Aids will provide you with a revised notice upon request, and we will post the revised notice in designated locations at Mobile Hearing Aids.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with Mobile Hearing Aids, please complete and return a Complaint Form (a copy of which is available upon request) or contact our Compliance Officer at (440) 310-7037. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Other Uses of Medical Information
Mobile Hearing Aids will not use or disclose your protected health information without a specific written authorization from you. If you provide us with this written authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent we have already made with your permission, and we are required to retain our records of the care that we provided you.
If you would like to contact Mobile Hearing Aids regarding any questions on HIPAA Compliance, please contact Mobile Hearing Aids’ Compliance Officer at (440) 310-7037.
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