WILLIAMS MEDICAL SUPPLY, 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.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the patient, significant new rights to understand and control how your health information is used. "HIPAA" provides penalties for covered entities that misuse personal health information.
As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information (hereafter also referred to as PHI).
We may use and disclose your medical records only for each of the following purposes: treatment, payment and health care operations.
- Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include consultation with your Physician about your medical need for equipment and/or supplies.
- Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your equipment and/or supplies to your insurance company for payment.
- Health care operations include the business aspects of running our business such as conducting quality assessment and improvement activities, accreditation activities, and customer service. An example would be internal quality assessment review. We may contact you for information about health-related benefits and services that may be of interest to you.
- Required by Law means we will use and disclose medical information about when required by law or for national priority uses and disclosures such as a national emergency.
Any other uses and disclosures including, but not limited to marketing, sale of PHI, and most uses and disclosures of psychotherapy notes will be made only with written authorization from you or your designated representative.
You have the following rights with respect to your PHI, which you can exercise by presenting a written request to us:
- The right to request restrictions on certain uses and disclosures of PHI, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
- The right to reasonable requests to receive confidential communications of protected health information from us.
- The right to inspect and copy your protected health information,
- The right to amend your protected health information.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of this notice from us upon request.
- The right to notification if a breach of your medical information occurs.
- The right to restrict disclosures of your PHI to health plans if you have paid for services out or pocket in full.
We are required by law to maintain the privacy of your PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. This notice is effective as of April 14, 2003 and last revised Sept. 23, 2013. We are required to abide by our Notice
of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all PHI that we maintain. We will post and you may request a written copy of any revised Notice of Privacy Practices from our company. You have recourse if you feel that your privacy protections have been violated. You have the
right to file written complaint with our office, the Dept. of Health and Human Services, or with the Office of Civil Rights about violations of the provisions of this notice or the policies and procedures of our company. We will not retaliate against you for filing a complaint.
To request further information about our HIPAA Policies or to file a complaint, contact our privacy officer at:
WILLIAMS MEDICAL SUPPLY
1501 Church Street
Nashville, TN 37203-3004
For more information about HIPAA or to file a complaint:
THE U.S. DEPT. OF HEALTH & HUMAN SERVICES OFFICE FOR CIVIL RIGHTS
200 INDEPENDENCE AVE, S.W.
ROOM 5029F, HHH BUILDING
WASHINGTON, D.C. 20201
(202) 619-0257 Toll Free: 1-877-696-6775