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What’s New with All Florida Medical Supplies in Spring Hill, FL

What’s New

What’s New
MEDI-SYSTEMS
NOTICE OF USES OF PROTECTED HEALTH INFORMATION
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) AND HEALTH INFORMATION TECHNOLOGY FOR ECONOMIC AND CLINICAL HEALTH (HITECH)
EFFECTIVE 5/12/11
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED OR DISCLOSED AND HOW YOU MAY OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
In accordance with the requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the Federal Health Information Technology for Economic and Clinical Health Act (the “HITECH” Act), Medi-Systems is required to inform you of its practices in relation to the protected health information (“PHI”) that it maintains about you. HIPAA mandates minimum standards that a covered entity such as Medi-Systems must maintain in relation to your protected health information. This Notice of Uses is being provided to help you understand how Medi-Systems meets these minimum standards. It is also meant to inform you of the ways that Medi-Systems may use the personal information it collects about you and how it may disclose it.
UNDERSTANDING YOUR PROTECTED HEALTH INFORMATION
When you receive care from a healthcare provider, a record of that treatment is made. This record will typically contain information on your diagnosis, treatment, and future plan of treatment and is often collectively referred to as your medical record. This medical record includes protected health information and lays the foundation for determining your plan of care and treatment and allows for a successful means of communication between all healthcare professionals that contribute to your care. HIPAA protects information found in your medical record from disclosure without your authorization. The information protected by HIPAA includes:
1. Any information related to your past, present or future physical or mental health;
2. The past, present or future payment for health services you have received;
3. The specific care that you have received, are receiving or will receive;
4. Any information that identifies you as the individual receiving the care; and
5. Any information that someone could reasonably use to identify you as receiving the care.
This information is referred to as protected health information throughout this Notice.
TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS
As a Covered Entity, Medi-Systems is required to inform you of how it may use your protected health information. In providing treatment to you, Medi-Systems will use your protected health information for the purposes of treatment, payment and certain healthcare operations (“TPO”) without your written authorization. Treatment - As it pertains to Medi-Systems, treatment means providing to you supplies and durable medical equipment services as ordered by your physician. Treatment also includes coordination and consultation with your physician and other health care providers. As Medi-Systems provides these services to you, information obtained during this process will be recorded in your medical record. Medi-Systems will use this information, in coordination with your physician, to determine the best course of treatment for you. Payment - Payment purposes consist of activities required to obtain reimbursement from your insurance carrier for the services ordered by your physician and provided to you by Medi-Systems. This includes, but is not limited to, eligibility determination, precertification, billing and collection activities, obtaining documentation required by your insurer, and when applicable, disclosure of limited information to consumer reporting agencies. Healthcare operations - Operations can include, but are not limited to, review of your protected health information by members of Medi-System’s professional healthcare staff to ensure compliance with all federal and state regulations. This information will then be utilized to continually improve the quality and effectiveness of the services provided to you by Medi-Systems. Healthcare operations also include Medi-System’s business management and general administrative activities.
OTHER USES AND DISCLOSURES
In order to release information contained in your medical record for purposes other than treatment, payment or healthcare operations, Medi-Systems must obtain a specific signed authorization from you. You may revoke such authorization at any time, except to the extent Medi-Systems has taken action in reliance on the authorization.
EXCEPTIONS WHEN AUTHORIZATION IS NOT REQUIRED FOR PURPOSES OTHER THAN TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS.
There are a limited number of uses and disclosures of protected health information that do not require Medi-Systems to obtain a written authorization from you. Medi-Systems may, in the following circumstances, disclose your protected health information without authorization:
1. Medi-Systems may disclose limited health information about you to notify local agencies (i.e. power, gas, phone company, and emergency medical services), in the event of an emergency (i.e. flood, hurricane, etc.), of your need for life sustaining equipment or assistance in evacuation due to your medical condition.
2. Medi-Systems may disclose protected health information to others as required by law.
3. Medi-Systems may disclose protected health information for certain public health activities and purposes
4. Medi-Systems may disclose protected health information to a legally-authorized government authority, such as a social service or protective services agency, if we reasonably believe you are a victim of abuse, neglect or domestic violence.
5. Medi-Systems may disclose protected health information for law enforcement purposes and in response to court orders or subpoenas.
6. Medi-Systems may disclose protected health information to agencies authorized by law to conduct health oversight activities, including audits, investigations,
licensing and similar activities.
7. Medi-Systems may disclose protected health information to attorneys,
accountants, and others acting on behalf of Medi-Systems, provided they have
signed written contracts agreeing to safeguard the confidentiality of the
information
YOUR RIGHTS AS A PATIENT OF MEDI-SYSTEMS.
In accordance with HIPAA you have the following rights in relation to your protected health information. 1. You may request, in writing, additional restrictions to the use or disclosure of your protected health information; however, Medi-Systems is not required to agree to the request for restrictions. 2. You have the right to request amendments to your medical record. 3. You have the right to obtain a copy of this Notice of Uses 4. You have the right of access to inspect and obtain a copy of your medical record, subject to certain limitations. 5. You have the right to obtain an accounting of disclosures of your medical record for purposes other than treatment, payment and healthcare operations. 6. You have the right to request communication of your medical record by alternative means (i.e. electronically) or at alternative locations 7. You have the right to revoke authorization to use or disclose your protected health information except to the extent that action has already occurred.
RESPONSIBILITIES OFMEDI-SYSTEMS.
In accordance with HIPAA, Medi-Systems is required to:
1. Maintain the confidentiality of your protected health information. Your state laws may provide more protection than the federal laws and, in that case, we will abide by the more restrictive statute. 2. Provide you with notice of our legal obligations and privacy practices regarding information it may accumulate about you and is obligated to abide by the terms of this notice 3. Notify you if it is unable to agree to a requested restriction, and make every effort to accommodate reasonable requests for communication of health information by alternative means. 4. Post its Notice of Uses on its web site at www.allfloridamedical.com. 5. Notify you if Medi-Systems discovers a breach of your unsecured PHI. Unsecured PHI is PHI that is not (i) secured by a technology standard that renders PHI unusable, unreadable, or indecipherable to unauthorized individuals or (ii) secured by a technology that is developed or endorsed by a standards developing organization accredited by the American National Standards Institute. Under HITECH, a breach is any unauthorized acquisition, access, use, or disclosure of PHI which compromises (presents a significant risk of financial, reputational, or other harm to you) the security or privacy of such information, except where an unauthorized person to who such information is disclosed. In addition, if the unsecured protected health information of more than 500 of our clients, was or is reasonably believed to have been accessed, acquired or disclosed during a breach, we are required to notify: (a) the media; and (b) the Secretary of the United States Department of Health and Human Services. Our notice of breach will include, to the extent possible, 1. (a) A brief description of what happened, including the date of the breach and the date of the discovery of the breach, if known. 2. (b) A description of the types of Unsecured PHI involved in the breach (such as full name, Social Security Number, date of birth, home address, account number, or disability code). 3. (c) The steps you should take to protect yourself from potential harm resulting from the breach. 4. (d) A brief description of what Medi-Systems is doing to investigate the breach, to mitigate losses, and to protect against any further breaches. 5. (e) The toll-free telephone number, an e-mail address, web site, or postal address for the individuals to contact Medi-Systems to ask questions or learn additional information. Please be advised that in addition to these responsibilities, Medi-Systems reserves the right to change the terms of its Notice of Uses and make those changes applicable to all protected health information maintained at that time. If there is a change to its Notice of Uses, it will provide you with a revised notice to the most recent address that you have supplied to Medi-Systems. Medi-Systems. will not use nor disclose your protected health information without your authorization, except as described in this notice.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions, would like additional information, or if you suspect misuse of your protected health information and believe that your rights have been violated, you may, without fear of retaliation, contact:
Tammy McKenzie- HIPAA Privacy Officer Medi-Systems
1426 Pinehurst Drive
Spring Hill, FL 34606
352-683-3545
OR
The Office of Civil Rights
U.S. Department of Health & Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington D.C. 202011
1-(800)-368-1019
Acknowledgement of Receipt of Notice of Information Privacy Practices, Supplier Standards and
Patient Rights and Responsibilities:
Patient or Patient’s Representative: __________________________________
Date: ______________
Patient’s Name (printed) ________________________________________________________________
I give my consent for MEDI-SYSTEMS to use my protected health information as listed in this Notice of
Information Privacy Practices.
Patient or Patient’s Representative: __________________________________
Date: _______________