Users Manual

Appendix
202
Appendix
HIPAA Privacy Notice
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.
is notice of privacy practices (the “HIPAA Privacy Notice”) describes how we may use and
disclose your Medical Information to carry out treatment, payment or health care operations
and for other purposes that are permitted or required by law, including by the Health Insurance
Portability and Accountability Act, and all regulations issued thereunder (“HIPAA”). It also
describes your rights to access and control your Medical Information. As used herein, “Medical
Information” is information about you, including demographic information, that may identify
you and that relates to your past, present or future physical or mental health or condition and
related health care services.
Uses and Disclosures of Medical Information
We will only use and disclose your Medical Information as permitted by law. Except for
disclosures outlined in this HIPAA Privacy Notice and/or permitted by law, we will obtain
your written authorization before using your Medical Information or disclosing it to any
outside persons or organizations. Most uses or disclosures of your Medical Information
constituting psychotherapy notes will be made only aer receiving your written authorization.
We will not use or disclose your Medical Information for purposes of marketing, except as
permitted by law and/or outlined in this HIPAA Privacy Notice. We will not sell your Medical
Information, without rst obtaining your written authorization. You may revoke any written
authorization you have provided to us at any time, except to the extent that we have made any
uses or disclosures of your Medical Information in reliance on such authorization. To revoke
a previously issued authorization, please send your request in writing, along with a copy of the
authorization being revoked to our Privacy Ocer. If a copy of the applicable authorization is
not available, please provide a detailed description and date of the same to our Privacy Ocer.
ere are some situations where we may use or disclose your Medical Information without
your prior written authorization, as described further below:
Uses and Disclosures of Your Medical Information Related to the Treatment and Services
Provided By Us
Treatment, Payment and Health Care Operations: We may use your Medical Information for
treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the
quality of care that you receive without your authorization. We may use or disclose Medical
Information about you without your authorization for several other reasons.
Example of Treatment: In connection with treatment, we may use your Medical Information to
provide you with one of our products.
Example of Payment: We may use your Medical Information to generate a health insurance
claim and to collect payment on invoices for services and/or medical devices provided.
Example of Health Care Operations: We may use your Medical Information in order to process
and fulll your orders and to provide you with customer service.
Appointment Reminder and Other Communications: We may use or disclose your Medical
Information without your prior written authorization to provide you or others with, among
other things, (i) appointment reminders; (ii) product/supply reorder notications; and/or (iii)
information about treatment alternatives or other health-related products and services that we
provide.