PRIVACY POLICY

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

Treatment: Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.

Payment: Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

Health Care Operations: Your health information may be used as necessary to support the day-to-day activities and management of our company. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.

Law Enforcement: Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.

Public Health Reporting: Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.

Other Uses and Disclosures: In addition to treatment, payment and health care operations, we may use and disclose your protected health information as follows:

Uses and Disclosures With Authorization: Uses and disclosures not outlined above will only be made with your written authorization, which you may revoke in writing at any time.

Individual Rights: You have certain rights under the Federal privacy standards. These include:

Our Duties and Responsibilities: The Company is required by law to maintain the privacy of your protected health information and to provide you with a written notice of these policies. We are also required to abide by the privacy policies and procedures as outlined in this notice. We reserve the right to amend or modify our privacy policies and procedures as needed or required by changed in the Federal or State regulations.

Breach Notification: We are required to notify you of a breach of unsecured protected health information.

Requests to Inspect Protected Health Information: You may generally inspect or copy the protected health information that we maintain. As permitted by Federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting our office. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

Complaints: You may file a complaint with our Privacy Official if you believe your rights have been violated or if you would like to offer comments regarding our Privacy Practices. You may also file a complaint with the Secretary of the Department of Health and Human Services by mail or on their web site at www.hhs.gov. You will not be penalized or otherwise retaliated against for filing a complaint.

Contact Person: The name and address of the person you can contact for further information concerning our privacy practices is:

Karen Kaczmarek, Privacy Officer
At Home Infusion Services, LLC

3500 NW Boca Raton Blvd, Suite 704
Boca Raton, FL 33431
Telephone: (561)353-4663 or (877)309-2207

This privacy policy effective 1/1/2010, revised 9/23/13