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:
- Business Associates. We may contract with one or more business associates through the course of our operations. We may disclose your protected health information to our business associates so that they can perform the job we have asked them to do. To protect your protected health information, however, we require that business associates appropriately safeguard your information.
- Notification. We may use or disclose information to notify, or assist in notifying, a family member, personal representative or other person responsible for your care of your location and general condition.
- Communication with Family. Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify protected health information relevant to such person’s involvement in your care or payment related to your care.
- Supply Reminders and Treatment Alternatives. We may contact you for order or re-order reminders, or to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- Health Oversight Activities. We may disclose protected health information about you to a health oversight agency for activities authorized by law.
- Food and Drug Administration (FDA). We may disclose to the FDA protected health information that relates to adverse events involving product defects or post-marketing surveillance to enable product recalls.
- Public Health. We may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury or disability and other public health responsibilities.
- Victims of Abuse. We may disclose protected health information about you if we believe you are a victim of abuse, neglect, or domestic violence to a government authority, including a social service or protective services agency, authorized by law to receive reports of such abuse, neglect, or domestic violence.
- Threat to Health or Safety. We may use and disclose protected health information about you when necessary to prevent a serious threat to your health and safety or to the health and safety of the public or another person.
- Correctional Institutions. Should you be an inmate of a correctional institution, we may disclose to the institution or agency thereof protected health information necessary for your health and the health and safety of other individuals.
- As Required By Law. We may disclose protected health information when required to do so by federal, state or local law, or in response to a valid subpoena.
- Law Enforcement. We may release protected health information about you if asked to do so by a law enforcement official.
- Lawsuits / Disputes / Court Proceedings. If you are involved in a lawsuit, dispute or court proceeding, we may disclose protected health information about you in response to a court or administrative order. We may disclose protected health information about you in response to the following: subpoenas, discovery requests or other lawful processes by others involved in the dispute. Such disclosures will be made only after efforts have been made to inform you about the request or to obtain an order protecting the information requested.
- Coroners and Medical Examiners. We may disclose protected health information about you to a coroner or medical examiner for identification purposes, determining a cause of death, or other duties as authorized by law.
- Funeral Directors. We may disclose protected health information about you to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to you.
- Armed Forces Personnel. We may use and disclose your protected health information if you are a member of the Armed Forces for activities deemed necessary by appropriate military command authorities.
- National Security and Intelligence Activities. We may disclose protected health information about you to authorized federal officials for the conduct of lawful intelligence, counter-intelligence, and other national security activities. We may also disclose your protected health information to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.
- Workers’ Compensation. We may disclose protected health information for workers’ compensation or other similar programs established by law.
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:
- The right to request restrictions on the use and disclosure of your protected health information. This includes your right to restrict disclosure of PHI to health plans if you paid for the relevant care.
- The right to opt out of any future fundraising communications if you have received fundraising materials from us previously.
- The right to receive confidential communications concerning your medical condition and treatment.
- The right to inspect and copy your protected health information.
- The right to amend or submit corrections to your protected health information.
- The right to receive an accounting of how and to whom your protected health information has been disclosed.
- The right to receive a printed copy of this notice.
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