Notice of Privacy Practices
This notice describes how protected health information about you may be used. Please review it carefully.
Our company is dedicated to maintaining the privacy of your identifiable health information. In conducting our business, we will create records regarding you and
the services we provide to you. This Notice tells you about the ways in which Charron Medical Services (referred to as “we” or Charron Medical Services) may
collect, use, and disclose your protected health information and your rights concerning your protected health information. “Protected health information” is
information about you that can reasonably be used to serve you and that relates to you, or the payment for that care.
We are required by law to maintain the confidentiality of health information that identifies you; as well as by federal and state laws to provide you with
this Notice about your rights and our legal duties and privacy practices with respect to your protected health information. We must follow the terms of this Notice
while it is in effect. Some of the uses and disclosures described in this Notice may be limited in certain cases by applicable state laws that are more stringent
than the federal standards. If you have questions about this notice, please contact the Privacy Officer at Charron Medical Services at 6038897220 further
The terms of this notice apply to all records containing your health information that are created or retained by our organization. We reserve the right
to revise or amend our notice of privacy practices. Any revision or amendment to this notice will be effective for all of your records our practice has created or
maintained in the past, and for any of your records we may create or maintain in the future. Our organization will post a copy of our current notice in our office in
a prominent location, and you may request a copy of our most current notice by calling us.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
We may use and disclose your protected health information for different purposes. The examples below are provided to illustrate the types of uses and
disclosures we may make without your authorization for payment, home care operations, and treatment.
● Payment. We use and disclose your protected health information in order bill and collect payment for the services and items you may receive from us. For
example, we may contact your health insurer to certify that you are eligible for benefits and we may provide your insurer with details regarding your treatment
to determine if your insurer will cover, or pay for, your equipment. We also may use and disclose your health information to obtain payment from third parties
that may be responsible for such costs.. Also, we may use your health information to bill you directly for services and items.
● Home Care Operations. We use and disclose your protected health information in order to perform our home care activities, such as providing equipment
appropriate to your needs, or administrative activities, including data management or quality assessment activities.
● Treatment. We may use and disclose your protected health information to coordinate services with other health care providers involved in your care. For
example, we may collect measurements to identify appropriate seating and mobility system(s). We may obtain and disclose information on CPT diagnosis
codes, diagnosis and prognosis, functional limitations, preexisting
health conditions, hospitalizations, prior use of equipment, and information specific to
qualifying the patient as dictated by CMN / detailed written order forms.
● Appointment Reminders . We may use and disclose your health information to contact you and remind you of visits / deliveries.
Services . We may use and disclose your health information to inform you of benefits or services that may be of interest to you.
● Release of information to Family / friends. We may release your health information to a friend or family member that is helping you to pay for your health
care, or who assists in taking care of you.
● Disclosures Required by Law . We will use and disclose your health information when we are required to do so by federal, state or local law.
OTHER PERMITTED OR REQUIRED DISCLOSURES
● As Required by Law . We must disclose protected health information about you when required to do so by law.
● Public Health Activities . We may disclose protected health information to public health agencies for reasons such as preventing or controlling disease,
injury, or disability.
● Health Oversight Activities . We may disclose protected health information to government oversight agencies. Oversight activities can include, for example,
investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities
necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.
● Judicial and Administrative Proceedings . We may disclose protected health information in response to a court or administrative order. We may also
disclose protected health information about you in certain cases in response to a subpoena, discovery request, or other lawful process.
● Law Enforcement . We may disclose protected health information under limited circumstances to a law enforcement official in response to a warrant or
similar process; to identify or locate a suspect; or to provide information about the victim of a crime.
● To Avert a Serious Threat to Health or Safety . We may disclose protected health information about you, with some limitations, when necessary to prevent
a serious threat to your health and safety or the health and safety of the public or another person.
● Workers Compensation . We may disclose protected health information to the extent necessary to comply with state law for workers’ compensation
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have certain rights regarding protected health information that the Plan maintains about you.
● Right To Access Your Protected Health Information. You have the right to review or obtain copies of your protected health information records, with
some limited exceptions. Usually the records include referral information, delivery forms, billing, claims payment, and medical management records. Your
request to review and/or obtain a copy of your protected health information records must be made in writing. We may charge a fee for the costs of producing,
copying, and mailing your requested information, but we will tell you the cost in advance.
● Right To Amend Your Protected Health Information. If you feel that protected health information maintained by us is incorrect or incomplete, you may
request that we amend the information. Your request must be made in writing and must include the reason you are seeking a change.
● Right to an Accounting of Disclosures . You have the right to request an accounting of disclosures we have made of your protected health information.
Your request for an accounting of disclosures must be made in writing and must state a time period for which you want an accounting.
● Right To Request Restrictions on the Use and Disclosure of Your Protected Health Information . You have the right to request that we restrict or
limit how we use or disclose your protected health information for services, payment, or health care operations. We may not agree to your request. If we do
agree, we will comply with your request unless the information is needed for an emergency. Right To Receive Confidential Communications . You have
the right to request that we use a certain method to communicate with you or that we send information to a certain location. For example, you may ask that
we contact you at work rather than at home. Your request to receive confidential communications must be made in writing.. We will accommodate all
reasonable requests. Your request must specify how or where you wish to be contacted.
● Contact Information for Exercising Your Rights . You may exercise any of the rights described above by contacting our privacy Office.
● Complaints . If you believe that your privacy rights have been violated, you may file a complaint with us and/or with the Secretary of the Department of
Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint