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The privacy of your medical information
is important to ZYGO. Although we are required by law to maintain
the privacy of your protected health information and provide
you with this notice, we are sincere in our pledge to ensure
the confidentiality of your nonpublic personal information, including
your medical records.
HOW WE MAY USE AND DISCLOSE
MEDICAL INFORMATION ABOUT YOU
We may share a client’s
personal information for the purpose of providing and repairing
durable medical equipment (DME). By signing a consent
form, the client acknowledges that personal information can
be shared for that express purpose.
We may use and disclose medical information as follows:
Treatment
We may share your information
with speech therapists, doctors, or case managers to help them
recommend appropriate medical equipment. For example, we might
send a copy of your speech evaluation to your doctor to obtain
a prescription for a speech generating device.
Payment
We may use and disclose
medical information to process your medical claims or coordinate
your benefits with other health plans. For example, we may need
to disclose medical information to determine your eligibility
for benefits.
Healthcare Operations
We may use and disclose
medical information for regular healthcare operations. For example,
we may disclose medical information to obtain prior authorization
for your DME, ensure proper claims processing, cooperate with
case management, and provide you with excellent customer service.
Business Associates
Business associates provide
necessary services to our organization through contracts. Some
examples of business associates are billing services and medical
equipment dealers. We may disclose medical information to our
business associates so they can perform the job we have asked
them to do. To protect your medical information, we require our
business associates to appropriately safeguard your information.
We will not share your information with these outside groups
unless there is a business need to do so and they agree to keep
it protected. We require our business associates to treat your
private information with the same high degree of confidentiality
that we do.
Marketing
We will never sell information
about you to any third party for marketing or any other purpose.
Further, we do not use personal information for investigative
consumer research or reporting.
Individuals Involved in Your
Care or Payment for Your Care
We may disclose your
medical information to a family member, friend, or other person
that you indicate is involved in your care or payment for your
care. This only pertains to your medical information that is
directly relevant to their involvement. We will only make this
disclosure if you agree or when required or authorized by law.
In the event of your incapacity or in an emergency, we will disclose
your medical information based on our professional judgment of
whether the disclosure would be in your best interest.
As Required By Law and For
Law Enforcement
We may use or disclose
your medical information when required or permitted by federal,
state, or local law, or by a court order.
Public Health and Safety
We may disclose medical
information about you to the extent necessary to avert a serious
and imminent threat to your health or safety or the health or
safety of others.
State and Federal Agencies
We may be required to
report information to state and federal agencies such as the
United States Department of Health and Human Services.
Lawsuits and Disputes
If you are involved in
a lawsuit or dispute, we may disclose medical information about
you in response to a court or administrative order. We may also
disclose medical information about you in response to a subpoena,
discovery request, or other lawful process by someone else involved
in the dispute. We will only make such disclosures if efforts
have been made to tell you about the request.
Military and National Security
Under certain circumstances,
we may disclose to military authorities the medical information
of armed forces personnel. We may disclose to authorized federal
officials medical information required for lawful intelligence,
counterintelligence, and other national security activities.
Workers’ Compensation
We may disclose medical
information to coordinate benefits with Workers’ Compensation
insurance carriers.
Other Uses and Disclosures
If we use or disclose
your information for any reason other than those listed above,
we will first obtain your written authorization. State laws may
prohibit us from disclosing the following types of sensitive
personal information without your authorization: chemical dependency,
mental health, psychotherapy, genetic, or HIV/AIDS records. If
you give us written authorization, you may revoke it at any time.
This will not affect information that has already been shared.
YOUR RIGHTS REGARDING YOUR
MEDICAL INFORMATION
You have the following
rights regarding protected health information we maintain about
you:
Right to Inspect and Copy
You have the right to
inspect and obtain a copy of most information we maintain about
you. You must request to do so in writing and you may be charged
a fee for the cost of copying your records.
Right to Request a Correction
If you feel that medical
information we have about you is incorrect or incomplete, you
have the right to ask us to change or amend the information.
Your request must be in writing.
Right to an Accounting of
Disclosures
You have the right to
request a list of disclosures we have made of your medical information
for purposes other than treatment, payment, healthcare operations,
and limited other activities. Your request must be in writing.
Your request may not be for a record of more than six years and
may not include dates before April 14, 2003.
Right to Request Restrictions
You have the right to
ask us to restrict how we use or disclose your information for
treatment, payment, or healthcare operations. You also have the
right to ask us to restrict information we may give to persons
involved in your care, such as a family member or friend. You
must make this request in writing. While we may honor your request
for restrictions, we are not required to agree to these restrictions.
Right to Request Confidential
Communications
You have the right to
ask that we communicate with you about health matters in a certain
way or at a certain location. We will attempt to accommodate
all reasonable requests and may require that you make your request
in writing.
Right to Receive a Paper Copy
of This Notice
You have the right to
ask for a paper copy of this notice at any time, and it will
always be available on our Web site at www.zygo-usa.com/privacy.htm.
If you wish to exercise any of
these rights, please contact ZYGO. You will find our contact
information in the box at the bottom. |
