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NOTICE OF PRIVACY PRACTICES
PLEASE REVIEW IT CAREFULLY
Your Information – Your Rights Our Responsibilities
This notice describes how medical information about you may be used or disclosed and how you can access this information from North Coast Medical Supply, LLC, dba Advanced Diabetes Supply (“ADS”), United States Medical Supply®, LLC, and US MED®, LLC,.
Your Rights – You have the Right to:
Get an electronic or paper copy of your medical record
• You can ask us to get an electronic/paper copy of your medical record and other health information we have about you.
• We will provide a copy or a summary of your health information, usually within 30 days of your request.
Ask us to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete.
Ask us how to do this
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
• You can ask us not to use or share your health information for treatment, payment, or our operations. We may say “no” if it would negatively affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
• You can ask for a list of the times we’ve shared your health information for seven years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free within 60 days of your request, but we may charge a small fee if you ask for another one within 12 months.
Get a copy of this privacy notice
• You can ask for a paper copy of this notice at any time.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated
• If you have questions regarding this notice, contact our Privacy Officer by mail at 8260 NW 27th St. #401, Miami, FL 33122; by phone at 1-800-787-6331; or by email at [email protected].
• Florida Complaint and Abuse Information – To report a complaint regarding the services you receive, call toll-free 888-419-3456. To report abuse, neglect, or exploitation, call toll-free 800-96-ABUSE.
• Accreditation Commission for Health Care (ACHC) accredits ADS and US MED. If you have a complaint about the quality of care at ADS and US MED, you may contact ACHC by phone at 1-855-937-2242 or email [email protected] or by mail at 139 Weston Oaks Ct. Cary, NC 27513.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Ave. S.W., Washington, D.C. 20201, or by calling 1-877-696-6775, or visiting the following website: www.hhs.gov/ocr/privacy/hipaa/complaints/
• We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. Call us if you have a clear preference for how we share your information in the situations described below. Tell us what you want us to do, and we will follow your instructions.
You have both the right and choice to tell us to:
• Share information with your family, close friends, or other individuals involved in your care
• Share information in a disaster relief situation If you are not able to tell us your preference, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. We never share your information for marketing purposes or sell your information unless you give us written permission to do so. In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again in this regard.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
1) Treat you
We can use your health information and share it with other healthcare professionals who are treating you. Example: A doctor treating you may ask us for our records.
2) Run our organization
We can use and share your health information to run our business, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.
3) Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these types of purposes. For more information see the following website: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help With Public Health and Safety issues
We can share health information about you for situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or violence issues
• Preventing/reducing threat to one’s health or safety
We can use or share your information for health research.
Comply with the Law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services, FDA, and any other Public Health authority,
if it wants to see that we’re complying with federal privacy law.
Address Workers’ Compensation, law enforcement, school, employer or other government requests
We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law officials
• With health oversight agencies for activities authorized by law
• For government functions such as military, national security, presidential protective services, whistleblower suits or workforce member crimes
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Organ and Tissue Donation
If you are an organ or tissue donor, your medical information may be released to organizations that handle organ procurement or organ, eye and tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Coroners, Medical Examiners, and Funeral Directors
Your medical information may be released to a coroner or medical examiner. For example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the facility to funeral directors as necessary to carry out their duties.
• We are required to maintain the privacy security of your PHI.*
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties & privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
• We will only disclose the PHI of deceased individuals in accordance with the established performance criteria in state and Federal law
For more information about this notice, see the following website: http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to the Terms of this Notice – We can change the terms of this notice and the changes will apply to all information we have about you. The new notice will be available upon request, on our website, and we will mail a copy to you.
This Notice of Privacy Practices applies to North Coast Medical Supply, LLC, dba Advanced Diabetes Supply (“ADS”), United States Medical Supply®, LLC, and US MED®, LLC, with an Effective Date of March 21, 2023.
*Protected Health Information