Privacy Statement

Notice of Privacy Practices

 

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

 

Oberlin Hearing Care is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information.  If you have questions about any part of this notice or if you want more information about the privacy practices at Oberlin Hearing Care please contact:

 

The Oberlin Hearing Care HIPAA Privacy Officer or Senior Patient Care Coordinator

            Oberlin Hearing Care

            224 W. Lorain Street – Suite D

            Oberlin, OH 44074

            (440) 774-5819

 

 

Effective Date of This Notice:  April 14, 2003

 

I.          How Oberlin Hearing Care May Use or Disclose Your Health Information

 

Oberlin Hearing Care collects health information from you and stores it in a chart and on a computer.  This is your medical record.  The medical record is the property of Oberlin Hearing Care, but the information in the medical record belongs to you.  Oberlin Hearing Care protects the privacy of your health information.  The law permits Oberlin Hearing Care to use or disclose your health information for the following purposes:

 

1.         Treatment.         Oberlin Hearing Care may use your identifiable health information to treat you.  For example, we may perform assessments of your hearing in order to help us diagnose your hearing status.  Many people who work for Oberlin Hearing Care may use or disclose your identifiable health information in order to treat you or to assist others in your treatment.  Additionally, we may disclose your identifiable health information to others who may assist in your care, including but not limited to, your physicians, therapists, hearing aid and earmold manufacturers and laboratories, your spouse, children, parents or personal representatives appointed by you.

 

2.         Payment.          Oberlin Hearing Care may use and disclose your identifiable health information in order to bill and collect payment for the services and items you may receive from us.  For example, we may use and disclose your identifiable health information, including but not limited to, to contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment.   We also may use and disclose your identifiable health information to obtain payment from third parties that may be responsible for such costs, such as family members, and government or private agencies.  Also, we may use your identifiable health information to bill you directly for services and items.

 

3.         Regular Health Care Operations. Oberlin Hearing Care may use and disclose your identifiable health information to operate our business.  For example, we may use and disclose your information, including but not limited to, to evaluate the quality of care you received from us, or to conduct cost-management and business activities for our practice.

 

4.         Information provided to you.      We may use and disclose your identifiable health information to provide you with copies of your health record and, further, to allow you to review and modify your health record when you suspect errors are present.

           

5.         Directory.          We may list your name, address, phone number, and your hearing health status in an office directory, should such a directory be necessary in order to assist us in matters of your treatment, payment, or health care operations.

 

6.         Notification and communication with family.       We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your incapacity.  If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification.  If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.

 

7.         Required by law.           As required by law, we may use and disclose your health information.

 

8.         Public health.    As required by law, we may disclose your health information to public health authorities for purposes related to:  preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.

 

9.         Health oversight activities.         We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.

 

10.        Judicial and administrative proceedings.            We may disclose your health information in the course of any administrative or judicial proceeding.

 

11.        Law enforcement.          We may disclose your health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.

 

12.        Deceased person information.   We may disclose your health information to coroners, medical examiners and funeral directors.

 

13.        Organ donation.            We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.

 

14.        Research.         We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board or Oberlin Hearing Care’s privacy board.

 

15.        Public safety.    We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

 

16.        Specialized government functions.         We may disclose your health information for military, national security, prisoner and government benefits (only for health plans) purposes.  (Note that disclosures for government benefits purposes are limited to health plans only.)

 

17.        Worker’s compensation.            We may disclose your health information as necessary to comply with worker’s compensation laws.

18.        Marketing.         We may contact you to provide appointment reminders or to give you information about other treatments or health-related benefits and services that may be of interest to you.

 

19         Change of Ownership.   In the event that Oberlin Hearing Care is sold or merged with another organization, your health information/record will become the property of the new owner.

 

 

II.         When Oberlin Hearing Care May Not Use or Disclose Your Health Information

 

Except as described in this Notice of Privacy Practices, Oberlin Hearing Care will not use or disclose your health information without your written authorization.  If you do authorize Oberlin Hearing Care to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

 

III.        Your Health Information Rights

 

1.         You have the right to request restrictions on certain uses and disclosures of your health information.  Oberlin Hearing Care is not required to agree to the restriction that you requested.

 

2.         You have the right to receive your health information through a reasonable alternative means or at an alternative location.  Advise our staff of your desire to do so.

 

3.         You have the right to inspect and copy your health information.

 

4.         You have a right to request that Oberlin Hearing Care amend your health information that is incorrect or incomplete.  Oberlin Hearing Care is not required to change your health information and will provide you with information about Oberlin Hearing Care’s denial and how you can disagree with the denial.

 

5.         You have a right to receive an accounting of disclosures of your health information made by Oberlin Hearing Care, except that Oberlin Hearing Care does not have to account for the disclosures described in parts 1 (treatment), 2 (payment), 3 (health care operations), 4 (information provided to you), 5 (directory listings) and 16 (certain government functions) of section I of this Notice of Privacy Practices.

 

6.         You have a right to a paper copy of this Notice of Privacy Practices.

 

If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact

 

The Oberlin Hearing Care HIPAA Privacy Officer or Senior Patient Care Coordinator

            Oberlin Hearing Care

            224 W. Lorain Street – Suite D

            Oberlin, OH 44074

            (440) 774-5819

 

IV.        Changes to this Notice of Privacy Practices

 

Oberlin Hearing Care reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment.  Until such amendment is made, Oberlin Hearing Care is required by law to comply with this Notice. 

 

You will be notified of any changes in Oberlin Hearing Care’s Notice of Privacy Practices within 60 days by mail, email, or fax.

V.         Complaints

 

Complaints about this Notice of Privacy Practices or how Oberlin Hearing Care handles your health information should be directed to:

 

The Oberlin Hearing Care HIPAA Privacy Officer or Senior Patient Care Coordinator

            Oberlin Hearing Care

            224 W. Lorain Street – Suite D

            Oberlin, OH 44074

            (440) 774-5819

 

If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:

 

Department of Health and Human Services

Office of Civil Rights

Hubert H. Humphrey Bldg.

200 Independence Avenue, S.W.

Room 509F HHH Building

Washington, DC  20201

 

You may also address your compliant to one of the regional Offices for Civil Rights.  A list of these offices can be found online at http://www.hhs.gov/ocr/regmail.html.