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Privacy & Security
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ CAREFULLY
The CPAP Store LLC is required to maintain the privacy of Protected Health
Information (PHI) and to provide individuals with notice of our legal duties and
privacy practices with respect to PHI. PHI is information that may identify you
and that relates to your past, present or future physical or mental health
condition and related health care services. This Notice of Privacy Practices
("Notice") describes how we may use and disclose PHI to carry out treatment,
payment or health care operations and for other specified purposes that are
permitted or required by law. The Notice also describes your rights with respect
to PHI about you.
The CPAP Store LLC is required to follow the terms of this Notice. We will not
sell your name and address or other identifying information for any purpose. We
will not use or disclose PHI about you without your written authorization,
except described in this Notice. We reserve right to change our practices and
this Notice and to make the new notice effective for all PHI we maintain. Upon
request, we will provide any revised Notice to you.
Effective Date
This Notice is effective as of April 14, 2003.
Your Health Information Rights
You have the following rights with respect to PHI about you:
Obtain a paper copy of the Notice upon request. You may request a copy of the
Notice at any time. Even if you have agreed to receive Notice electronically,
you are still entitled to a paper copy. You may obtain a paper copy at any The
CPAP Store LLC pharmacy or by calling The CPAP Store LLC Customer Relationship
Center at 1-877-272-7626
Request a restriction on certain uses and disclosures of PHI. You have the right
to request additional restrictions on our use or disclosure of PHI about you for
treatment, payment, health care operations, communication with individuals
involved in your care or our Business Associates by submitting a written request
for the restriction. You may submit your request in person at The CPAP Store LLC
or by mail to the attention of our Privacy Office at The CPAP Store LLC Privacy
Office, 7513 W. Kennewick Ave., Suite D, Kennewick, WA 99336. We are required to
agree to those restrictions
Inspect and obtain a copy of PHI. You have the right to access and copy PHI
about you contained in a designated record set for as long as we maintain the
PHI. The designated record set usually will include prescription and billing
records. To inspect or copy PHI about you, you must send a written request. You
may submit your request in person at any The CPAP Store or by mail to the
attention of our Privacy Office at The CPAP Store LLC Privacy Office, 7513 W.
Kennewick Ave., Suite D, Kennewick, WA 99336. We may charge you a fee for the
costs of copying, mailing and supplies that are necessary to fulfill your
request. We may deny your request to inspect and copy in certain limited
circumstances. If you are denied access to PHI about you, you may request that
the denial be reviewed.
Request an amendment of PHI. If you believe that the PHI we maintain about you
is incomplete or incorrect, you may request that we amend it. You may request an
amendment for as long as we maintain the PHI. To request an amendment, you must
send a written request to the attention of our Privacy Office at The CPAP Store
LLC Privacy Office, 7513 W. Kennewick Ave., Suite D, Kennewick, WA 99336 You
must include a reason that supports your request. In certain cases, we may deny
your request for amendment. If we deny your request for amendment, you have the
right to file a statement of disagreement with the decision and we may give a
rebuttal to your statement.
Receive an accounting of disclosures of PHI. You have the right to receive an
accounting of the disclosures we have made of PHI about you after April 14, 2003
for most purposes other than treatment, payment, or health care operations. The
accounting will exclude certain disclosures, such as disclosures made directly
to you, disclosures you authorize, disclosures to friends or family members
involved in your care, and disclosures for notification purposes. The right to
receive an accounting is subject to certain other exceptions, restrictions. and
limitations. To request an accounting, you must submit a request in writing to
the attention of our Privacy Office at The CPAP Store LLC Privacy Office, 7513
W. Kennewick Ave., Suite D, Kennewick, WA 99336. Your request must specify the
time period, but may not be longer than six years. The first accounting you
request within a 12 month period will be provided free of charge, but you may be
charged for the cost of providing any additional accountings in the same 12
month period. We will notify you of the cost involved and you may choose to
withdraw or modify your request at that time.
Request communications of PHI by alternative means or at alternative locations.
For instance, you may request that we contact you about medical matters only in
writing or at a different residence or post office box. To request confidential
communication of PHI about you by an alternative means or at an alternative
location, you must submit a request in writing. You may submit your request in
person at The CPAP Store or by mail to the attention of our Privacy Office at
The CPAP Store LLC Privacy Office, 7513 W. Kennewick Ave., Suite D, Kennewick,
WA 99336. Your request must state how or where you would like to be contacted.
We will accommodate all reasonable requests.
Examples of How We May Use and Disclose PHI
The following are descriptions and examples of ways we use and disclose PHI:
We will use PHI for treatment. Examples: Information obtained by the staff will
be used to dispense prescription durable medical equipment (DME) and supplies to
you. We will document in your record information related to the DME equipment
and supplies dispensed to you and services provided to you. The CPAP Store LLC
provide sleep disorder management programs, such as apnea education. Our staff
and/or business associates may collect information about you in order to provide
these services and monitor your progress within the program. We may also share
this information with your physician as needed to coordinate your care.
We will use PHI for healthcare operations. Examples: The CPAP Store LLC may use
information in your health record to monitor the performance of the staff
providing treatment to you. This information will be used in an effort to
continually improve the quality and effectiveness of the health care and service
we provide. Also, in the rare event that The CPAP Store LLC is sold, we may
transfer patient records to the purchaser.
We are likely to use or disclose PHI for the following purposes:
Health-related communications: The CPAP Store LLC provides a special customer
care service to its customers. Under this program, we may contact you,
consistent with applicable law, to provide refill reminders or information about
treatment alternatives (including the availablity of clinical trials) or other
health-related benefits and services that may be of interest to you. If you do
not wish to participate in this special care service, you may notify us of this
fact at any time in writing, by telephone or in person at The CPAP Store LLC.
Communication with individuals involved in your care or payment for your care:
Health professionals such as our staff, may, consistent with applicable law,
disclose to a family member, other relative, close personal friend or any person
you identify, PHI relevant to that person's involvement in your care or payment
related to your care if your therapist, in his or her professional judgment,
determines that it is in your best interests.
Business Associates: There are some services provided by us through contracts
with business associates. Examples include the electronic transmission of claims
to insurers and DME benefit managers, creation of paper billings for services
that cannot be electronically transmitted, and payment reconciliation services.
We may also contract with business associates to provide data aggregation
services relating to our health care operations. When these services are
contracted for, we may disclose PHI about you to our business associate so that
they can perform the job we have asked them to do or to bill you or your
third-party payer for services rendered. To protect PHI about you, we require
our business associates to appropriately safeguard the PHI.
Food and Drug Administration (FDA): We may disclose to the FDA, or persons under
the jurisdiction of the FDA, PHI relative to adverse events with respect to
product defects, or post marketing surveillance information to enable product
recalls, repairs, or replacement.
Public health: As required by law, we may disclose PHI about you to public
health or legal authorities charged with preventing or controlling disease,
injury, or disability.
Health oversight activities: We may disclose PHI about you to an oversight
agency for activities authorized by law. These oversight activities include
audits, investigations, and inspections, as necessary for any licensure and for
the government to monitor the health care system, government programs, and
compliance with civil rights laws
Worker's compensation: We may disclose PHI about you as authorized by and as
necessary to comply with laws relating to worker's compensation or similar
programs established by law.
Law enforcement: We may disclose PHI about you for law enforcement purposes to a
law enforcement official as required by law, court order, warrant, or
administrative request.
Judicial and administrative proceedings: If you are involved in a lawsuit or
dispute, we may disclose PHI about you in response to a court or administrative
order.
As required by law: We must disclose PHI about you when required to do so by
law.
We are permitted to use or disclose PHI about you for the following purposes
Research: We may disclose PHI about you to researchers when their research has
been approved by an institutional review board that has reviewed the research
proposal and established protocols to ensure the privacy of your information.
Coroners, medical examiners, and funeral directors: We may release PHI about you
to a coroner or medical examiner. This may be necessary, for example, to
identify a deceased person, determine the cause of death or other duties as
authorized by law. We may also disclose PHI to funeral directors, consistent
with applicable law, to carry out their duties.
Organ or tissue procurement organizations: Consistent with applicable law, we
may disclose PHI about you to organ procurement organizations or other entities
engaged in the procurement, banking, or transplantation of organs for the
purpose of tissue donation and transplant.
Correctional institution If you are or become an inmate of a correctional
institution, we may disclose PHI to the institution or its agents when necessary
for your health or the health and safety of others.
To avert a serious threat to health or safety: We may use and disclose PHI about
you when we believe in good faith that disclosure is necessary to prevent a
serious threat to your health and safety or the health and safety of the public
or another person and the disclosure is to a person reasonably able to prevent
the threat. We may disclose your PHI for a medical emergency when we are unable
to obtain your consent or authorization due to your condition or the nature of
the medical emergency
Victims of abuse, neglect, or domestic violence: We may disclose PHI about you
to a government authority. such as a social service or protective services
agency, if we reasonably believe, in our professional judgment, you are a victim
of abuse, neglect, or domestic violence. We will only disclose this type of
information (1) to the extent required by law, (2) if you agree to the
disclosure, or (3) if the disclosure is allowed by law and we believe it is
necessary to prevent serious harm to you or someone else or the law enforcement
or public official that is to receive the report represents that it is necessary
and will not he used against you.
Military and veterans: If you are a member of the armed forces, we may release
PHI about you as required by military command authorities. We may also release
PHI about foreign military personnel to the appropriate military authority.
National security and intelligence activities: We may release PHI about you to
authorized federal officials for intelligence, counterintelligence, and other
national security activities authorized by law.
Protective services for the President and others: We may disclose PHI about you
to authorized federal official so they may provide protection to the President,
other authorized persons or foreign heads of state or conduct special
investigations.
Other Uses and Disclosures of PHI
The CPAP Store LLC will obtain your written authorization before using or
disclosing PHI about you for purposes other than those provided for above or as
otherwise permitted or required by law. You may revoke an authorization in
writing at any time. Upon receipt of the written revocation, we will stop using
or disclosing PHI about you, except to the extent that we have already taken
action in reliance on the authorization.
For More Information or to Report a Problem
If you have questions or would like additional information about The CPAP Store
LLC's privacy practices, you may call The CPAP Store LLC Customer Relationship
Center at 1-877-272-7626 or write to the attention of our Privacy Office at The
CPAP Store LLC Privacy Office, 7513 W. Kennewick Ave., Suite D, Kennewick, WA
99336. If you believe your privacy rights have been violated, you can file a
complaint with our Privacy Office or with the Secretary of Health and Human
Services. There will be no retaliation for filing a complaint.
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