Notice of Privacy Practices
for Tri-County Medical & Ostomy Supplies, Inc.
This notice describes how health
information about you (as a patient of Tri-County Medical & Ostomy
Supplies, Inc.) may be used and disclosed, and how you can get access
to your health information. This is required by the Privacy Regulations
created as a result of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA).
Our Commitment to your Privacy: Our company is dedicated to maintaining
the privacy of your health information. We are required by law to maintain
the confidentiality of your health information. We realize that these
laws are complicated, but we must provide you with the following important
information:
Use and Disclosure of your Health Information in certain special circumstances.
The following circumstances may require us to use or disclose your health
information:
1. To public health authorities and health oversight agencies that are
authorized by law to collect information.
2. Lawsuits and similar proceedings in response to a court or administrative
order.
3. If required to do so by a law enforcement agency or official.
4. When necessary to reduce or prevent a serious threat to your health
and safety or the health and safety of another individual or the public.
We will only make disclosures to a person or organization able to help
prevent the threat.
5. If you are a member of U.S. or foreign military forces (including
veterans) and if required by the appropriate authorities.
6. To federal officials for intelligence and national security activities
authorized by law.
7. To correctional institutions or law enforcement officials if you
are an inmate or under the custody of a law enforcement official.
8. For Workers Compensation and similar programs.
Your Rights Regarding Your Health
Information
1. Communications. You can request that our practice communicate with
you about your health and related issues in a particular manner or at
a certain location. For instance, you may ask that we contact you at
home, rather than work. We will accommodate reasonable requests.
2. You can request a restriction in our use or disclosure of your health
information for treatment, payment, or health care operations. Additionally,
you have the right to request that we restrict our disclosure of your
health information to only certain individuals involved in your care
or the payment for your care, such as family members and friends. We
are not required to agree to your request; however, if we do agree,
we are bound by our agreement except when otherwise required by law,
in emergencies, or when the information is necessary to treat you.
3. You have the right to inspect and obtain a copy of the health information
that may be sued to make decisions about you, including patient medical
records and billing records, but not including psychotherapy notes.
You must submit your request in writing to us. There will be a charge
to copy these records and we reserve the right to have 3 to 7 day to
copy and distribute these records.
4. You may ask us to amend your health information if you believe it
is incorrect or incomplete, and as long as the information is kept by
or for our company. To request an amendment, your request must be made
in writing and submitted to our company. You must provide us with a
reason that supports your request for amendment and we will set an appointment
for you to discuss this with us and your physician at a time that is
convenient for the patient, physician and our company.
5. Right to a copy of this notice. You are entitled to receive a copy
of this Notice of Privacy Practices. You may ask us to give you a copy
of this Notice at any time. To obtain a copy of this notice, contact
our office.
6. Right to file a complaint. If you believe your privacy rights have
been violated, you may file a complaint with our office or with the
Secretary of the Department of Health and Human Services at Hubert H.
Humphrey Building, 200 Independence Avenue S.W., Washington, DC 20201.
To file a complaint with our office, call us at (423) 282-6933. All
complaints must be submitting in writing. You will not be penalized
for filing a complaint.
7. Right to provide an authorization for other uses and disclosures.
Our practice will obtain your written authorization for uses and disclosures
that are not identified by this notice or permitted by applicable law.
If you have any questions regarding this notice or our health information
privacy policies, please contact us.
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