Revision Date: 04-15-2005
Notice of Privacy Practices
As Required by the Privacy Regulations Promulgated Pursuant
to the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
THIS NOTICE DESCRIBES HOW PRIVATE HEALTH INFORMATION (PHI)
ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR
IDENTIFIABLE HEALTH INFORMATION.
PLEASE REVIEW THIS
NOTICE CAREFULLY.
If you have any questions about this notice, please contact
our Privacy Officer at 866-304-3903 Ext. 135.
OUR PLEDGE REGARDING INFORMATION:
We are committed to protecting information about you and
your health. We create a record of the care and services you receive from your home
health care provider. We need this record to prepare claims which are sent to
your insurance plan to obtain reimbursement for the services you receive. This notice applies to all of our
records.
We are required by law to:
* Maintain the privacy of your information;
* Give you this notice of our legal duties and privacy
practices related to your information; and
* Follow the terms of the notice that are currently in
effect.
How we May Use and Disclose Information About
You:
Payment. We may use and disclose
PHI so that we can bill and be paid for the treatment and services you receive
from your home health provider who is contracted to Reimbursement Associates
for receivables management. . For
example, we may need to give information about your diagnosis to your insurance
company so they will pay for the home care you received.
We may release relevant PHI to a friend, family member, or
anyone else you designate that is involved in your care or payment related to
your care. We may also disclose PHI to those assisting in disaster relief
efforts so that your family can be notified about your condition, status and
location.
We may also use or disclose PHI for the following purposes:
* As required by law
* To avert a threat to health or safety
* Worker’s Compensation
* Public health activities
* Health oversight activities
* Lawsuits and disputes
* Government functions
* Custodial law enforcement
Your Rights Regarding Your
Information
You have the following rights regarding information we
maintain about you:
Right to Inspect and Copy. You have
the right to inspect and obtain a copy of the PHI contained in your record. You
must submit your request in writing to: Reimbursement Associates a dba of RAOps, Inc.
ATTN: Privacy Officer, PO Box 248, Orland CA 95963. In some cases, we may deny your
request. There is usually a fee for
the costs of copies, mail, staff time and/or supplies as needed to fulfill your
request. These costs must be
prepaid.
Right to Amend. You have a right to
amend your PHI. You must submit your request along with the reason for
amendment in writing to: Reimbursement Associates a dba
of RAOps, Inc. ATTN: Privacy Officer, PO Box 248,
Orland CA 95963.
Right to an Accounting of Disclosures.
You have the right to request an "accounting of disclosures." This is
a list of our disclosures of your PHI except any made (1) to you, (2) prior to
April 14, 2003, (3) as a result of your specific written permission, or (4) for
Treatment, Payment, Health Care Operations, Those Involved in Your Care, or for
government functions. You may submit your request in writing to our Privacy
Officer. The request must include the time period (not longer than six years)
for the disclosures you wish to see listed. The first list you request will be free.
We may charge you for the costs of providing additional lists.
Right to Request Restrictions. You
have the right to request restrictions on the PHI we use or disclose about you
as described in the sections above for Treatment, Payment, Health Care
Operations, and Those Involved in Your Care. In some cases, we may not agree to
your request. You must submit your request for restrictions in writing to
Reimbursement Associates a dba of RAOps,
Inc. ATTN: Privacy Officer, PO Box 248, Orland CA 95963.
Right to Request Confidential
Communications. You have the right to request that we communicate with
you in a certain way or at a certain location. You must submit your request for
confidential communications in writing to Reimbursement Associates a dba of RAOps, Inc. ATTN: Privacy
Officer, PO Box 248, Orland CA 95963. We will honor reasonable requests.
Right to a Paper Copy of This Notice.
You have the right to a paper copy of this notice at any time. To obtain a
paper copy of this notice, contact our Privacy Officer. You may also obtain a copy of this
notice on our website, www.raops.com . A copy may also
be requested in writing to: Reimbursement Associates a dba
of RAOps, Inc.
ATTN: Privacy Officer, PO Box 248, Orland CA 95963.
We reserve the right to change the terms of this notice, and
apply any changes to all PHI that we maintain. We will
post a current copy of this notice in our facility and on our website. The
effective date of the notice is located at the top, right-hand corner on the
first page.
COMPLAINTS
If you believe your privacy rights have been violated, you
may file a complaint with us or with the Secretary of the Department of Health
and Human Services. To file a complaint with us, contact our Privacy Officer at
866-304-3903 ext. 135. You
will not be penalized for filing a complaint.
OTHER USES AND DISCLOSURES OF INFORMATION
Other uses and disclosures of PHI not covered by this notice
will be made only with your authorization. You may also revoke the authorization
at any time by sending a request in writing to us at Reimbursement Associates a
dba of RAOps, Inc. ATTN:
Privacy Officer, PO Box 248, Orland CA 95963 After you
revoke your authorization, we will no longer use or disclose your identifiable
health information for the reasons described in the authorization. Please note, we
are required to retain records of your care.