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APPLE HOMECARE ASSOCIATES
Notice of Privacy Practices
This notice describes how protected health information about you may be used
and disclosed and how you can get access to this information. Please review it
carefully.
Our company is dedicated to maintaining the privacy of your identifiable
health information. In conducting our business, we will create records regarding
you and the services we provide to you. This Notice tells you about the ways in
which Apple Homecare Associates (referred to as "we") may collect,
use, and disclose your protected health information and your rights concerning
your protected health information. "Protected health information" is
information about you that can reasonably be used to serve you and that relates
to you, or the payment for that care.
We are required by law to maintain the confidentiality of health information
that identifies you; as well as by federal and state laws to provide you with
this Notice about your rights and our legal duties and privacy practices with
respect to your protected health information. We must follow the terms of this
Notice while it is in effect. Some of the uses and disclosures described in this
Notice may be limited in certain cases by applicable state laws that are more
stringent than the federal standards.
If you have questions about this notice, please contact the Privacy Officer
at Apple Homecare Associates at 508-829-2012 for further information.
The terms of this notice apply to all records containing your health
information that are created or retained by our organization. We reserve the
right to revise or amend our notice of privacy practices. Any revision or
amendment to this notice will be effective for all of your records our practice
has created or maintained in the past, and for any of your records we may create
or maintain in the future. Our organization will post a copy of our current
notice in our office in a prominent location, and you may request a copy of our
most current notice by calling us.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
We may use and disclose your protected health information for different
purposes. The examples below are provided to illustrate the types of uses and
disclosures we may make without your authorization for payment, home care
operations, and treatment.
 | Payment. We use and disclose your protected health information in
order bill and collect payment for the services and items you may receive from
us. For example, we may contact your health insurer to certify that you are
eligible for benefits and we may provide your insurer with details regarding
your treatment to determine if your insurer will cover, or pay for, your
equipment. We also may use and disclose your health information to obtain
payment from third parties that may be responsible for such costs, such as
family members. Also, we may use your health information to bill you directly
or services and items. |
 | Home Care Operations. We use and disclose your protected health
information in order to perform our home care activities, such as providing
equipment appropriate to your needs, or administrative activities, including
data management or quality assessment activities. |
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 | Treatment. We may use and disclose your protected health information
to coordinate services with other health care providers involved in your care.
For example, we may perform an oximetry test to evaluate the appropriateness
of oxygen equipment; collect measurements to identify appropriate seating and
mobility system(s). We may obtain and disclose information on Arterial Blood
Gases, oxygen saturation results, CPT diagnosis codes, diagnosis and
prognosis, functional limitations, pre-existing health conditions,
hospitalizations, prior use of equipment, and information specific to
qualifying the patient as dictated by CMN / detailed written order forms. |
 | Appointment Reminders. We may use and disclose your health information
to contact you and remind you of visits / deliveries. |
 | Health-related Benefits and Services. We may use and disclose your
health information to inform you of health-related benefits or services that
may be of interest to you. |
 | Release of information to Family / friends. We may release your health
information to a friend or family member that is helping you to pay for your
health care, or who assists in taking care of you. |
 | Disclosures Required by Law. We will use and disclose your health
information when we are required to do so by federal, state or local law. |
OTHER PERMITTED OR REQUIRED DISCLOSURES
 | As Required by Law. We must disclose protected health information about
you when required to do so by law. |
 | Public Health Activities. We may disclose protected health information
to public health agencies for reasons such as preventing or controlling disease,
injury, or disability. |
 | Victims of Abuse. Neglect, or Domestic Violence. We may disclose
protected health information to government agencies about abuse, neglect, or
domestic violence. |
 | Health Oversight Activities. We may disclose protected health
information to government oversight agencies. Oversight activities can include,
for example, investigations, inspections, audits, surveys, licensure and
disciplinary actions; civil, administrative, and criminal procedures or actions;
or other activities necessary for the government to monitor government programs,
compliance with civil rights laws and the health care system in general. |
 | Judicial and Administrative Proceedings. We may disclose protected
health information in response to a court or administrative order. We may also
disclose protected health information about you in certain cases in response to
a subpoena, discovery request, or other lawful process. |
 | Law Enforcement. We may disclose protected health information under
limited circumstances to a law enforcement official in response to a warrant or
similar process; to identify or locate a suspect; or to provide information
about the victim of a crime. |
 | To Avert a Serious Threat to Health or Safety. We may disclose protected
health information about you, with some limitations, when necessary to prevent a
serious threat to your health and safety or the health and safety of the public
or another person. |
 | Special Government Functions. We may disclose information as required by
military authorities or to authorized federal officials for national security
and intelligence activities. |
 | Workers Compensation. We may disclose protected health information to
the extent necessary to comply with state law for workers’ compensation
programs. |
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have certain rights regarding protected health
information that the Plan maintains about you.
 | Right To Access Your Protected Health Information. You have the right
to review or obtain copies of your protected health information records, with
some limited exceptions. Usually the records include referral information,
delivery forms, billing, claims payment, and medical management records. Your
request to review and/or obtain a copy of your protected health information
records must be made in writing. We may charge a fee for the costs of
producing, copying, and mailing your requested information, but we will tell
you the cost in advance. |
 | Right To Amend Your Protected Health Information. If you feel that
protected health information maintained by us is incorrect or incomplete, you
may request that we amend the information. Your request must be made in
writing and must include the reason you are seeking a change. We may deny your
request if, for example, you ask us to amend information that was not created
by us, or you ask to amend a record that is already accurate and complete. If
we deny your request to amend, we will notify you in writing. You then have
the right to submit to us a written statement of disagreement with our
decision and we have the right to rebut that statement. |
 | Right to an Accounting of Disclosures. You have the right to request
an accounting of disclosures we have made of your protected health
information. The list will not include our disclosures related to your
treatment, our payment or health care operations, or disclosures made to you
or with your authorization. The list may also exclude certain other
disclosures, such as for national security purposes. Your request for an
accounting of disclosures must be made in writing and must state a time period
for which you want an accounting. This time period may not be longer than six
years and may not include dates before April 14, 2003. Your request should
indicate in what form you want the list (for example, on paper or
electronically). The first accounting that you request within a 12-month
period will be free. For additional lists within the same time period, we may
charge for providing the accounting, but we will tell you the cost in advance. |
 | Right To Request Restrictions on the Use and Disclosure of Your Protected
Health Information. You have the right to request that we restrict or
limit how we use or disclose your protected health information for services,
payment, or health care operations. We may not agree to your request. If
we do agree, we will comply with your request unless the information is needed
for an emergency. Your request for a restriction must be made in writing. In
your request, you must tell us (1) what information you want to limit; (2)
whether you want to limit how we use or disclose your information, or both;
and (3) to whom you want the restrictions to apply. |
 | Right To Receive Confidential Communications. You have the right to
request that we use a certain method to communicate with you or that we send
information to a certain location. For example, you may ask that we contact
you at work rather than at home. Your request to receive confidential
communications must be made in writing.. We will accommodate all reasonable
requests. Your request must specify how or where you wish to be contacted. |
 | Right to a Paper Copy of This Notice. You have a right at any time to
request a paper copy of this Notice. You may ask us to give you a copy of this
notice at any time. |
 | Contact Information for Exercising Your Rights. You may exercise any
of the rights described above by contacting our privacy Office. |
 | Complaints. If you believe that your privacy rights have been
violated, you may file a complaint with us and/or with the Secretary of the
Department of Health and Human Services. All complaints must be submitted in
writing. You will not be penalized for filing a complaint. |
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