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 READ IT CAREFULLY.
In the process of providing quality services to you, Progressive Medical, Inc. and Scriptwise, Ltd. (referred to below as we, us or our) receive from health care providers, health plans and/or other sources, certain personal health information about you relating to your physical or mental health or conditions, the provision of health care (including medications) to you or payment for such care. We are required by law to protect the privacy of your health information.
In this notice, which we are required to provide to you, we describe how we may use your health information, the circumstances under which we may disclose it to others, and your rights to have access to this information.
If we change our privacy policy, we will furnish you a revised notice within 60 days by mail or by posting it on our Web site at www.progressive-medical.com.
USE / DISCLOSURE
Under the Health Insurance Portability Accountability Act of 1996, as amended (HIPAA), we are required to use and disclose your health information to:
1) You or someone who has been authorized by law to act on your behalf as your personal representative;
2) The Secretary of the United States Department of Health and Human Services, if required; and
3) Where otherwise required to do so by federal or state law.
We may use or disclose your health information to operate our business and do what is necessary to provide service to you. Examples of when we may disclose health information about you include:
For Health Care Operations. We may use or disclose health information necessary for us to provide service to you, manager your health care coverage, and to operate our business.
To Plan Sponsors. If we are servicing you through an employer health or health benefit plan, we may disclose to or share certain general health information or benefit eligibility with the plan sponsor. We may also share with the plan sponsor certain health information as may be necessary for plan administration provided that the sponsor agrees to certain limitations on the use and disclosure of such health information.
To Care Providers. We may disclose health information necessary to physicians, hospitals and other care providers in order to enable them to provide care to you.
For Appointment Reminders. We may use health information to contact you to remind you or confirm appointments with your health care providers.
Under limited circumstances when we may use or disclose your health information to:
Persons to whom you have authorized us in writing or verbally to disclose such information.
Persons involved in your health care, such as a spouse, family member, other relative or close personal friend in the event of a medical emergency, or when otherwise permitted by law.
A Public Health Authority or Government Agency for purposes of preventing or controlling disease or to avoid a serious threat to health of safety.
A Public Authority authorized to receive reports of child abuse or neglect or domestic violence.
Workers Compensation Authorities or Your Employer as required or permitted by law relating to work-related illness or injuries.
A Health Oversight Agency authorized to audit or investigate for fraud or abuse.
To Judicial or Administrative Authorities such as in response to a court order, subpoena or search warrant.
Law Enforcement Agencies, for activities such as victim or crime investigations or to locate missing persons.
Governmental Agencies relating to military or veterans affairs, national security and intelligence activities.
Researchers if the researchers agree to comply with all federal and state privacy requirements.
Sources for Bodily Organs for procurement, banking or transplantation of organs.
Medical Examiners/Coroners/Funeral Directors for the purpose of identifying a deceased person or to determine a cause of death as otherwise required by law.
Except as described above, we may not use or disclose your health information without your consent. You may revoke your authorization, except if we have already acted based on your authorization. To revoke your authorization, contact us at 1-800-777-3574.
In addition to HIPAA, there may be other federal and state laws which more strictly limit the ways in which we use or disclose your health information particularly with regard to certain highly confidential information relating to: alcohol or drug abuse; HIV/AIDS; genetic testing; mental health; sexually-transmitted disease; reproductive health information; and child or adult abuse, neglect or sexual assault. It is our intent to comply with any such more stringent laws.
YOUR RIGHTS WITH REGARD TO YOUR HEALTH INFORMATION
You have the right to ask to restrict uses or disclosures of your information for treatment, payment, or health care operations. You also have the right to ask to restrict disclosures to family members or to others who are involved in your health care or payment for your health care. We may also have policies on dependent access that may authorize certain restrictions. Please note that while we try to honor your request and will permit requests consistent with its policies, we are not required to agree to any restriction.
You have the right to ask and receive confidential communications or information in a different manner or at a different place (for example, by sending information to an address other than your home address).
You have the right to see and obtain a copy of health information that may be used to make decisions about you such as claims and case or medical management records. You also may receive a summary of this health information. You must make a written request to inspect and copy your health information. In certain limited circumstances, we may deny your request to inspect and copy your health information.
You have the right to ask to amend information we maintain about you if you believe the health information about you is wrong or incomplete. If we deny your request, you may have a statement of your disagreement added to your health information.
You have the right to receive an accounting of disclosures of your information made by us during the six years prior to your request. This accounting will not include disclosures of information: (i) made prior to April 14, 2003; (ii) for treatment, payment, and health care operations purposes; (iii) to you or pursuant to your authorization; and (iv) to correctional institutions or law enforcement officials; and (v) other disclosures that federal law does not require us to provide an accounting.
You have the right to a paper copy of this notice. You may ask for a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our Web site, www.progressive-medical.com.
HOW TO EXERCISE YOUR RIGHTS
Contacting us. If you have any questions about this notice or want to exercise any of your rights, please contact us at 1-800-777-3574.
Filing a complaint. If you believe your privacy rights have been violated, you may file a complaint with us at the following address:
Progressive Medical, Inc.
250 Progressive Way
You may also notify the Secretary of the U.S. Department of Health and Human Services of your complaint. We will not take any action against you for filing a complaint.
Ó 2007 Progressive Medical, Inc.
