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 review it carefully.
The terms of this Notice of Privacy Practices applies to
Progressive Medical, Inc. and subsidiaries including Scriptwise,
Ltd. We are required by law to maintain the privacy of protected
personal health information and to provide patients with notice of
our legal duties and privacy practices with respect to your
protecting your personal health information. We are required to
abide by the terms of this Notice so long as it remains in effect.
We reserve the right to change the terms of this Notice of Privacy
Practices as necessary and to make the new Notice effective for all
personal health information maintained by us. You may receive a
copy of any revised notices at www.progressive-medical.com or a
copy may be obtained by mailing a request to Attention: Compliance
Officer, 250 Progressive Way, Westerville, OH 43082.
Uses and Disclosures of Your Personal Health Information
Your Authorization
Except as outlined below, we will not use or disclose your
personal health information for any purpose unless you have signed
a form authorizing the use or disclosure. You have the right to
revoke that consent or authorization in writing unless we have
taken any action in reliance on the consent or authorization.
Uses and Disclosures for Treatment
We will make uses and disclosures of your personal health
information as necessary for coordination and management of your
health care and related services. This includes the coordination or
management of your health care with a third party, i.e. we could
disclose your protected health information, as necessary, to
another organization to assist in providing medical products or
care to you. We may use or disclose information, as necessary, to
contact you to obtain information on your use of provided medical
equipment and/or supplies, and your progress while using. We would
also disclose your protected health information to a nurse case
manager or claims adjuster handling your claim.
Uses and Disclosures for Payment
We will make uses and disclosures of your personal health
information as necessary for payment purposes of those health
professionals and facilities that have treated you or provided
services to you. For instance, we may forward information regarding
services provided to your insurance company to arrange payment for
the services provided to you or we may use your information to
prepare a bill to send to you or to the person responsible for your
payment.
Uses and Disclosures for Health Care Operations
We will use and disclose your personal health information as
necessary, and as permitted by law, for our health care operations,
which include but are not limited to, quality assessment
activities, clinical improvement, professional peer review and
training, licensing, business management and conducting or
arranging other business activities.
Family and Friends Involved In Your Care
With your approval, we may from time to time disclose your
personal health information to designated family, friends and
others who are involved in your care or in payment of your care in
order to facilitate that person's involvement in caring for you or
paying for your care. If you are unavailable, incapacitated, or
facing an emergency medical situation and we determine that a
limited disclosure may be in your best interest, we may share
limited personal health information with such individuals without
your approval.
Business Associates
Certain aspects and components of our services are performed
through contracts with outside persons or organizations, such as
auditing, accreditation, vendors, legal services, etc. At times, it
may be necessary for us to provide certain of your personal health
information to one or more of these outside persons or
organizations who assist us with our health care operations. In all
cases, we require these business associates to appropriately
safeguard the privacy of your information.
Reminders and Services
We may contact you to provide reminders on upcoming service or
product reminders. You have the right to request and we will
accommodate reasonable requests by you to receive communications
regarding your personal health information from us by alternative
means or at alternative locations. For instance, if you wish
reminders to not be left on voice mail or sent to a particular
address, we will accommodate reasonable requests. You may request
such confidential communication in writing and may send your
request to Attention: Compliance Officer, 250 Progressive Way,
Westerville, OH 43082.
Other Uses and Disclosures
We are permitted or required by law to make certain other uses
and disclosures of your personal health information without your
consent or authorization.
- We may release your personal health information for any purpose
required by law;
- We may release your personal health information for public
health activities, such as required reporting of disease, injury,
and birth and death and for required public health
investigations;
- We may release your personal health information as required by
law if we suspect child abuse or neglect; we may also release your
personal health information as required by law if we believe you to
be a victim of abuse, neglect, or domestic violence;
- We may release your personal health information to the Food and
Drug Administration if necessary to report adverse events, product
defects, or to participate in product recalls;
- We may release your personal health information to your
employer when we have provided health care to you at the request of
your employer; in most cases you will receive notice that
information is disclosed to your employer;
- We may release your personal health information if required by
law to a government oversight agency conducting audits,
investigations, or civil or criminal proceedings;
- We may release your personal health information if required to
do so by a court or administrative ordered subpoena or discovery
request; in most cases you will have notice of such release;
- We may release your personal health information to law
enforcement officials as required by law to report wounds and
injuries and crimes;
- We may release your personal health information to coroners
and/or funeral directors consistent with law;
- We may release your personal health information if necessary to
arrange an organ or tissue donation from you or a transplant for
you;
- We may release your personal health information for certain
research purposes when such research is approved by an
institutional review board with established rules to ensure
privacy;
- We may release your personal health information in limited
instances if we suspect a serious threat to health or safety;
- We may release your personal health information if you are a
member of the military as required by armed forces services; we may
also release your personal health information if necessary for
national security or intelligence activities; and
- We may release your personal health information to workers'
compensation agencies if necessary for your workers' compensation
benefit determination.
Rights that You Have
Access to Your Personal Health Information
You have the right to copy and/or inspect much of the personal
health information that we retain on your behalf. All requests for
access must be made in writing and signed by you or your
representative. We will charge you $.50/pg +$10 search fee if you
request a copy of the information. We will also charge for postage
if you request a mailed copy and will charge for preparing a
summary of the requested information if you request such summary.
You can view printable request for this information by accessing
forms at www.progressive-medical.com or a copy may be
obtained by mailing a request to Attention: Compliance Officer, 250
Progressive Way, Westerville, OH 43082.
Amendments to Your Personal Health Information.
You have the right to request in writing that personal health
information that we maintain about you be amended or corrected. We
are not obligated to make all requested amendments but will give
each request careful consideration. All amendment requests, in
order to be considered by us, must be in writing, signed by you or
your representative and must state the reasons for the
amendment/correction request. If we make an amendment or correction
you request, we may also notify others who work with us and have
copies of the uncorrected record if we believe that such
notification is necessary. You can view printable request for this
information by accessing forms at www.progressive-medical.com
or a copy may be obtained by mailing a request to Attention:
Compliance Officer, 250 Progressive Way, Westerville, OH
43082.
Accounting for Disclosures of Your Personal Health
Information.
You have the right to receive an accounting of certain
disclosures made by us of your personal health information after
April 14, 2003. Requests must be made in writing and signed by you
or your representative. You can view printable request for this
information by accessing forms at www.progressive-medical.com or a
copy may be obtained by mailing a request to Attention: Compliance
Officer, 250 Progressive Way, Westerville, OH 43082.The first
accounting in any 12-month period is free; you will be charged a
fee of $.50/pg +$10 search fee for each subsequent accounting you
request within the same 12-month period.
Restrictions on Use and Disclosure of Your Personal Health
Information.
You have the right to request restrictions on certain of our
uses and disclosures of your personal health information for
treatment, payment, or health care operations. You can view
printable request for this information by accessing forms at
www.progressive-medical.com or a copy may be obtained by mailing a
request to Attention: Compliance Officer, 250 Progressive Way,
Westerville, OH 43082.
We are not required to agree to your restriction request but
will attempt to accommodate reasonable requests when appropriate
and we retain the right to terminate an agreed-to restriction if we
believe such termination is appropriate. In the event of a
termination by us, we will notify you of such termination. You also
have the right to terminate, in writing or orally, any agreed-to
restriction to sending such termination notice to Attention:
Compliance Officer, 250 Progressive Way, Westerville, OH 43082.
Complaints
If you believe your privacy rights have been violated, you can
file a complaint with Attention: Compliance Officer, 250
Progressive Way, Westerville, OH 43082. You may also file a
complaint with the Secretary of the U.S. Department of Health and
Human Services in Washington D.C. in writing within 180 days of a
violation of your rights. There will be no retaliation for filing a
complaint.
Acknowledgment of Receipt of Notice.
Please sign and return acknowledgment that you received this
Notice of Practice Practices.
For Further Information
If you have questions or need further assistance regarding this
Notice, you may contact Attention: Compliance Officer, 250
Progressive Way, Westerville, OH 43082.
As a patient, you retain the right to obtain a paper copy of
this Notice of Privacy Practices, even if you have requested such
copy by e-mail or other electronic means.
EFFECTIVE DATE: This Notice of Privacy Practices is effective
April 14, 2003.
© 2007 Progressive Medical, Inc.