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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.
Diabetic Promotions, Inc. (DPI) is a health care product
provider subject to the Health Insurance Portability and
Accountability Act of 1996, as amended ("HIPAA").
We have always been committed to protecting the information
you share with us and we are required by law to:
- Maintain the privacy of your protected health information;
- Provide
this Notice of our legal duties and privacy practice with
respect to protected health information to any customer
who requests it.
- Abide by the terms of this Notice until
adoption of a new one; and
- To post this notice on our website:
www.DiabeticPromotions.com
Uses and Disclosures for Payment,
Treatment or Healthcare Operations: Under HIPAA, we may use, receive or disclose
your protected health information for payment, treatment
or healthcare operations without obtaining a written authorization
from you. Example of this use include but are not limited
to:
Payment: We may use and disclose your protected health information
to receive payment for the products and services we provide.
Payment activities may include sending claims to your health
insurance carrier or medical plan, reviewing the medical
necessity of the services rendered with your physician, and
coordinating the payment of benefits between medical plans.
Treatment: We may disclose protected health information
to your medical care providers for management or coordination
of that care.
Healthcare Operations: We may use and disclose you protected
health information for our business planning and operational
purposes. For example, we may use or disclose your protected
health information for activities such as verification of
eligibility for benefits with your health insurance carrier
or for training and quality control purposes within our organization.
Business Associates: We may contract with other businesses
for certain services. These businesses may require access
to your personal health information in order to perform a
payment or healthcare operations for us. These Business Associates
must agree in writing that they will follow these privacy
practices and will protect the privacy of your health information.
Unless you authorize us otherwise, your protected health
information will be available only to the individuals who
need the information to conduct payment, treatment or healthcare
operation activities.
Other Uses and Disclosures: Other disclosure DPI may make:
- To comply with legal proceedings, court or administrative
order or subpoena;
- To law enforcement officials for limited
law enforcement purposes;
- To public Health Authorities for
certain required public health activities;
- To avert a serious
threat to the health or safety of you or any other person;
- To
comply with laws and regulations related to workers' compensation
or similar programs;
- To a coroner, medical examiner or funeral
director for purposes of carrying out his or her duties;
- To
federal officials for lawful intelligence activities or
if you are imprisoned;
- To your personal representative appointed
by you or designated by law;
- When otherwise required by
law; and
- To inform you of other products and services that
may be of interest to you.
- These uses and disclosures may
be subject to special rules under HIPAA or other laws.
Limitation on Use and Disclosure: If a use or disclosure
of your protected health information identified in this Notice
is subject to a law more stringent that HIPAA, the more stringent
law will apply. If you have a question about your rights
under any particular federal or state law, please write to
the DPI Privacy Contact.
Authorizations Required for all Other
Uses and Disclosures: Any other use or disclosure of your protected health information
not identified within this notice will be made only with
your written authorization. You have the right to limit the
type of information and the persons to whom it should be
disclosed. You may revoke your written authorization at any
time, and the revocation will be followed to the extent action
on the authorization has not yet been taken.
Diabetic Promotions, Inc.
P. O. Box 5400
Willowick, OH 44095
Attn: Compliance Officer
YOUR RIGHTS:
Below are your privacy and confidentiality rights as a customer
of Diabetic Promotions, Inc. Please note that all requests
must be made in writing.
- You may request the DPI places a restriction on certain
uses and disclosures of your protected health information.
We are not required to agree to a requested restriction.
To request a restriction, please write to our Privacy Contact
and provide specific information as to the disclosures that
you with to restrict and the reasons for your request. We
will respond in writing.
- You may request that our confidential communications
of your protected health information be sent to alternative
locations or by alternative communicative means. For
example, you may ask that we send information or products
to your office rather than your home address. We are
not required to accommodate your request unless the request
is reasonable.
- You may make a written request to inspect
and obtain a copy of the protected health information
that may be uses by DPI to make decisions about your
care or treatment. Be specific as to the information
requested. A reasonable fee may be imposed for copying
and mailing the requested information.
- You may request that DPI amend your protected
health information or record if you believe that information
is incorrect or incomplete. DPI cannot amend information
it did not create and will refer you to the provider of
services if you are requesting amendment to diagnosis or
treatment information.
- You may receive an accounting of certain disclosures
of your protected health information made by DPI for purposes
other that treatment, payment or healthcare operations
in the six years prior to the date of the request, but
not for disclosures made prior to April 14, 2003.
- Request and obtain a paper copy of this Notice
at any time, even if you have agreed to receive it electronically.
To exercise
any of these rights, please write to the address listed at
the end of this Notice. There are circumstances where DPI
is allowed to deny or limit your requests. In such event
you may have the right to object and obtain a review of our
decision. We will provide you with further information about
these rights at that time. If you would like more specific
information about these matters, contact the DPI Privacy
Contact.
Changes to this Notice: DPI reserves the right to change
the terms of this Notice and its privacy practices and to
make a new provisions effective for all protected health
information it maintains. Any amended Notice will be made
available to you in the same way that this Notice is available
to you.
Complaints and Privacy Contact: You may file a complaint
with our Privacy Contact and with the Secretary of the Department
of Health and Human Services if you believe your privacy
rights have been violated. There addresses are available
under contact information below. All complaints must be filed
in writing. Federal Law prohibits retaliation against you
for filing a complaint.
Privacy Contact Information: If you have any questions
about this Notice write to:
Diabetic Promotions, Inc.
P. O. Box 5400
Willowick, OH 44095
Attn: Compliance Officer
To contact the Secretary of Health and Human Services, write
to:
U.S. Department of Health and Human Services
Hubert Humphrey Building
200 Independence Avenue, S. W.
Washington, D.C. 20201
Effective Date of Notice: April 14, 2003. DPI is required
to follow the terms of this notice until it is replaced.
DPI reserves the right to change this Privacy Statement at
any time as allowed by law and will notify you of any changes
as required by law. DPI reserves the right to make the changes
apply to all information DPI maintains.
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