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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 Pelton’s (referred to as “we”) may collect, use, and disclose your protected health information. “Protected health information” is information about you that can reasonably be used to serve you and 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 the 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 Official at Pelton’s for further information privacy@peltons.com or
860-347-7880 x750.
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 business 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 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, treatment, and health care operations.
- Payment. We may use and disclose your protected health information in order to bill and collect payment for the services, equipment 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 treatment. 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 for services, equipment and supplies.
- 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 obtain and disclose information on ICD-9 diagnosis codes, diagnosis and prognosis, functional limitations, medications, pre-existing health conditions, hospitalizations, prior use of equipment, and information specific to qualifying the patient as dictated by CMN / detailed written order forms.
- Health Care Operations. We use and disclose your protected health information in order to perform our health care activities, such as providing services appropriate to your needs, or administrative activities, including data management or quality assessment activities.
- Deliveries. We may use and disclose your health information to contact you and remind you of, or schedule, a delivery.
- 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.
- Communication with Individuals Involved In Your Care. We may release 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
- 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 agencies 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 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.
- Research. We may disclose protected health information for research when the use or disclosure for research has been approved by an institutional review board that has reviewed the research proposal and research protocols to address the privacy of your protected health information.
- Relating to Decedents. We may disclose protected health information relating to an individual’s death to coroners, medical examiners or funeral directors, and to organ procurement organizations relating to organ, eye, or tissue donations or transplant
We will not use or disclose your health information without your written authorization, except at described in this notice.
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