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Privacy Policy
NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
The Let Them Hear Foundation has the legal and ethical responsibility to
safeguard the privacy of all patients and to protect the confidentiality of
their health information. The privacy of your personal and health information
is important to us. Please review this notice carefully. This notice describes
how medical and personal information about you may be used and disclosed and
how you can get access to this information.
OUR PLEDGE TO PROTECT YOUR PRIVACY
The Let Them Hear Foundation is committed to protecting the privacy of your
medical and personal information. Personal and health information includes
both medical information and individually identifiable information, such as
your name, address, telephone number or social security number. Let Them Hear Foundation protects your personal and health information in electronic,
written and oral forms when used throughout our organization. In accordance
with Federal and State laws, our privacy practices are shown below. While many
of these practices are already in place, certain provisions take effect April
14, 2003, and will remain in effect unless otherwise replaced or modified.
We may modify or change our privacy practices from time to time, particularly
as new laws and regulations become effective. Any changes will be effective
for all the personal and health information we maintain, even information in
existence before the change. If we materially modify our privacy practices,
we will provide you with a new notice advising you of the changes.
So that we may best meet your medical needs, we share your medical records
with the health care providers involved in your care. We share your information
only to the extent necessary to collect payment for the services we provide,
to conduct our business operations, and to comply with the laws that govern
health care. We will not use or disclose your information for any other purpose
without your permission.
WHO WILL COMPLY WITH THIS NOTICE
All employees, volunteers, trainees, students, contractors and medical staff
members of the Let Them Hear Foundation.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding your medical information:
- RIGHT TO INSPECT AND OBTAIN A COPY OF YOUR MEDICAL RECORDS
You have the right to inspect and obtain a copy of the medical records that
the Let Them Hear Foundation uses to make decisions about you and your treatment,
subject to certain limited exceptions. This information includes your medical
and billing records, but may not include some mental health information. We
reserve the right to charge a fee to cover the cost of providing your records
to you .
- RIGHT TO REQUEST AN AMMENDMENT TO YOUR MEDICAL RECORD :
Correction : If you believe that the medical
information the Let Them Hear Foundation has on file for you is inaccurate
or incomplete, you may request that we correct the medical information in your
records. This request must be done in written form. Your written request must
explain why the information should be corrected. If, however, after reviewing
your medical records, your physician determines that they are correct or complete,
we may deny your request. We will provide you with a written explanation for
our denial.
Addendum : In addition, an adult patient
of the Let Them Hear Foundation who believes that an item or statement in his/her
medical record is inaccurate or incomplete has the right to provide the Let Them Hear Foundation with a written addendum to his/her record.
- RIGHT TO AN ACCOUNTING OF THE LET THEM HEAR FOUNDATION DISCLOSURES
OF YOUR MEDICAL RECORDS:
You have the right to request an “accounting of disclosure” which
is a list describing how we have shared your medical information with outside
parties. We will begin maintaining disclosures starting April 14, 2003 for
purposes other than treatment, payment and health care operations. Those functions
are described below in the section entitled “How We May Use and Disclose
Medical Information About You”. If you request this accounting more than
once in a 12-month period, we may charge you a cost-based fee.
- RIGHT TO REQUEST RESTRICTIONS:
You have the right to request restrictions on certain uses or disclosures
of your personal and medical information. You can request, in writing, that
we place additional restrictions on the use or disclosure of your personal
and health information. We are not required to agree to these restrictions,
but if we elect to do so, we will abide by our agreement unless the information
is needed to provide you with emergency treatment or comply with the law. If
we deny your request, we will inform you in writing why we cannot honor your
request.
- RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS:
You have the right to receive certain communications confidentially. You
can request that we communicate with you in confidence about your personal
and medical information by alternative means or to an alternative location.
We will not ask the reasons for your request and will use our best efforts
to accommodate all reasonable requests.
- RIGHT TO A COPY OF THIS NOTICE UPON REQUEST:
You have the right to a copy of this Notice. It is available at the Front
Desk and on our internet site (http://www.letthemhear.org)
under the Privacy Policy link.
USES AND DISCLOSURES OF YOUR PERSONAL AND HEALTH INFORMATION:
The following sections describe different ways that we may use and disclose
your personal and medical information. We will try to limit the amount of information
that we use or disclose to the “minimum necessary” to accomplish
the purpose of the disclosure or use. Let Them Hear Foundation may use and
disclose your personal and health information, without your authorization,
only in the following ways:
FOR TREATMENT :
We may disclose your personal and health information to a provider who requests
this information to treat you.
FOR PAYMENT :
We may use and disclose your personal and health information to bill and
receive payment for the services you receive.
FOR HEALTHCARE OPERATIONS :
We may use and disclose your personal and health information for functions
necessary to run the Let Them Hear Foundation and assure that our patients
receives quality care. We may also share your personal and medical information
with affiliated healthcare providers to coordinate your care.
BUSINESS ASSOCIATES:
We may use or disclose your personal and health information with outside
companies that perform business services for us, such as, but not limited to,
collection companies, accountants and attorneys. We may need to share your
medical information so that it can perform a service on our behalf. The Let Them Hear Foundation will limit the disclosure of your information to the “minimum
necessary” for the business associate to perform services for the Let Them Hear Foundation. In addition, we will have a written contract in place requiring
the business associate to safeguard the privacy of your personal and medical
records.
HEALTH AND WELLNESS INFORMATION :
We may use your personal and health information to contact you with information
about health-related services, appointment reminders or treatment alternatives.
We may use your personal health information to inform you about up coming conferences
or patient-oriented events.If you do not wish to receive this
type of information, you may request to opt-out of receiving this information
from the Let Them Hear Foundation by sending an e-mail to serazo@calear.com
or calling the phone number (650) 494-1000. We may provide your basic contact
information and the dates you received services at the Let Them Hear Foundation
(no medical information is provided) to the LET THEM HEAR FOUNDATION (a non-profit
sector of the Let Them Hear Foundation) for the purposes of conducting fundraising
on their behalf. This organization may contact you in an effort to raise money
for the foundation and its operations. If you receive a request for a donation
from this organization, it will include information indicating how you can
opt out from receiving any further fundraising communications.
STORE POLICIES
Any credit card information you provide to make purchases from our online
store, donations to the Let Them Hear Foundation, or payments to your California
Ear Institute or Let Them Hear Foundation account will only be used in conjunction
with that transaction
Because the products we sell are medical in nature, all sales are final.
INDIVIDUALS INVOLVED IN YOUR CARE :
We may disclose your personal and health information to a family member,
friend, or other person if you are unavailable to agree such as in a medical
emergency or disaster relief. We will disclose this information only to the
extent necessary to help with your health care or with payment for your health
care.
RESEARCH; DEATH; ORGAN DONATION :
We may use or disclose your personal and health information for research
purposes in limited circumstances. We may disclose the personal and health
information of a deceased person to a coroner, medical examiner, funeral director
or organ procurement organization for certain purposes.
PUBLIC HEALTH AND SAFETY :
We may use and disclose your personal and health information to the extent
necessary to avert a serious and imminent threat to your health or safety or
the health or safety of others. We may disclose your personal and health information
to appropriate authorities if we reasonably believe that you are a possible
victim of abuse, neglect, domestic violence or other crimes .
REQUIRED BY LAW :
We will use or disclose your personal and health information when we are
required to do so by law.
PROCESS AND PROCEEDINGS :
We may disclose your personal and health information in response to a court
or administrative order, subpoena, discovery request or other lawful process.
LAW ENFORCEMENT :
We may disclose limited information to a law enforcement official concerning
the personal or health information of a suspect, fugitive, material witness,
crime victim or missing person. We may disclose the personal and health information
of an inmate or other person in lawful custody to a law enforcement official
or correctional institution under certain circumstances.
MILITARY AND VETERANS:
We may disclose to Military authorities the personal and medical information
of Armed Forces personnel. We may disclose to authorize federal officials personal
and health information required for lawful intelligence, counterintelligence,
and other national security activities.
HEALTH AND OVERSIGHT ACTIVITIES:
We may disclose medical information to a health oversight agency, such as
the California Department of Health Services, for activities authorized by
law. These oversight activities include audits, investigations, inspections,
and licensure. These activities are necessary for the government to monitor
the healthcare system, government programs, and compliance with civil rights
laws.
CHANGES TO THIS NOTICE
We reserve the right to change our privacy practices and update this Notice
accordingly. We reserve the right to make the revised or changed Notice effective
for medical information we already have about you as well as any information
we receive in the future. We post copies of the revised notice on our website
(http://www.letthemhear.org) under
the Privacy Policy link. If the Notice is changed, we will post the new
Notice at our Front Desk and provide it to you upon request. The Notice contains
the effective date on the first page, in the right-hand corner.
COMMENTS OR COMPLAINTS
We welcome your comments about our Notice and our privacy practices. If you
believe your privacy rights
have been violated, you may file a complaint with the Let Them Hear Foundation
HIPAA Privacy Officer or with
the Secretary of the Department of Health and Human Services.
To register a comment or complaint with the Let Them Hear Foundation, please
contact:
HIPAA Privacy Officer
1900 University
Ave Suite 101
E.Palo Alto, CA 94303
Phone: (650) 494-1000
Fax: (650) 322-8228
E-mail: serazo@calear.com
To register a complaint with the Department of Health and Human Services:
Secretary of the Department of Health and Human Services 200
Independence Avenue, S.W.
Washington , D.C. 20201
PLEASE BE ASSURED THAT NO ONE WILL RETALIATE OR TAKE ACTION AGAINST
YOU FOR FILLING A COMPLAINT.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this Notice
or the laws that apply to us will be made only with your written authorization.
If you provide us with written authorization to use or disclose medical or
personal information about you, you may revoke that authorization, in writing,
at any time. If you revoke your authorization, we will no longer use or disclose
medical or personal information about you for the activities covered by the
authorization, except if we have already acted in reliance on your permission.
We are unable to take back any disclosures we have already made with your authorization,
and we are required to retain our records of the care that we provided to you.
If you have any questions regarding this Notice please contact the Let Them Hear Foundation’s Privacy Officer at (650) 494- 1000.
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