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 CAREFULLY
Hearing Plus’ Duties
Hearing Plus is required by law to maintain the privacy of your protected health information. This Notice of Privacy
Practices tells you how your protected health information may be used and how Hearing Plus keeps your information
private and confidential. This notice explains the legal duties and practices relating to your protected health
information. As part of Hearing Plus legal duties this Notice of Privacy Practices must be given to you. Hearing Plus will notify you promptly if a breach occurs that may have compromised the privacy or security of your information. Hearing Plus is required to follow the terms of the Notice of Privacy Practices currently in effect.
Hearing Plus may change the terms of its notice. The change, if made, will be effective for all protected health information that it maintains. New or revised notices of privacy practices will be posted on the Hearing Plus website at www.hearingpluscleveland.com and will be available at all Hearing Plus sales locations.
Uses and Disclosures of your Protected Health Information
Protected health information includes demographic and medical information that concerns the past, present, or future health of an individual. Demographic information could include your name, address, telephone number, social security number and any other means of identifying you as a specific person. Protected health information contains specific information that identifies a person or can be used to identify a person.
Protected health information is health information created or received by a healthcare provider, health plan, employer, or health care clearinghouse. Hearing Plus acts as a healthcare provider, a medical product manufacturer, and is also an employer. This medical information is used by Hearing Plus in many ways while performing normal business activities.
Your protected health information may be used or disclosed by Hearing Plus for purposes of providing products, services, and payment. Your protected health information may be shared, with or without your consent, with another health care provider for purposes providing products, services and payment. Hearing Plus may send the medical information to insurance companies, financial companies, Medicaid, or community agencies to obtain payment for the services provided to you.
Unless you notify Hearing Plus that you object, Hearing Plus may provide your health information to individuals such as family and friends, who are involved in your hearing health. Hearing Plus may do so if you tell Hearing Plus to do so, or if you know Hearing Plus is sharing this information and you do not stop Hearing Plus from doing so. Your information may be used by certain Hearing Plus personnel during audits and investigations to improve operations. Hearing Plus also may send you appointment reminders and information about other health related benefits and services.
Some protected health information can be disclosed without your written authorization as allowed by law. Those circumstances include:
- Government investigations and audits
- Public health purposes including vital statistics, disease reporting, public health surveillance, investigations,
- interventions and regulation of health professionals
- Court orders, warrants, or subpoenas
- Law enforcement purposes, administrative investigations and judicial administrative proceedings
Other uses and disclosures of your protected health information by Hearing Plus will require your written authorization. These authorizations will have expiration dates and can be revoked by you at any time in writing as specified in the authorization. These uses and disclosures may be for marketing and for research purposes. We may not sell your protected health information without your authorization.
You have the right to request Hearing Plus to restrict the use and disclosure of your protected health information to provide products, services, and payment. You may also limit disclosures to individuals. Hearing Plus is not required to agree to any restriction.
You have the right to be assured that your information will be kept confidential. Hearing Plus may mail or call you with appointment reminders. We will make contact with you in the manner and at the address or phone number you select. You may be asked to put your request in writing. You may provide an address other than your residence where you can receive mail and where we may contact you.
You have the right to inspect and receive a copy of your protected health information. Your inspection of information will be supervised at an appointed time and place. You may be denied access as specified by law. If access is denied, you have the right to request a review by a licensed hearing professional who was not involved in the decision to deny access. This licensed hearing professional will be designated by Hearing Plus..
You have the right to correct your protected health information. Your request to correct your protected health information must be in writing and provide a reason to support your request correction. Hearing Plus may deny your request, in whole or part, if it finds the protected health information:
- Was not created by Hearing Plus
- Is not protected health information
- Is by law not available for your inspection, or
- Is accurate and complete
If your correction is accepted, Hearing Plus will make the correction and tell you and others who need to know about the correction. If your request is denied, you may send a letter detailing the reason you disagree with the decision. Hearing Plus will respond to your letter in writing. You also may file a complaint, as described below in the section titled Complaints.
You have the right to receive a summary of certain disclosures Hearing Plus may have made of your protected health information. This summary does not include:
- Disclosures made to you
- Disclosures to individuals involved with your hearing health care
- Disclosures authorized by you
- Disclosures made to provide products, services, and payment
- Disclosures for public health
- Disclosures for health professional regulatory purposes
This summary does include disclosures made for:
- Purposes of research, other than those you authorized in writing
- Responses to court orders, subpoenas, or warrants
You may request a summary for not more than the 6 year period preceding the date of your request.
If you received this Notice of Privacy Practices electronically, you have the right to a paper copy upon request.
For Further Information
Requests for further information about the matters covered by this notice may be directed to Hearing Plus at 4760 Ridge Road, Brooklyn, Ohio, 44144.
If you believe your privacy rights have been violated, you may file a complaint with the Hearing Plus HIPAA Privacy Officer at Hearing Plus at 4760 Ridge Road, Brooklyn, Ohio, 44144 and with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue, S.W. Washington, D.C. 20201/ telephone 2026190257 or toll free at 8776966775. The complaint must be in writing, describe the acts or omissions that you believe violate your privacy rights, and be filed within 180 days of when you knew or should have known that the act or omission occurred. Hearing Plus will not retaliate against you for filing a complaint.
This Notice of Privacy Practices is effective beginning September 1, 2013, and shall be in effect until a new Notice of Privacy Practices is approved and posted. FORM FSP2 Update 08/14/13 (modified 05/11/18)