NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW DATA ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS DATA. PLEASE REVIEW IT CAREFULLY.
Why We Are Sending This Notice.
RespirTech is committed to protecting the privacy of your health data. Federal and state laws require us to protect the privacy of your health data. We must give you notice of our legal duties and our privacy practices. We are required to do the following:
- We must protect data your health data.
- We must notify you about how we protect your health data.
- We must explain how, when and why we use or disclose your health data.
- We may only use or disclose your health data as we have described in this Notice.
How We Protect Your Data.
- We restrict access to your health data to only RespirTech staff members who provide services to you. All RespirTech staff members have been trained to protect privacy. Staff members who violate these policies are subject to disciplinary action.
- We use safeguards to protect your health data. These safeguards comply with federal regulations regarding security.
- We periodically review our policies and practices. We monitor our computer networks. We monitor and test our security to ensure the privacy and security of your health data.
USES AND DISCLOSURES OF YOUR HEALTH DATA
There are a number of ways in which we use or disclose your health data in providing health benefits to you.
1. Uses and Disclosures for Treatment, Payment or Health Care Operations.
When you first became a patient or customer of RespirTech, you authorized the release of your medical records for the following purposes:
- Payment and insurance coverage
- Conducting quality of care and performance review
- Assuring coordination of medical services
Without further notice to you, RespirTech may use your health data for the following purposes:
- Treatment. We may use or disclose your health data to assist medical providers in coordinating and managing your care.
- Payment. We may use or disclose your health data to facilitate the payment to medical providers who have provided services to you. We may also disclose your health data with contractors that provide claims processing services to RespirTech
- Health Care Operations. We may use or disclose your health data to perform necessary health plan functions. For example, we may use your data to help us train new staff and to conduct quality improvement activities.
2. Uses and Disclosures Authorized by Law.
Under certain circumstances, we are authorized by law to use or disclose your health data without obtaining authorization from you and without notifying you of such uses or disclosures. These circumstances may include when the use or disclosure is:
- For public health activities. For example, when reporting to public health authorities the exposure to certain diseases or reporting data about immunizations.
- For health oversight activities. For example, when disclosing health data to a state or federal health oversight agency so it can monitor the safety or medical devices.
- About victims of abuse, neglect or domestic violence.
- For organ or tissue donation purposes.
- For judicial or administrative proceedings. For example, when responding to a court order.
- For law enforcement purposes.
- To a coroner or medical examiner.
- To avert a serious threat to health or safety to you, another person or to the public.
- Related to specialized government functions. For example, regarding military personnel.
We may also make disclosures without your consent or authorization when required to do so by state or federal law.
3. Other Uses and Disclosures.
We may also contact you to tell you about treatment options or other health services that may be of interest to you.
4. Uses and Disclosures that Require Authorization.
For all other purposes, we may be required to obtain a specific authorization to use or release your health data. If you provide an authorization to us, you may revoke it at any time.
YOUR INDIVIDUAL RIGHTS
1. Right to Access and Copy Your Health Data.
You may access, inspect and receive a copy of your health data contained in our records. You need to make your request in writing. Write or call RespirTech and ask for a “RespirTech Information Access Form”. We may charge a reasonable fee for copies. There are limited situations in which we may deny your request for access. In these situations, we will let you know why we cannot grant your request and how you may ask for a review of our denial.
2. Right to Request an Amendment of Your Health Data.
You may request that we amend your health data. You need to make your request in writing and explain your reason for the amendment. Write or call RespirTech and ask for a “RespirTech Information Amendment Request Form”. Under limited circumstances, we may deny your request. If we do so, you may file a statement of disagreement with us. You may also ask that any future disclosures of your health data include your requested amendment and our denial of your request.
3. Right to Request Restrictions on Uses and Disclosures of Your Health Data.
You may request that we restrict our use or disclosure of your health data for payment or health care operations. You need to make your request in writing. We are not required to agree to your request for a restriction. However, if we do agree, we will comply with our agreement, unless there is an emergency or we are otherwise required to use or disclose the data. If we decide to end our agreement to the restrictions, we will tell you.
4. Right to Request Confidential Communications.
You may request that we communicate with you in a specific way or at a specific location. For example, you may request that we contact you at an address other than your home address. We will agree to your request if we determine that your request is reasonable. You need to make your request in writing.
5. Right to Request an Accounting of Disclosures of Health Data.
You may request a listing of certain disclosures we have made of your health data. You need to make your request in writing. You may ask for disclosures made up to six (6) years before the date of your request. We will provide you one accounting in any 12 month period free of charge.
6. Right to Receive a Copy of this Notice.
You have the right to receive a paper copy of this Notice at any time. To exercise any of these rights, contact our Privacy Office at the telephone number or address listed below.
QUESTIONS OR COMPLAINTS
If you are concerned that your privacy rights have been violated, you may file a complaint with RespirTech. Contact : Privacy Official @ RespirTech, 1380 Energy Lane, Suite 113, St. Paul, MN 55108 1-800-793-1261 (Toll Free) Or, 651-379-8953 (Direct Dial)
You may also submit a written complaint to the U.S. Department of Health and Human Services at: Region V Office for Civil Rights, U.S. Department of Health and Human Services, 233 N. Michigan Avenue, Suite 240 Chicago, IL 60601 Hotline: (800) 368-1019
We support your right to the privacy of your health data. We will not retaliate in any way if you file a complaint with us or with the U.S. Department of Health and Human Services.
CHANGES TO OUR PRIVACY PRACTICES
We will send a new Notice to you when we make a significant change in our privacy practices.
QUESTIONS?
If you want more information about our privacy practices, please call the RespirTech Privacy Official toll free at: 1-800-793-1261
