This document describes the type of information that our audiology practices gather about you, with whom that information may be shared, and the safeguards we have in place to protect it. You have the right to the confidentiality of your medical & hearing care information and the right to approve or refuse the release of specific information except when the release is required by law. If the practices described in this notice meet your expectations, there is nothing you need to do. If you prefer that we not share hearing care information, we may honor your written request in certain circumstances described below. If you have any questions regarding this Privacy Notice, please contact our Privacy Officer, Airyn Cristiano.

Our Legal Duty

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this notice about our privacy practices, our legal duties, and your right concerning your health information. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect of April 14, 2003 and will remain in effect. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. We reserve the right to change this notice and to make the revised notice effective for medical information we already have about you as well as any information we receive in the future.

Uses and Disclosures of Health Information

We use and disclose health information about you for treatment, payment, and healthcare operations. For example:

Treatment: We may use or disclose your health information to a physician or
other healthcare provider who is currently providing treatment to you.

In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosure permitted by your authorization while it was in effect. Unless you give a written authorization, we cannot use or disclose your health information for any reason except those described in this notice.

We must disclose your health information to you, as described in the Patient Rights section of this Notice. We may disclose your health information to a family member, friend or other person to the extent necessary to contact you, help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.

We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. We may also tell your family or friends your condition. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up your hearing aids, a loaner hearing aid, supplies such as batteries, etc.

Marketing Health-Relation Services: Our audiology office does not use patient information for any marketing purposes. We do send invitations to educational seminars to the general public by zip codes.

Health-Related Benefits and Services: We may use and disclose medical information to tell you about health related benefits or services that my be of interest to you, or to review treatment options. In this connection, we may contact you via telephone or letter, unless you specify in writing alternative means of contacting you which we are capable of providing.

Required by Law: We may use or disclose your health information when it is required by federal, state, or local law to do so, in response to a court order or administrative order, a subpoena, discovery request, or other lawful process, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose you health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to lawfully authorized federal officials health information required by lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institutions or law enforcement officials having lawful custody of protected health information of inmate or patient under certain circumstances.

Appointment Reminders: We may use or disclose your health information to provide you with appointment reminders (such as phone calls, or letters).

Right to Inspect and Copy

You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.

To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing. If you request a copy of the information we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed.

Disclosure Accounting: You have the right to receive a list of instances in which we or our business associates disclosed your health information for any purpose, other than treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.

Restriction: You have the right to request in writing that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency.)

Alternative Communication: You have the right to request that we communicate with you about your health information by alternative means or to alternative locations, such as at work or by mail. (You must make your request in writing). Your request must specify the alternative means or locations, and provide satisfactory explanation how payments will be handled under the alternative means or location you request.

Right to Amend: You have the right to request that we amend your health information (Your request must be in writing. It must explain why the information should be amended). We may deny your request under certain circumstances when: the information was not created by us, is not part of the medical information kept by or for the practice, is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.

Questions and Complaints

If you desire further information about our privacy practices or if you have questions, please contact us. If you are concerned that we may have violated your privacy right, or you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.

We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.