Notice of Privacy Practices
Zounds Hearing, Inc.
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
Zounds 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 Zounds keeps your information private and confidential. This notice explains the legal duties and practices relating to your protected health information. As part of Zounds legal duties this Notice of Privacy Practices must be given to you. Zounds is required to follow the terms of the Notice of Privacy Practices currently in effect.
Zounds 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 Zounds website at www.ZoundsHearing.com and will be available at all Zounds 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 health care provider, health plan, employer, or health care clearinghouse. Zounds acts as a health care provider, a medical product manufacturer, and is also an employer. This medical information is used by Zounds in many ways while performing normal business activities.
Your protected health information may be used or disclosed by Zounds for purposes of providing Zounds products, services, and payment. Your protected health information may be shared, with or without your consent, with another health care provider for purposes providing Zounds products, services and payment. Zounds 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 Zounds that you object, Zounds may provide your health information to individuals such as family and friends, who are involved in your hearing health. Zounds may do so if you tell Zounds to do so, or if you know Zounds is sharing this information and you do not stop Zounds from doing so. Your information may be used by certain Zounds personnel during audits and investigations to improve operations. Zounds 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 the department will require your written authorization. This authorization will have an expiration date that can be revoked by you in writing. These uses and disclosures may be for marketing and for research purposes. We may not sell your protected health information without your authorization.
Y0u have the right to request Zounds to restrict the use and disclosure of your protected health information to provide Zounds products, services, and payment. You may also limit disclosures to individuals. Zounds is not required to agree to any restriction.
You have the right to be assured that your information will be kept confidential. Zounds 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 Zounds.
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. Zounds may deny your request, in whole or part, if it finds the protected health information:
- Was not created by Zounds
- Is not protected health information
- Is by law not available for your inspection, or
- Is accurate and complete
If your correction is accepted, Zounds 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. Zounds 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 Zounds 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 Zounds 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 a 6-year period from 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 the person who gave you the notice.
If you believe your privacy rights have been violated, you may file a complaint with the Zounds HIPAA Privacy Officer 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 202-619-0257 or toll free at 877-696-6775. 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. Zounds 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 08/4/14