MEDICAL CARE PRODUCTS, INC.
Notice of Health Information Practices
Effective Date 01/01/2003
This notice describes how medical information about you may be used and disclosed
and how you can get access to this information. Please review it carefully.
Medical Care Products (MCP) believes that the information we gather about you
is of a very private nature and we are dedicated to keeping this information confidential. The records we create in providing
you with care are by law kept confidential. We are also required to inform you of our policies concerning the use and storage
of your personal health information.
Medical Care Products maintains the right to update our Privacy Notice. Your
personal health information will always be maintained by our current policies designated in our current Privacy Notice. A
current copy of our Privacy Notice is prominently displayed in our showroom and on our website (www.ostomymcp.com). If you
have any comments or questions about our Privacy Notice you may call our privacy official at (904) 396-7827.
The following describes the manner in which we will use and disclose your personal health information:
We may collect and share appropriate information about you to document the medical necessity of the equipment, supplies
or services we are providing. Examples include diagnosis, prescription, referral and physician or health care provider information.
We may share appropriate information about you to bill and collect payment for the health care we provide, including
insurance companies and third parties, which includes family members or other financially responsible parties you have informed
us of. Examples include insurance coverage and eligibility verification.
We may use and disclose information to monitor and operate or business. Examples include satisfaction surveys, health
care outcomes and utilization reporting, reports provided to any federal, state or local authority (as required by law), or
to remind you of equipment, supplies or service needs.
We may release appropriate information about you to family or friends that are helping you with the financial responsibilities
incurred while receiving equipment, supplies or services from us.
We may use and disclose information about you to respond to a court or legal authoritative body that legally requests
information about you. Examples include providing documents for legal subpoenas or discovery proceedings and our staff testifying
about the care we have provided.
The following describes your rights to the information we maintain about
You have the right to direct the use of your personal health information.
You have the right to terminate or revise your authorizations or consents that pertain to our use of your personal
health information, and have those terminations or revisions affect any new equipment, supply, or service provisions. We are
not required to accept your terms. If we do accept your restrictions, we will honor your specifications, except where prohibited
by law. All requests must be in written form.
You have the right to request a copy of your personal health information as long as any federal, state or local law
does not prohibit it. This request must in writing. There is a charge for copying, producing and delivering your information.
You have the right to request, in writing, a revision to your personal health information. Revision requests will be
evaluated on an individual basis and amended, if appropriate. At no time will a revision be made that may erroneously record
the personal health information stored by us. Your written request must detail the requested revision and the reasons for
the modification. If no explanation is provided, no revision will be made. If we deny your request for amendment, you have
the right to file a statement of disagreement.
You have the right to request an accounting of non-routine disclosures we have made with your personal health
information. You can receive one free accounting in a twelve-month period. We will charge for any accounting services that
exceed one per twelve months. You must agree to this charge before we will provide any accounting of services. These requests
cover dates of service on or after April 14th, 2003.
You have the right to file a complaint about our use of your personal health information with us or the Secretary of
the Department of Health and Human Services.