Red Ball Medical Supply, Inc
Effective April 14, 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.
Red Ball Medical 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.
Red Ball Medical maintains the right to update our Privacy Notice. Your personal health information will always be maintained according to the policies designated in our current Privacy Notice. A current copy of our Privacy Notice is prominently displayed at our office at 1020 North Market Street in Shreveport, LA. If you have any comments or questions about our Privacy Notice you may call us at 424-8393, or if long distance at 1-800-256-8393, and ask to speak with a Privacy Officer.
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 products and/or services that we provide. Examples of what we might collect and share 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 products and/or services that we provide, including insurance companies and third parties, which includes family members or other financially responsible parties of whom you have informed us. Examples include insurance coverage and eligibility verification.
We may use and disclose information to monitor and operate our 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 of how we might respond would include providing documents for legal subpoenas or discovery proceedings and allowing our staff to testify about the products and/or services we have provided.
The following describes your rights to the information we maintain about you:
You have the right to direct the use of your personal health information by Red Ball Medical.
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 be 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 your information will be 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 that we have made with your personal health information. You can receive one free accounting in a twelve-month period. We will charge for any additional accounting requested during that same twelve-month period. You must agree to this charge before we will provide this additional accounting of services. These requests cover dates of service on or after April 14, 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.