“NOTICE OF PRIVACY PRACTICES”
If you have any questions about this notice, please contact (Mark Haddad privacy
official contact) of our office at (714-229-9178), or our web site at (www.suncoasthearingaids.com).Written request to Suncoast Hearing Aids & Repair Services,
P.O. Box 6539,
Buena Park, Ca 90622.
This notice describes the information privacy practices followed by our employees,
staff and other office personnel. The practices described in this notice will
also be followed by hearing health care providers you consult with by telephone
(when your regular health care provider is not available) who provide “call
coverage” for your hearing health care provider.
YOUR HEALTH INFORMATION
This notice applies to the information and records we have about your hearing
health care information, and hearing aid services you receive at this office.
We are required by law to give you this notice. It will tell you about the ways
in which we may use and disclose hearing health care information about you and
describes your rights and our obligations regarding the use and disclosure of
that information.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
For Treatment: We may use your hearing health information about you to provide
you with hearing aid related services. We may disclose hearing health information
about you to doctors, nurses, technicians, office staff or other personnel who
are involved in taking care of you and your hearing health care.
For Payment: We may use and disclose health information about you so that
the treatment and services you receive from this office may be billed to and
payment may be collected from you, an insurance company or third party.
For Hearing Health Care Operations: We may use and disclose hearing health
information about you in order to run the office and make sure that you and
our other clients receive quality care.
Appointment Reminders: We may contact you as a reminder that you have an appointment
for hearing aid related services in our office.
Treatment Alternatives: We may tell you about or recommend possible hearing
aid solutions.
Health- Related Products and Services: i.e. Hearing Aids, Batteries, and other
Hearing aid related products.
SPECIAL SITUATIONS
We may use or disclose hearing health care information about you without your
permission for the following purposes, subject to all applicable legal requirements
and limitations :
To avert a serious threat to health or safety.
Required by law.
Research
Military, Veterans, National Security and Intelligence.
Workers Compensation.
Public Health Risks.
Health Oversight Activities.
Lawsuits and Disputes
Law Enforcement
Family and Friends: We may disclose hearing health care information about you
to your family or friends if we obtain a verbal agreement to do so or if we
give you an opportunity to object to such a disclosure and you do not raise
an objection.
OTHER USES AND DISCLOSER OF HEALTH INFORMATION
We will not use or disclose your health information for any purpose other than
those identified in the previous sections without your specific, written Authorization.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
Right to inspect and Copy: You have the right to inspect and copy your hearing
health information, such as hearing health care and billing records, that we
you to make decisions about your care. You must submit a written request to
( Mark Haddad designated privacy official contact) in order to inspect and
/ or copy you hearing health care information. We may charge you for copies.
Right to Amend: If you believe the hearing health care information we have
about you is incorrect or incomplete, you may ask us to amend the information.
You have the right to request an amendment as long as the information is kept
by this office.
If there is no valid reason we may deny or refuse your request for changes.
All requests must be issued in writing to our privacy officer Mark Haddad.
RIGHT TO AN ACCOUNTING OF DISCLOSURE: This is a list of the disclosures we
made of hearing health care information about you for purposes other than treatment,
payment and health care operations. To obtain this list, you must submit your
request in writing to ( Mark Haddad designated privacy official contact).
Right to Request Restrictions: You have the right to request restriction or
limitation on the hearing health care information we use or disclose about
you for treatment, payment or hearing health care operations. To request restrictions,
you may complete and submit the Request For Restriction On use/Disclosure of
Hearing Health Care information to (Mark Haddad designated privacy official
contact).
Right to Request Confidential Communications: You have the right to request
that we communicate with you about hearing health care matters in a certain
way or at a certain location.
Right to a Paper Copy of This Notice: You may request one at the time that
services are rendered,
Or down load it from our web site (www.suncoasthearingaids.com)
WE ARE NOT REQUIRED TO AGREE TO YOU REQUEST
If we do not agree with your need for information, we will not comply with
you request unless the information is needed to provide you emergency treatment.
CHANGES TO THIS NOTICE.
We reserve the rights to change this notice. You are entitled to a copy of
the notice currently in effect.
COMPLAINTS
If you believe your privacy rights have been violated,
you may file a complaint with our office or with the
Secretary of the Department of Health Services. To file
a complaint with our office, contact (Mark Haddad (Hearing Aid Dispenser)
in writing at the address in the beginning of this notice. You will not be
penalized for filing a complaint.
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