NOTICE OF PRIVACY PRACTICES

This notice describes how hearing healthcare information about you may be used and disclosed, and how you can get access to this information.  Please review it carefully. The privacy of your health information is important to us.

 

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 rights concerning your health information.
We must follow the privacy practices that are described in this notice while it is in
effect. This notice is effective starting June 12, 2006 and will remain in effect until
we replace it. We reserve the right to change our privacy practices and the terms
of this notice at any time, provided such changes are permitted by applicable law.

We reserve the right to make the changes in our privacy practices and the new
terms of our notice effective for all health information that we maintain, including
health information we created or received before we made the changes. Before
we make a significant change in our privacy practices, we will change this notice
and make the updated version available upon request.

You may request a copy of our notice at any time. For more information about our
privacy practices, or for additional copies of this notice, please contact us using
the information listed at the end of this notice.

 


USE AND DISCLOSURE OF YOUR 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 treating you, including hearing aid manufacturers
and other providers of hearing healthcare devices, and/or related supplies.

Payment: We may use and disclose your health information to obtain payment
for services we provide you with.

Healthcare Operations: We may use and disclose your health information
in connection with our healthcare operations. Healthcare operations include
quality assessment and improvement activities, reviewing the competence or
qualifications of healthcare professionals, evaluating practitioner and provider
performance, conducting training programs, accreditation, certification, licensing
or credentialing activities.

Your Authorization: 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 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 disclosures permitted by your authorization while it was in
effect. Unless you give us a written authorization, we cannot use or disclose your
health information for any reason except those described in this notice.

To Your Family and Friends: 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
help with your healthcare or payment for your healthcare, but only if you agree
that we may do so.

Persons Involved In Care: We may use or disclose health information to notify,
or assist in the notification of (including identifying or locating) a family member,
your personal representative or another person responsible for your care, of your
location, your general condition, or death. If you are present, then prior to use or
disclosure of your health information, we will provide you with an opportunity to
object to such uses or disclosures. In the event of your incapacity or emergency
circumstances, we will disclose health information based on a determination
using our professional judgment disclosing only health information that is
directly relevant to the person’s involvement in your healthcare. We will also
use our professional judgment and experience with common practice to make
reasonable inferences of your best interest in allowing a person to pick up hearing
aids, batteries, impressions, audiograms, or similar forms of health information.

Marketing Health-Related Services: We will not use your health information
for marketing communications without your written authorization.

Required by Law: We may use or disclose your health information when we are
required to do so by law.

Fundraising: We may provide medical information to one of our affiliated
fundraising foundations to contact you for fundraising purposes. We will limit
our use and sharing to information that describes you in general (not personally),
including terms and dates of your health care. In any fundraising materials, we
will provide you with a description of how you may choose not to receive future
fundraising communications.

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,
domestic violence, or other crimes. We may disclose your health information to
the extent necessary to avoid a serious threat to your health or safety and/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
authorized federal officials health information required for 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 voicemail messages, postcards,
newsletters, or letters), as well as information about treatment alternatives.

Patient Rights Access: You have the right to view or receive copies of your health
information, with limited exceptions. You may request that we provide copies in
a format other than photocopies. We will use the format you requested unless we
cannot practicably do so. You must make a request in writing to obtain access to
your health information. You may obtain a form to request access by using the
contact information listed at the end of this notice. You may also request access by
sending us a letter to the address at the end of this notice. If you request copies,
we may charge you $14 for 1-10 pages and $0.50 per page for pages 11-40, and
$0.33 per page for every additional page. Actual postage costs will be added if
you would like the information mailed to you. If you request an alternative format,
we will charge a cost-based fee for providing your health information in that
format. If you prefer, we will prepare a summary or an explanation of your health
information for a fee. Contact us using the information listed at the end of this
notice for a full explanation of our fee structure.

Disclosure Accounting: You have the right to receive a list of instances in which
we or our business associates have disclosed your health information for purposes,
other than treatment, payment, healthcare operations and other activities, for the
last 6 years, but not before June 12, 2006. 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.

Restrictions: You have the right to request 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. You must make your request in writing. Your request
must specify the alternative means or location, and provide satisfactory
explanation about how payments will be handled under the alternative
means and/or location you request.

Amendment: You have the right to request that we amend your health
information. Your request must be in writing and explain why the information
should be amended. We may deny your request under certain circumstances.

Electronic notice: If you receive this notice on our website or by electronic mail
(e-mail), you are entitled to receive this notice in written form.

QUESTIONS AND COMPLAINTS

If you want more information about our privacy practices or have questions or
concerns, please contact us.
If you are concerned that we may have violated your privacy rights, 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 make us aware of your concern by using the
contact information listed at the end of this notice. You may also 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 the U.S. Department
of Health and Human Services.

Compliance Officer: Steve W. Barlow

Telephone: 1-888-906-7141

Address: 2501 Cottontail Lane, Suite 101
Somerset, NJ 08873


Last Updated: Jul 16, 2015