We are committed to protecting your health information. This Notice of Privacy Practices ("Notice") is provided pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") as revised in the 2013 HIPAA Omnibus Rule . This Notice describes how we may use and disclose your protected health information to carry out treatment, payment or audiological/health care operations and for other purposes that are permitted or required by law. This Notice also describes your rights and our duties with respect to your protected health information.
SEE BELOW FOR ENTIRE STATEMENT
SEE BELOW FOR ENTIRE STATEMENT
Notice of Privacy Practices
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.
ABOUT THIS NOTICE
North Jersey Hearing Aid Center, LLC. is committed to protecting your health information. This Notice of Privacy Practices ("Notice") is provided pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") as revised in the 2013 HIPAA Omnibus Rule . This Notice describes how we may use and disclose your protected health information to carry out treatment, payment or audiological/health care operations and for other purposes that are permitted or required by law. This Notice also describes your rights and our duties with respect to your protected health information.
"Protected health information" is information about you that may identify you and that relates to your past, present or future physical or mental health/condition and related audiological/health care services. We must follow the privacy practices that are described in this Notice while it is in effect. If you have any questions about this Notice, please contact our Privacy Officer, Justin Haworth, at (201)787-4368 or [email protected]
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
The following categories describe the different ways that we may use and disclose your protected health information. These examples are not meant to be exhaustive, but to illustrate the types of uses and disclosures that may be made.
We may use and disclose your protected health information to provide, coordinate, or manage your audiological treatment and any related services. We may also disclose your protected health information to other third party providers involved in your audiological/health care. For example, your protected health information may be provided to a physician or other audiological/health care provider (e.g. a specialist or laboratory) to whom you have been referred to ensure that the physician or other audiological/health care provider has the necessary information to diagnose or treat you.
We may use and disclose your protected health information so that the treatment and health care services you receive may be billed to you, your insurance company, a government program, or third party payors. This may include certain activities that your health insurance plan may undertake before it approves or pays for the audiological/health care services we recommend for you, such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For example, we may provide your health plan with medical information about the audiological/health care services North Jersey Hearing Aid Center, LLC. rendered to you for reimbursement purposes.
3. Audiological/Health Care Operations
We may use and disclose your protected health information for audiological/health care operation purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and for our operation and management purposes. For example, we may use your protected health information to review the quality of the treatment and services you receive and to evaluate the performance of our team members in caring for you. We also may disclose information to audiologists, physicians, nurses, technicians, medical students, and other personnel for educational and learning purposes.
4. Treatment Communications
We may provide treatment communications concerning treatment alternatives or other health related products or services. For communications for which we or a business associate may receive financial remuneration in exchange for making the communication, we must obtain written authorization unless the communication is made face-to-face and/or involving promotional gifts of nominal value. If you do not wish to receive these communications please submit a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States.
5. Fundraising Activities
We may use or disclose your demographic information and dates of services provided to you, as necessary, in order to contact you for fundraising activities supported by North Jersey Hearing Aid Center, LLC.. You have the right to opt out of receiving fundraising communications. If you do not want to receive these materials, please submit a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States.
6. Others Involved in Your Healthcare
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person's involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. Also, for example, if you are brought into this office and are unable to communicate normally with your clinician for some reason, we may find it is in your best interest to give your hearing instrument and other supplies to the friend or relative who brought you in for treatment. We may also use and disclose protected health information to notify such persons of your location, general condition, or death. We also may coordinate with disaster relief agencies to make this type of notification. We also may use professional judgment and our experience with common practice to make reasonable decisions about your best interests in allowing a person to act on your behalf to pick up your hearing instruments, supplies, records, or other things that contain protected health information about you.
7. Required by Law
We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.
8. Public Health
We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.
9. Business Associates
We may disclose your protected health information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. To protect your health information, however, we require the business associate to appropriately safeguard your information.
10. Communicable Diseases
We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
11. Health Oversight
We may disclose your protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies
seeking this information include government agencies that oversee the audiological/health care system, government benefit programs, other government regulatory programs and civil rights laws.
12. Abuse or Neglect
We may disclose your protected health information to a public health authority that is authorized by law to receive reports of abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
13. Food and Drug Administration
We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products to enable product recalls, to make repairs or replacements, or to conduct post marketing surveillance, as required by law.
14. Legal Proceedings
We may disclose your protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), and in certain conditions in response to a subpoena, discovery request or other lawful process.
15. Law Enforcement
We may disclose your protected health information, so long as applicable legal requirements are met, for law enforcement purposes.
16. Coroners, Funeral Directors, and Organ Donation
We may disclose your protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose your protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out its
duties. We may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.
We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
18. Serious Threat to Health or Safety
Consistent with applicable federal and state laws, we may disclose your protected health information to prevent or lessen a serious threat to your health and safety or to the health and safety of another person or the public.
19. Military Activity and National Security
If you are involved with military, national security or intelligence activities or if you are in law enforcement custody, we may disclose your protected health information to authorized officials so they may carry out their legal duties under the law.
20. Workers' Compensation
We may disclose your protected health information as authorized for workers' compensation or other similar programs that provide benefits for a work-related illness.
21. For Data Breach Notification Purposes
We may use or disclose your protected health information to provide legally required notices of unauthorized access to or disclosure of your health information.
22. Required Uses and Disclosures
Under the law, we must make disclosures to you and when required by the Secretary of the
U.S. Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. Seq.
SPECIAL PROTECTIONS FOR HIV, ALCOHOL AND SUBSTANCE ABUSE, MENTAL HEALTH AND GENETIC INFORMATION
Certain federal and state laws may require special privacy protections that restrict the use and disclosure of certain health information, including HIV-related information, alcohol and substance abuse information, mental health information, and genetic information. Some parts of this Notice may not apply to these types of information.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION BASED UPON YOUR WRITTEN AUTHORIZATION
The following uses and disclosures will be made only with your written authorization:
1. Uses and disclosures of protected health information for marketing purposes for which we or a business associate may receive remuneration; and
2. Disclosures that constitute a sale of protected health information.
Other uses and disclosures of your protected health information not described in this Notice will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke this authorization, at any time, in writing, except to the extent that North Jersey Hearing Aid Center, LLC. has taken an action in reliance on the use or disclosure indicated in the authorization. Additionally, if a use or disclosure of protected health information described above in this Notice is prohibited or materially limited by other laws that apply to use, it is our intent to meet the requirements of the more stringent law.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
The following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.
1. Right to be Notified if there is a Breach of Your Protected Health information
You have the right to be notified upon a breach of any of your unsecured protected health information.
2. Right to Inspect and Copy
You may inspect and obtain a copy of your protected health information that is contained in your medical and billing records and any other records that North Jersey Hearing Aid Center, LLC. uses for making decisions about you. To inspect and copy your medical information, you must submit a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States. If you request a copy of your information, we may charge you a reasonable fee for the costs of copying, mailing or other costs incurred by us in complying with you request. Under federal law, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, we may deny your request to inspect and/or copy your protected health information. A decision to deny access may be reviewable. Please contact our Privacy Officer, Justin Haworth, at (201)787-4368 or [email protected] if you have questions about access to your medical record.
3. Right to Request Restrictions
You may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice. To request a restriction on who may have access to your protected health information, you must submit a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States. Your request must state the specific restriction requested and to whom you want the restriction to apply. North Jersey Hearing Aid Center, LLC. is not required to agree to a restriction that you may request, unless you are asking us to restrict the use and disclosure of your protected health information to a health plan for payment or audiological/health care operation purposes and such information you wish to restrict pertains solely to a audiological/health care item or service for which you have paid us "out-of-pocket" in full. If we believe it is in your best interest to permit the use and disclosure of your protected health information, your protected health information will not be restricted. If we do agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment.
4. Right to Request Confidential Communication
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. You must request this by submitting a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States.
5. Right to Request Amendment
You may request an amendment of your protected health information contained in your medical and billing records and any other records that North Jersey Hearing Aid Center, LLC. uses for making decisions about you, for as long as we maintain the protected health information. You must request for an amendment by submitting a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States, and provide the reason(s) that support your request. In certain cases, we may deny your request for an amendment. If we deny your request for an amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
6. Right to an Accounting of Disclosures
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice. It excludes disclosures we may have made to you, for a resident directory, to family members or friends involved in your care, or for notification purposes. The right to receive this information is subject to certain exceptions, restrictions and limitations. Additionally, limitations are different for electronic health records. You must request for an accounting of disclosures by submitting a written request to our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States, and provide the reason(s) that support your request.
7. Right to Obtain a Paper Copy of this Notice
You have the right to receive a paper copy of this Notice even if you have agreed to receive this notice electronically. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this Notice, you can contact our Privacy Officer, Justin Haworth, at (201)787-4368 or [email protected] You may also obtain a copy of this Notice at http://www.northjerseyhearing.com.
COMPLAINTS OR QUESTIONS
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. If you have a question about this Notice or wish to file a complaint with us, please contact our Privacy Officer, Justin Haworth, at (201)787-4368 or [email protected] or the Corporate Privacy Officer at the address listed below. All complaints must be submitted in writing. North Jersey Hearing Aid Center, LLC. will not retaliate against you for filing a complaint.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice at any time. The new Notice will be effective for all health information we already have about you as well as any information we receive in the future. You can also obtain a revised Notice at http://www.northjerseyhearing.com or by contacting our Privacy Officer, Justin Haworth, North Jersey Hearing Aid Center, LLC., 195 Fairfield Ave. Suite 4B West Caldwell, New Jersey 07006 United States.
North Jersey Hearing Aid Center, LLC.
Attn: Corporate Privacy Officer
This Notice is effective as of April, 2013.
Information posted to the Site may not be protected by any federal or state confidentiality, privacy, or security laws, including the administrative simplification provision of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (HIPAA). This Site is not intended to be, and must not be taken to be, the practice of medicine or the practice of other health care services by Our Company. Use of the Site and the Services does not create a physician/patient, provider/patient, confidential, or privileged relationship, or any other relationship that would give rise to any duties on the part of Our Company.
What Information Does Our Company Gather and how is it Gathered?
Generally: When you visit our web site, we automatically collect non-personally identifiable information such as IP addresses and web site usage information from you. To become a Our Company member, you will either be asked to provide a basic profile about yourself by filling out an online registration form with personal information such as your name, mailing address, email address, phone number, and related information, and in some cases payment information (including credit and/or debit card number and expiration date). A record of the fact that you are a member also is maintained.
Cookies: We use a standard Internet technology called “cookies” to store and track visitor information. A cookie is a small text file that is automatically stored on your computer for future retrieval. Cookies allow us to, among other things, count the number of unique visitors to the site to measure traffic patterns on our site, personalize a user experience to our site and facilitate the login for registered members. We also use web beacons (invisible images often referred to as pixel tags or clear GIFs) on our sites in order to recognize users and assess traffic patterns, and we include web beacons and cookies in our e-mail messages, including newsletters, in order to count how many e-mail messages have been opened.
Other Site Features: Certain other features such as “send this link to a friend,” or any feature of substantially the same functions, may also require us to collect personally identifiable information, such as the name and e-mail address of both the sender and the recipient.
Third Party Ad Servers: Some of the advertisements and other services that appear on our web site are delivered to you by Internet advertising companies. These companies utilize certain technologies including cookies to deliver advertisements and marketing messages and to collect anonymous information about your visit to our sites and other web sites. If you would like more information about this practice or to opt out of having this information used by companies that are part of the Network Advertising Initiative to provide targeted ads, please visit
Our Company allows third parties to place cookies on our site for advertising purposes. This Online Privacy Statement does not cover the collection methods or use of the information collected by these vendors. These vendors have their own privacy policies and may be members of the Network Advertising Initiative (“NAI”). To remove yourself from some or all NAI member advertising programs, please visit the NAI Opt-Out Page and follow the relevant instructions. Please note that if you delete, block, or otherwise restrict cookies, or if you use a different computer or Internet browser, you may need to renew your opt-out choice.
How Do We Use and Disclose Your Information?
Traffic Analysis: To ensure what we offer matches your needs, we may provide third parties with aggregate statistics about our customers, traffic patterns, and related site information. This data reflects site usage patterns gathered during thousands of Member visits to our Web site each month but does not contain behavioral, personal, or identifying information about any individual member, unless that member has given us permission to share that information.
Occasionally, we may also use the information we collect to notify you about important changes to our Web site, new services, and special offers we think you will find valuable.
Third Parties: We may share your information with other companies whose products and services may be of interest to you. These third parties may contact you as part of their marketing efforts. We evaluate such companies to identify products and services that serve the needs of our Members as well. We cannot and do not, however, make any representations about the practices and policies of these companies.
Service Providers: We may use other companies to perform services including, without limitation, facilitating some aspects of our web sites, sending e-mail, fulfilling purchase requests, and serving, customizing or delivering marketing or ads. These other companies may be supplied with or have access to your information solely for the purpose of providing these services to us or on our behalf. They do not have any independent right to use or disclose your information.
Affiliates. We may share your information with our other businesses and affiliated companies. We may combine the information that we collect from you with information that you provide to us in connection with your use of our other products, services and web sites, or information we collect from third parties.
Ads. Information about your activities on our site and other non-personally identifiable information about you may be used to limit the online ads you encounter to those we believe are consistent with your interests.
Legal Process. We may share personal information about you to respond to subpoenas, court orders, or other legal process, or to exercise our legal rights or defend against legal claims.
How Do You Opt In or Opt Out of Contact With Us?
Our Company gives you the option to remove all your information, at any time, from our database. If you don’t want to receive any form of direct contact from us, whether it is e-mail, information on discounts or promotional offers, or you want us to remove all your information, please send a letter or e-mail to the address found on the Contact Us page.
Violation of Law, Rule, or Regulation
The conditions enumerated above will not apply in the event that you engage in certain improper conduct. Specifically, Our Company shall have the right to use or release to third parties personally identifiable information regarding users who use this or any other site on the World Wide Web for any fraudulent purpose, or who otherwise violate any law, rule, or regulation, or who engage in conduct which The Our Company deems improper.
How Do We Protect Children Who Visit Our Site?
We will not knowingly collect personally identifiable information from children (e.g., under the age of 13). Where appropriate, we will take reasonable measures to inform children NOT to submit such information to our site or in response to advertisements on our site. If we become aware that we have inadvertently received personal information from a visitor under the age of thirteen on the Site, we will delete the information from our records. ?If a child has managed to provide us with such information; the child’s parent or legal guardian should send a letter or e-mail to the address found on the Contact Us page.
How Do We Ensure Security for Online Purchases and Transmission of Information?
We use commercially reasonable administrative, technical, personnel and physical measures to safeguard your personal information in our possession against loss, theft and unauthorized use, disclosure or modification.
We utilize encryption/security software to safeguard the confidentiality of personal information we collect. This software provides a limited degree of protection against unauthorized access or disclosure, as well as accidental loss, alteration, or destruction.
No data transmission over the Internet, unfortunately, can be guaranteed to be 100% secure. As a result, while Our Company strives to protect your personal information, we cannot ensure or warrant the security of any information you transmit to us or from our online products or services, and you do so at your own risk. Our policy does not extend to anything that is inherent in the operation of the Internet, and therefore beyond our control, and is not to be applied in any manner contrary to applicable law or governmental regulation.
Like most websites, communications to, from and through the Our Company Web site are not confidential, and your communications may be read or intercepted by others. However, we are not responsible for any breach of security or for the actions of these parties.
We want you to be aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it or any portions thereof. By using Our Company you consent to the collection and use of information by Our Company in the manner described and explained above.
Please note that if Our Company and any lines of its business are sold or disposed of as a going concern, whether by merger, sale of assets or otherwise, the relevant customer database of healthcarealliance.org could, in whole or in part, be sold or otherwise transferred to a third party as part of that transaction. There may be instances when we may disclose your information without providing you with a choice in order to protect our legal rights or those of our affiliates, or those of our or our affiliates’ employees, agents and contractors; to protect the safety and security of visitors to our web sites; to protect against fraud or for risk management purposes; or to comply with the law or legal process.
How to Contact us regarding your Privacy Concerns
Transfer of Information
Your information may be stored and processed in the United States or any other country where we have facilities, and by providing us with your information; you consent to the transfer of information outside of your country.