NOTICE OF PRIVACY PRACTICES (cont’d)
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inCourage
®
Airway Clearance Therapy | INSTRUCTION MANUAL
3.
Other Uses and Disclosures.
We may also contact you to tell you about treatment options or other health services
that may be of interest to you.
4.
Uses and Disclosures that Require Authorization.
For all other purposes, we may be required to obtain a specific authorization to use
or release your health data. If you provide an authorization to us, you may revoke it
at any time.
YOUR INDIVIDUAL RIGHTS
1.
Right to Access and Copy Your Health Data.
You may access, inspect and receive a copy of your health data contained in our
records. You need to make your request in writing. Write or call RespirTech and ask for
a “RespirTech Information Access Form.” We may charge a reasonable fee for copies.
There are limited situations in which we may deny your request for access. In these
situations, we will let you know why we cannot grant your request and how you may
ask for a review of our denial.
2.
Right to Request an Amendment of Your Health Data.
You may request that we amend your health data. You need to make your request
in writing and explain your reason for the amendment. Write or call RespirTech
and ask for a “RespirTech Information Amendment Request Form.” Under limited
circumstances, we may deny your request. If we do so, you may file a statement of
disagreement with us. You may also ask that any future disclosures of your health
data include your requested amendment and our denial of your request.
3.
Right to Request Restrictions on Uses and Disclosures of Your Health Data.
You may request that we restrict our use or disclosure of your health data for payment
or health care operations. You need to make your request in writing. We are not
required to agree to your request for a restriction. However, if we do agree, we
will comply with our agreement, unless there is an emergency or we are otherwise
required to use or disclose the data. If we decide to end our agreement to the
restrictions, we will tell you.
4.
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You may request that we communicate with you in a specific way or at a specific
location. For example, you may request that we contact you at an address other than
your home address. We will agree to your request if we determine that your request is
reasonable. You need to make your request in writing.
Summary of Contents for inCourage
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