Privacy & Policies
HIPAA
RETURN & EXCHANGE POLICY
PATIENT RIGHTS AND RESPONSIBILITIES
HIPAA LAW FOR DME: ATLANTIC MEDICAL SUPPLY
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DIS-CLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IN CAREFULLY.
In accordance with the requirements of the health Insurance Portability and Accountability Act of 1996 (“HIPAA”), Atlantic Medical Supply is required to inform you of its practices in relation to the protected health information that it maintains about you. HIPAA mandates minimum standards that a covered entity such as Atlantic Medical Supply must maintain in relation to your protected health information. This Notice of Uses is being provided to help you understand how Atlantic Medical Supply meets these minimum standards. It is also meant to inform you of the ways that Atlantic Medical Supply may use the personal information it collects about you and how it may disclose it.
UNDERSTANDING YOUR PROTECTED HEALTH INFORMATION
When you receive care from a healthcare provider, a record of that treatment is made. This record will typically contain information on your diagnosis, treatment, and future plan of treatment and is often collectively referred to as your medical record. This medical record includes protected health information and lays the foundation for determining your plan of care and treatment and allows for a successful means of communication between all healthcare professionals that contribute to your care.
HIPAA protects information found in your medical record from disclosure without your authorization.
The information protected by HIPAA includes:
1. Any information related to your past, present or future physical or mental health
2. The past, present or future payment for health services you have received
3. The specific care that you have received, are receiving or will receive
4. Any information that identifies you as the individual receiving the care
5. Any information that someone could reasonably use to identify you as receiving the care
This information is referred to as protected health information throughout this notice.
TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS
As a Covered Entity, Atlantic Medical Supply is required to inform you of how it may use your protected health information. In providing treatment to you, Atlantic Medical Supply will use your protected health information for the purposes of treatment, payment and healthcare operations.
Treatment - As it pertains to Atlantic Medical Supply, treatment means providing to your drugs, medications, supplies, and durable medical equipment services as ordered by your physician. Treatment also includes coordination and consultation with your physician and other health care providers. As Atlantic Medical Supply provides these services to you, information obtained during
Payment - Payment purposes consist of activities required to obtain reimbursement from your insurance carrier for the services ordered by your physician and provided to you by Atlantic Medical Supply This includes, but is not limited to, eligibility determination, pre-certification, billing and collection activities, obtaining documentation required by your insurer, and when applicable, disclosure of limited information to consumer reporting agencies.
Healthcare operations - Operations can include, but are not limited to, review of your protected health information by members of Atlantic Medical Supply professional healthcare staff to ensure compliance with all federal and state regulations. This information will then be utilized to continually improve the quality and effectiveness of the services provided to you by Atlantic Medical Supply.
Healthcare operations also include Atlantic Medical Supply business management and general administrative activities.
OTHER USES AND DISCLOSURES
In order to release information contained in your medical record for purposes other than treatment, payment or healthcare operations, GENAO'S MEDICAL SUPPLY must obtain a specific signed authorization form from you. You may revoke such authorization at any time, except to the extent GENAO'S MEDICAL SUPPLY has taken action in reliance on the authorization.
There are a limited number of other uses and disclosures of protected health information that do not require a specific authorization from you. GENAO'S MEDICAL SUPPLY may in the following circumstances disclose your protected health information.
1. GENAO'S MEDICAL SUPPLY may disclose limited health information about you to notify local agencies (i.e. power, gas, phone, and emergency medical services), in the event of an emergency (i.e. flood, hurricanes, etc.), of your need for life sustaining equipment or assistance in evacuation due to your medical condition.
2. GENAO'S MEDICAL SUPPLY may disclose to a member of your family, other relative,
or a close personal friend, or any other person identified by you, the protected health information directly relevant to such person's involvement with your care or payment related to health care.
3. GENAO'S MEDICAL SUPPLY may disclose protected health information to others as required by law.
4. GENAO'S MEDICAL SUPPLY may disclose protected health information for certain public health activities and purposes.
5. GENAO'S MEDICAL SUPPLY may disclose protected health information to a legally authorized government authority, such as a social service or protective services agency, if we reasonably believe you are a victim of abuse, neglect or domestic violence.
6. GENAO'S MEDICAL SUPPLY may disclose protected health information for law enforcement purposes and in response to court orders or subpoenas.
7. GENAO'S MEDICAL SUPPLY may disclose protected health information to agencies authorized by law to conduct health oversight activities, including audits, investigations, licensing and similar activities.
8. GENAO'S MEDICAL SUPPLY may disclose protected health information to attorneys, accountants, and others acting on behalf of GENAO'S MEDICAL SUPPLY, provided they have signed written contracts agreeing to safeguard the confidentiality of the information.
9. GENAO'S MEDICAL SUPPLY may leave messages for you on your answering machine or at an alternative phone number or contact that you have given us for that purpose.
10. GENAO'S MEDICAL SUPPLY may mail marketing information, as requested by you, while you are a customer of GENAO'S MEDICAL SUPPLY.
MEDICARE AND MEDICAID SUPPLIER STANDARDS
Atlantic Medical Supplies must adhere to the Medicare and Medicaid Supplier Standards to obtain and maintain billing privileges. These standards, outlined in 42 C.F.R. pt. 424, sec. 424.57(c), ensure that suppliers operate with integrity and provide quality service to beneficiaries. Compliance is mandatory for all suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).
Regulatory Compliance: Atlantic Medical Supplies must operate in accordance with all applicable federal and state regulations, ensuring that all Medicare-covered items meet licensure requirements.
Accurate Representation: The supplier must not submit false statements or misrepresentations on billing applications. Complete and accurate information must be provided, with any changes reported to the Centers for Medicare & Medicaid Services (CMS) within 30 days.
Authorized Signatures: Billing applications must be signed by an individual authorized to bind the supplier legally.
Inventory Management: The supplier must fill orders from its own inventory or through compliant contracts with other companies, ensuring no contracts are made with excluded entities.
Beneficiary Education: Atlantic Medical Supplies must inform beneficiaries about rental and purchase options for durable medical equipment, including documentation of this communication.
Warranty Compliance: The supplier must honor all warranties under state law and cannot charge beneficiaries for repairs or replacements covered under warranty.
Physical Location: A physical facility must be maintained for business operations, including the storage of records. Post office boxes are not acceptable as primary business locations.
Accessibility for Inspections: The facility must be accessible for CMS inspections during reasonable business hours, with appropriate signage indicating hours of operation.
Communication Accessibility: A primary business telephone must be listed under the supplier's name, ensuring beneficiaries can easily contact the supplier.
Liability Insurance: A comprehensive liability insurance policy of at least $300,000 must be maintained, covering the supplier's business and product liability.
Beneficiary Contact Restrictions: Suppliers must not contact beneficiaries by phone regarding Medicare-covered items without prior written consent or if they have previously furnished a covered item.
Delivery Accountability: Atlantic Medical Supplies is responsible for the delivery of items and must maintain proof of delivery, providing necessary usage instructions to beneficiaries.
Complaint Management: The supplier must address beneficiary questions and complaints, maintaining documentation of all interactions.
Maintenance of Rented Items: Any rented items must be maintained in working order, with repairs or replacements provided at no charge to beneficiaries.
Returns Policy: The supplier must accept returns of substandard or unsuitable items.
Disclosure of Standards: Supplier standards must be disclosed to all beneficiaries receiving Medicare-covered items.
Compliance with Disclosure Regulations: The supplier must adhere to all relevant disclosure provisions.
Supplier Number Integrity: Supplier numbers must not be conveyed or reassigned.
Complaint Resolution Protocol: A formal protocol must be in place to address beneficiary complaints, with records maintained for all communications.
Documentation of Complaints: Detailed records of all beneficiary complaints, including actions taken, must be kept on file.
Information Provision: Atlantic Medical Supplies must provide any information required by Medicare upon request.
Accreditation Requirement: All DMEPOS suppliers must be accredited by a CMS-approved organization to retain their billing number, indicating compliance with specific product standards.
Notification of New Locations: Any new DMEPOS locations must be reported to the accreditation organization, which may provide temporary accreditation.
Quality Standards Compliance: All locations must meet DMEPOS quality standards and be accredited to bill Medicare.
Disclosure of Products and Services: Suppliers must disclose all products and services upon enrollment and notify the accrediting body of any new product lines to ensure proper accreditation.
By adhering to these standards, Atlantic Medical Supplies ensures compliance with Medicare and Medicaid regulations, ultimately enhancing the quality of care provided to beneficiaries.
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