Privacy Policy

Healthcare Management Services-Midwest,LLC
DBA HMS-Midwest, LLC
Healthcare Practice and Accounting Management Consultants

Click here for a PDF version of the privacy policy

 

Privacy Notice for HMS-Midwest, LLC 

As a healthcare professional partner, we care about our clients’ privacy and strive to protect the confidentiality of your medical information in our company. New federal legislation requires healthcare professionals and its business partners to issue this official notice of privacy practices. You have the right to the confidentiality of your medical information, and this practice is required by law to maintain the privacy of that information.
 
This company is required to abide by the terms of the Notice of Privacy Practices currently in effect, and to provide notice of its legal duties and privacy practices with respect to protected health information (PHI). If you have any questions about this Notice, please contact our privacy officer directly.

How We May Use and Disclose Medical Information About You

The following categories describe different ways that we may use and disclose medical information without your specific consent or authorization. Examples are provided for each category of uses or disclosures. Not all possible uses or disclosures are listed.
 
For Treatment.
We may use medical information about you to provide you with medical treatment or services. Example: In treating you with a specific condition, we may need to know if you have allergies that could influence which medications we prescribe for the treatment process.
 
For Payment.
We may use and disclose medical information about you so that the treatment and services you receive from us may be billed and payment may be collected from you, an insurance company or a third party ( e.g. EAP ). Example: We may need to send your Protected Health Information (PHI), such as your name, address, office visit date, and codes identifying your diagnosis and treatment to your insurance company for payment.
 
For Health Care Operations.
We may use and disclose medical information about you for health care operations to assure that you receive quality care. Example: We may use medical information to review our treatment and services and evaluate the performance of our staff in caring for you.
 
Other Uses or Disclosures That Can Be Made Without Your Consent or Authorization
As required during an investigation by law enforcement agencies

As required during an investigation by law enforcement agencies

To avert a serious threat to public health or safety

As required by military command authorities for their medical records

To workers’ compensation or similar programs for processing claims
In response to a legal proceeding

To a coroner or medical examiner for identification of a body

If an inmate, to the correctional institution or law enforcement official

As required by the US Food and Drug Administration (FDA)

Other healthcare providers’ treatment activities

Other covered entities’ and providers’ payment activities

Other covered entities’ healthcare operations activities (to the extent permitted under HIPAA)

Uses and disclosures required by law

Uses and disclosures in domestic violence or neglect situations

Health oversight activities

Other public health activities

We may contact you to provide appointment reminders or information about treatment alternatives or other health related  benefits and services that may be of interest to you
 

Uses and Disclosures of Protected Health Information Requiring Your Written Authorization

Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you give us authorization to use or disclose medical information about you, you may revoke that authorization about you for the reasons covered by your written authorization. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain our records of the care we have provided you.
 

Disclosures and Changes To Your Medical Information Right to Request Restrictions.

You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations or to someone who is involved in your care or the payment of your care. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment. To request restrictions, you must submit your request in writing to the Privacy Officer at this practice. In your request, you must tell us what information you want to limit.
 
Right to an Accounting of Non-Standard Disclosures
You have the right to request a list of the disclosures we made of medical information about you. To request this list, you must submit your request to the Privacy Officer at this practice. Your request must state the time period for which you want to receive a list of disclosures that is no longer than six years, and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (example: on paper or electronically). The first list you request within a 12 month period will be free. For additional lists, we reserve the right to charge you for the cost of providing the list.
 
Right to Amend
If you feel that medical 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 for as long as the information is kept. To request an amendment, your request must be made in writing and submitted to the Privacy Officer at this practice. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request, if the information was not created by us, is not part of the medical information that is kept at this practice, is not part of the information which you would be permitted to inspect and copy, or which we deem to be accurate and complete. If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and will provide you with at copy of any such rebuttal. Statements of disagreement and any corresponding rebuttals will be kept on file and sent out with any future authorized requests for information pertaining to the appropriate portion of your record.
 
Your Access To Medical Information Right to Inspect and Copy
You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually this includes medical and billing records but does not include psychotherapy notes; information complied for use in a civil, criminal, or administrative action or proceeding, and protected health information to which access is prohibited by law. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Privacy Officer at this practice. If you request a copy of this information, we reserve the right to charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by this practice will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
 
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. To obtain a paper copy of the current Notice, please request one in writing from the Privacy Officer at this practice.
 
Right to Request Confidential Communications
You have the right to request how we should send communications to you about medical matters, and where you would like those communications sent. To request confidential communications, you must make your request to the Privacy Officer at this practice. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. We reserve the right to deny a request if it imposes an unreasonable burden on the practice.
 
Complaints
If you believe that your privacy rights have been violated, you may file a complaint with the Privacy Officer at this practice or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized or discriminated against for filing a complaint.

Concerns or Complaints

To file a complaint with HMS-Midwest, LLC, please contact:
 
Tracy L. Freeze
P O Box 2257
Chesterton, IN  46304
219-926-8320
 
State of Michigan 
Allegations Division of the Department
of Consumer and Industry Services.
517-373-9196
 
State of Indiana
Health Professions Bureau
317-232-2960
 
All other states
Please use the address given below for the
US Department of Health and Human Services
 
US Department of Health and Human Services
Office of Civil Rights
233 N. Michigan Street Suite 240
Chicago, Illinois 60601
312-886-2359 TDD 312-353-5693
email: www.hhs.gov/ocr