Uses & Disclosers of Health Information
We use and disclose health information about you for treatment, payment, and healthcare options. For example:
Treatment: We may use medical information about you to provide you with medical treatment or procedures, health care, counseling, products and services and in order to make future decisions about your treatment or care, we may need information about your past, present, or future physical or mental health condition. Some of your personal health information that we may need includes test results, diagnoses, assessments, and prescriptions and other similar information.
Payment: We may use and disclose your health information about you so that the treatment and services you receive from or through The Lift Man LLC may be billed to, a payment may be collected by a third party. To determine your eligibility for coverage, to review medical necessity, and/or to determine appropriateness of justifications of charges.
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 professions, 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 to 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.
Persons involved with care: We may use or disclose health information to notify, or assist in the notification of (including identifying or location) 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 judgement and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up medical supplies or other similar forms of health information.
Marketing health-related services: We will not use your health information for marketing communication without your written authorization.
Required by Law: We may use or disclose your health information as required to do so by law.
Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonable believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose your health Information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.
Appointment Reminders: We may use and disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, letters, or emails).
Questions & Complaints
If you want more information about our privacy practices or have questions or concerns, please contact us by mail at The Lift Man LLC 5940 Furnas Road Indianapolis, IN 46221.
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 and disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us 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 the right to 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.
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 takes effect February 1,2017 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 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 significant change in out privacy practices, we will change this Notice and make the new Notice 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.
THE ACCESSIBILITY & MOBILITY EXPERTS
This notice describes how health information about you may be collected, used and disclosed by The Lift Man LLC and how you can get access to this information. Please review it carefully. The privacy of you health information is important to The Lift Man LLC.
Access: You have the right to look at or get 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 request unless we cannot practically due 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.
Disclosure Accounting: You have the right to receive a list of instance in which we or business associates disclosed your health information for purposes, other than treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before February 1, 2017. 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.
Restriction: 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 alternatives 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 how payment will be handled under the alternative means or location you request.
Amendment: You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances.
Electronic Notice: If you receive this Notice on our Web site or by electronic mail (e-mail), you are entitled to receive this Notice in written form.
P: (317) 830-6562
F: (317) 830-6585
4023 Heiney Road, Suite C
Indianapolis, IN 46241