HIPAA Notice of Privacy Practices
Our commitment to your privacy
Manifest Prosthetics, Orthotics & Bionics is required by federal law (the Health Insurance Portability and Accountability Act, or HIPAA) to maintain the privacy of your protected health information (PHI), to provide you with this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
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.
What is protected health information (PHI)?
PHI is information about you, including demographic information and information about your health care or payment for health care, that may identify you and that relates to your past, present, or future physical or mental health condition.
How we may use and disclose your PHI
The following describes the ways we may use and disclose your PHI without your written authorization. Not every use or disclosure within a category is listed, but every use and disclosure we make will fall into one of these categories.
For treatment
We may use and disclose your PHI to provide, coordinate, or manage your healthcare. For example, your prosthetic clinician may share information with your physical therapist to coordinate your gait training.
For payment
We may use and disclose your PHI to obtain payment for the services we provide. For example, we may submit claims and supporting documentation to your insurance carrier.
For healthcare operations
We may use and disclose your PHI to operate our practice, including quality assessment, training, and case management.
Other permitted uses and disclosures
- To business associates who perform services on our behalf under written confidentiality agreements;
- Required by law, such as in response to a court order or subpoena;
- Public health activities, such as reporting required by the FDA for medical-device adverse events;
- Health oversight, such as audits, investigations, or inspections by government agencies;
- Workers' compensation, as authorized by state workers' compensation laws;
- To avert a serious threat to health or safety.
Uses and disclosures that require your written authorization
We will obtain your written authorization before using or disclosing your PHI for marketing purposes (other than communications about your treatment), selling your PHI, or disclosing psychotherapy notes (if any).
Your rights regarding your PHI
Right to inspect and copy
You have the right to inspect and obtain a copy of your PHI maintained in our records. Requests must be made in writing. We may charge a reasonable, cost-based fee for copies.
Right to request amendment
If you believe PHI we have about you is incorrect or incomplete, you may request an amendment. Requests must be in writing and include a reason supporting the request. We may deny requests under certain circumstances.
Right to an accounting of disclosures
You have the right to request a list of certain disclosures we have made of your PHI for purposes other than treatment, payment, or healthcare operations.
Right to request restrictions
You have the right to request restrictions on certain uses and disclosures. We are not required to agree to your request, except in the case of a disclosure to a health plan for payment when you have paid in full out of pocket.
Right to request confidential communications
You may request that we communicate with you about medical matters in a specific way or at a specific location (for example, by mail to a specific address). We will accommodate reasonable requests.
Right to a paper copy of this notice
You have the right to a paper copy of this notice on request, even if you have agreed to receive it electronically.
Right to be notified of a breach
You have the right to be notified if there is a breach of your unsecured PHI.
Our duties
We are required by law to maintain the privacy of your PHI, provide this notice, and notify you in the event of a breach of unsecured PHI. We are required to abide by the terms of this notice currently in effect.
We reserve the right to change the terms of this notice. Any new notice will apply to all PHI we maintain. We will post the current notice on our Site and at our clinic.
How to file a complaint
If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer at the information below, or with the U.S. Department of Health and Human Services Office for Civil Rights:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
Privacy Officer
If you have questions about this notice or want to file a complaint with us:
Manifest Prosthetics, Orthotics & Bionics
Attn: Privacy Officer
Tampa, FL
(813) 801-9110
privacy@manifestpo.com
Contact us with questions
Manifest Prosthetics, Orthotics & Bionics
Tampa, FL
(813) 801-9110
info@manifestpo.com