HIPAA Privacy Notice

HEARTS ENTERAL, LLC

Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

At Hearts Enteral, LLC. Durable Medical Equipment (DME) services, we are dedicated to the rights and privacy of our clients and patients. We will always protect the confidentiality of health information of the people who rely on us for support. State and federal laws also protect the confidentiality of this sensitive information. As required by the Health Insurance Portability and Accountability Act (HIPAA) of 1996, this notice describes how health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.

Understanding Your Health Information We collect health information from you: through the coverage assistance form that you complete before you receive services from Hearts Enteral, LLC. A confidential health record is made to your personal record account; contact us by phone or email. This record usually contains information that identifies you, such as your name, date of birth, address, and phone numbers where you can be reached. It may also contain things like diagnoses, personal history, medication information, and treatment plans. Your health information is used to: plan for your coverage and reimbursement support services; for communication among your health care providers and insurance companies; as a legal document describing the care you received; as a way for Hearts Enteral, LLC to verify benefits and services with your health plan/insurance company; to help Hearts Enteral, LLC. review and improve health insurance coverage for affordable care of your health and management. Other uses and disclosures. Any uses or disclosures not specifically described in the Notice of Privacy Practices will not be made without your written authorization. We do not sell personal health information or use it for marketing or fundraising purposes.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Request confidential communications

•You can ask us to contact you in a

specific way (for example, home or office phone) or to send mail to a different address.

•We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

•You can ask us not to use or share certain health information.

•We will say “yes” unless a law requires us to share that information..

Get a list of those with whom we’ve shared information

•You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with,and why.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

•If someone has legally recognized authority, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

•We will make sure the person has this authority and can act for you before we take any action.

*File a complaint if you feel your rights are violated

•You can complain if you feel we have violated your rights by contacting our Privacy Officer.

•You can file a complaint with the U.S. Department of Health and Human

Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling

1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

•We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for

how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions, consistent with law and our policies.

In these cases, you have both the right and choice to tell us to:

•Share information with your family, close friends, or others involved in your care

•Share information in a disaster relief situation

If you are not able to tell us your

preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.