iPhone App Liability Waiver
ActivArmor is committed to maintaining the privacy of your health information. To fill your DME request, physicians, nurses, and other personnel may collect information about your health history and your current health status. ActivArmor may also directly collect such information electronically, during the ordering process for our products. The terms of this Notice apply to health information produced or obtained by ActivArmor.
The HIPAA Privacy Law requires us to provide this Notice to you regarding our privacy practices, our legal duties to protect your private information and your rights concerning health information about you. We are required to follow the privacy practices described in this Notice whenever we use or disclose your protected health information (PHI). Other companies or persons that perform services on our behalf, called Business Associates, must also protect the privacy of your information. Business Associates are not allowed to release your information to anyone else unless specifically permitted by law. There may be other state and federal laws, which provide additional protections related to communicable disease, mental health, substance or alcohol abuse, or other health conditions.
Your Health Information May Be Used And Disclosed
The HIPAA Privacy Law permits ActivArmor to make uses and disclosures of your health information for purposes of treatment, payment and health care operations.
- We use and may share health information about you for your health care and treatments. For example, a nurse or medical assistant will obtain treatment information about you and record. Alternatively, your physician may use information about you for fulfillment of your DME order, including information about your injury and which treatment option, such as surgery or medication, will best address your health needs.
- Health Care Operations: We may use and share health information about you for ActivArmor’s health care operations, which include planning, management, quality assessment, and improvement activities for the DME delivery service that we deliver. For example, we may use your health information to evaluate the skills of our staff. We also may use your information to review quality and health outcomes. We may share this information.
- Health-Related Benefits, Services and Treatment Alternatives: We may also contact you about new or alternative treatments or DME products and options. For example, we may offer to mail to you newsletters, coupons, or announcements.
- People Assisting in Your Care: In certain limited situations, ActivArmor may disclose essential health information to people such as family members, relatives, or close friends who are helping care for you through the scanning and fitting process. We will disclose information to them only if these people need to know the information to help you. For example, we may provide limited information to a family member so that they may assist you in scanning, fittings or adjustments. ActivArmor will determine if it would be in your best interest to disclose pertinent health information about you to the people assisting in your care.
- Research: ActivArmor may use or disclose health information about you for research purposes. Researchers may be allowed to use information about you in a restricted way to determine whether the potential study participants are appropriate.
- As Required by Law: We must disclose health information about you if federal, state, or local law requires us.
- Serious Threat to Health or Safety: Consistent with applicable laws, we may disclose your PHI if disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- Public Health Risks: As authorized by law, we may disclose health information about you to public health or legal authorities whose official responsibilities generally include the following:
- To prevent or control disease, injury or disability;
- To report problems with products or treatment;
- To notify people of recalls of products they may be using;
- Health Oversight Activities: We must disclose health information to a health oversight agency for activities that are required by federal, state or local law. Oversight activities include investigations, inspections, industry licensures, and government audits. These activities are necessary to enable government agencies to monitor various health care systems, government programs, and industry compliance with civil rights laws.
- Required by HIPAA Law: The Secretary of the Department of Health and Human Services (HHS) may investigate privacy violations. If your health information is requested as part of an investigation, we must share your information with HHS.
I. Situations In Which Your Health Information May Be Disclosed With Your Written Consent
- Marketing: We must obtain your written authorization before using your health information to send you any marketing materials. The only exceptions to this requirement are that:
- We can provide you with marketing materials in a face-to-face encounter or a promotional gift of very small value, if we so choose
- We may communicate with you about products or services relating to your treatment, to coordinate or manage your care, or provide you with information about different treatments, providers or care settings.
- Highly Confidential Information: Federal and state law requires special privacy protections for certain “Highly Confidential Information” about you, including any part of your health information that is about:
- Child abuse and neglect
- Domestic abuse of an adult with a disability
- Mental illness or developmental disability treatment or services
- Alcohol or drug dependency diagnosis, treatment, or referral
- Sexual assault
Before we share your Highly Confidential Information for a purpose other than those permitted by law, we must obtain your written permission.
II. Your Rights Regarding Health Information We Maintain About You
- Right to Inspect and Copy: You have the right to inspect and receive a copy of your PHI. A request to inspect your records may be made by sending a request to firstname.lastname@example.org. For copies of your PHI, requests must also be sent to email@example.com. For PHI in a designated record set that is maintained in an electronic format, you can request an electronic copy of such information. There may be a charge for copies of your PHI.
- Right to Request Amendment: If you believe that any health information we have about you is incorrect or incomplete, you have the right to ask us to change the information, for as long as ActivArmor maintains the information. To request an amendment to your health information, your request must be in writing, signed, and submitted to ActivArmor. If we deny your request, we will provide you a written explanation. You may respond with a statement of disagreement that will be maintained with your records. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you name, of the amendment and to include the changes in any future disclosures of that information.
- Right to Request Restrictions on Use and Disclosure: You have the right to request a restriction or limitation on certain uses and disclosures of your health information.
To request restrictions, you must make your request in writing to ActivArmor. In your request, you must tell us:
- What information you wish to limit
- Whether you wish to limit our use, disclosure, or both
- To whom you want the limits to apply – for example, if you want to prohibit disclosures for insurance payment, to persons involved in your care, or to your spouse.
You or your personal representative must sign it.
We are not required to agree to your request, but we will attempt to accommodate reasonable requests when appropriate. We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction.
- Right to an Accounting of Disclosures: With some exceptions, you have the right to receive an accounting of certain disclosures of your PHI. Your accounting request must be in writing and signed by you or your personal representative, and submitted to ActivArmor. Your request must specify the time in which the disclosures were made. These disclosures may not go back further than six years from the date of the request. You may receive one free accounting in any 12-month period. We will charge you for additional requests.
- Right to Request Alternate Communications: You have the right to request that we communicate with you about medical matters in a confidential manner. You must submit your request in writing to ActivArmor. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
- Right to Receive a Copy of this Notice: You have the right to a paper copy of this Notice of Privacy Practices even if you have agreed to receive the Notice electronically. You may ask us to give you a copy of this Notice at any time.
- Right to Cancel Authorization to Use or Disclose: Other uses and disclosures of your health information not covered by this Notice or the laws that govern us will be made only with your written authorization. You have the right to revoke your authorization in writing at any time, and we will discontinue future uses and disclosures of your health information for the reasons covered by your authorization. We are unable to take back any disclosures that were already made with your authorization, and we are required to retain the records of the care that we provided to you.
For further information: If you have questions, or would like additional information, you may contact us at firstname.lastname@example.org
To File a Complaint: You may submit any complaints with respect to violations of your privacy rights to ActivArmor. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services if you feel that your rights have been violated. There will be no retaliation from ActivArmor for making a complaint.
Changes to this Notice: If we make a material change to this Notice, we will provide a revised Notice available on our website, www.activarmor.com.
Contact Information: Unless otherwise specified, to exercise any of the rights described in this Notice, for more information, or to file a complaint, please contact us at email@example.com, or by filing a Contact Us form on our website, at www.activarmor.com.
Effective Date: This Notice is effective as of April 13, 2020.