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.
Good Night Medical takes your privacy seriously. We want to tell you about our privacy practices to protect your personal health information.
How do we use health information?
Good Night Medical uses your health information to treat you, to obtain payment for services, and to conduct normal business known as healthcare operations. Examples of how we use your information include:
Treatment –We keep a record of each visit. This record may include an initial evaluation, treatment plan, and notes.
Payment – We document the services you receive at each visit so that you, your insurance company or another third party can pay us. We may also tell your health plan about upcoming services that require their prior approval.
Health Care Operations – Health information is used to improve the services we provide, to train staff and students, for business management, for quality improvement, and for customer service.
We comply with all applicable state and federal laws, including any laws that impact our ability to use your health information for treatment, payment and operations.
We may also use information to:
Recommend treatment alternatives
Tell you about benefits and services
Communicate with family or friends involved in your care
Communicate with other healthcare providers or business associates for treatment, payment or health care operations. Business associates must follow our privacy rules.
Send appointment reminders. You may tell the scheduler that you do not wish to have an appointment reminder.*
Information we share
There are limited times when we are permitted or required to disclose health information without your signed permission. These situations are listed below:
For public health activities such as tracking diseases or medical devices
To protect victims of abuse or neglect for federal and state health oversight activities such as fraud investigations
For judicial or administrative proceedings
If required by law or for law enforcement
To coroners, medical examiners and funeral directors
For organ donation
To avert serious threat to public health or safety
For specialized government functions such as national security and intelligence
To Workers’ Compensation if you are injured at work
To a correctional institution if you are an inmate
For research following strict internal review to ensure protection of information.
All other uses and disclosures, not previously described, may only be made with your signed authorization. You may revoke your authorization at any time.
Good Night Medical is required by law to:
Maintain the privacy of your health information
Provide this notice of our duties and privacy practices
Abide by the terms of the notice currently in effect.
We reserve the right to change privacy practices, and make the new practices effective for all the information we maintain. Revised notices will be available to you.
You have the right to:
Request that we restrict how we use or disclose your health information. We may not be able to comply with all requests.
Request that we use a specific telephone number or address to communicate with you
Inspect and copy your health information (fees may apply)*
Request additions or corrections to your health information*
Receive an accounting of how your health information was disclosed (excludes disclosures for treatment, payment, healthcare operations, some required disclosures, as well as disclosures that you authorize)*
Obtain a paper copy of this notice even if you receive it electronically.
Requests followed by a star (*) must be in writing.
To Contact Us
If you would like to exercise your rights, or if you feel your privacy rights have been violated, or if you need more information, contact the Chief Compliance Officer, at 877-753-3742. Or, by mail at: Good Night Medical, 8999 Gemini Pkwy, Ste 220 Columbus, OH 43240.
All complaints will be investigated and you will not suffer retaliation for filing a complaint. You may also file a complaint with the Secretary of Health and Human Services in Washington, D.C.