RSIMEDSUPPLY.COM & REHAB SPECIALTIES, INC.

HIPAA PRIVACY NOTICE

UNDERSTANDING YOUR PROTECTED HEALTH INFORMATION (PHI):

Understanding what is in your health record and how your health information is used will help you to ensure its accuracy, allow you to better understand who, what, when, where and why others may access your health information, and assist you in making more informed decisions when authorizing disclosure to others. When you visit us, we keep a record of your symptoms, examination, test results, diagnoses, treatment plan, and other medical information. We also may obtain health records from other providers. In using and disclosing this protected health information (PHI), it is our objective to follow the Privacy Standards of the federal Health Insurance Portability and Accountability Act, 45 CFR Part 464, even if this is not required in order to treat students. The law allows us to use and disclose PHI without your specific authorization for treatment, payment, operations and other specific purposes explained on the next page. This includes the sharing of information, when necessary and appropriate, with other health care components of the University, such as the athletic department, student health center, campus pharmacy or the counseling center, as necessary for your continued care. It also includes contacting you for appointment reminders and follow-up care. All other uses and disclosures require your specific authorization.

YOUR HEALTH INFORMATION RIGHTS ALLOW YOU TO:

• Request a restriction on the uses and disclosures of PHI as described in this notice, although we are not required to agree to the restriction you request. You should address your request in writing to the Privacy Officer. We will notify you within 30 days if we cannot agree to the restriction.
• Obtain a paper copy of this Notice and upon written request, inspect and obtain a copy of your health record for a fee of $.60 per page and the actual cost of postage per NRS 629.061, except that you are not entitled to access, or to obtain a copy of, psychotherapy notes and information compiled for legal proceedings.
• Amend your health record by submitting a written request with the reasons supporting the request to the Privacy Officer. In most cases, we will respond within 30 days. We are not required to agree to the requested amendment.
• Obtain an accounting of disclosures of your health information, except that we are not required to account for disclosures for treatment, payment, operations, or pursuant to authorization, among other exceptions.
• Request in writing to the Privacy Officer that we communicate with you by a specific method and at a specific location.
We will typically communicate with you in person; or by letter, e-mail, fax, and/or telephone.
• Revoke an authorization to use or disclose PHI at any time except where action has already been taken.

OUR RESPONSIBILITIES AS REQUIRED BY LAW:

• Maintain the privacy of PHI and provide you with notice of our legal duties and privacy practices with respect to PHI.
• Abide by the terms of the notice currently in effect. We have the right to change our notice of privacy practices and we will apply the change to your entire PHI, including information obtained prior to the change.
• Post notice of any changes to our Privacy Policy in the lobby and make a copy available to you upon request.
• Use or disclose your PHI only with your authorization except as described in this notice.
• Follow the more stringent law in any circumstance where other state or federal law may further restrict the disclosure of your PHI.

FOR MORE INFORMATION OR TO REPORT A PROBLEM, CONTACT RSI MED SUPPLY AT:

7100 B GRAND BLVD
HOUSTON, 77054
(713) 791-1011

If you feel your rights have been violated, you may file a complaint in writing with the us. If you are not satisfied with the resolution of the complaint, you may also file a complaint with the Secretary of Health and Human Services. Filing a complaint will not result in retaliation.