HIPAA Notice

Our Legal Duty

MedGo Mobile Wound Care Solutions is required by federal law, including the Health Insurance Portability and Accountability Act (HIPAA), to maintain the privacy of your Protected Health Information (PHI), provide you with this Notice of our legal duties and privacy practices, abide by the terms of this Notice currently in effect, and notify you in the event of a breach of unsecured PHI.

What Is Protected Health Information (PHI)?

Protected Health Information includes information that:

• Identifies you
• Relates to your physical or mental health condition
• Relates to the provision of health care
• Relates to payment for health care

This includes wound care services, assessment and treatment records, medication management related to wound care, and care coordination with your providers.

How We May Use and Disclose Your Information

For Treatment

We may use and disclose your PHI to provide and coordinate your care. This includes communication with physicians and Advanced Practice Registered Nurses (APRNs), nurses and facility staff in assisted living, skilled nursing, or independent living communities, pharmacies, laboratories, hospice and home health agencies, and other health care providers involved in your care.

For Payment

We may use and disclose PHI to bill Medicare, Medicaid, or commercial insurance, verify coverage, and collect payment for services.

For Health Care Operations

We may use PHI for quality assessment and improvement, training and supervision, licensing and credentialing, compliance and audit activities, and business management functions.

Other Permitted or Required Disclosures

We may disclose PHI as required by federal or state law, for public health activities, to report abuse or neglect, for health oversight activities, in response to a court order or lawful subpoena, and to avert a serious threat to health or safety.

Your Rights Regarding Your Health Information

Under federal law, you have the right to:

1. 1

   Inspect and Obtain a Copy

   Request access to your medical record, subject to limited exceptions.

2. 2

   Request an Amendment

   Request correction of information you believe is incorrect or incomplete.

3. 3

   Request Restrictions

   Request limitations on certain uses or disclosures. We are not required to agree to all requests except where required by law.

4. 4

   Request Confidential Communications

   Request that we communicate with you in a specific manner or at a specific location.

5. 5

   Receive an Accounting of Disclosures

   Request a list of certain disclosures of your PHI made by us.

6. 6

   Obtain a Paper Copy of This Notice

   You may request a paper copy at any time.

Our Responsibilities

We are required to protect the privacy and security of your PHI, limit disclosures to the minimum necessary when appropriate, obtain authorization when required by law, maintain policies and procedures to safeguard information, and train our workforce regarding privacy protections.

Complaint Process

If you believe your privacy rights have been violated, you may file a complaint with:

You may also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Changes to This Notice

We reserve the right to revise this Notice. Any revised Notice will apply to all PHI we maintain and will be posted on our website, available upon request, and provided to new patients at intake.

Acknowledgment of Receipt

I acknowledge that I have received a copy of this Notice of Privacy Practices.