USES and DISCLOSURES:
Treatment: Your health information may be used by RESTORATIVE SUPPORT SYSTEMS CO. employees or disclosed to other healthcare professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment.
Payment: Your health information may be used to seek payment from your health plan, from other sources of coverage, such as an automobile insurer, or from credit card companies that you may use to pay for services.
Health Care Operations: Your health information may be used as necessary to support the day-to-day activities and management of Restorative Support Systems Co.
Law Enforcement: Your health information may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections, to facilitate law enforcement investigations and comply with government mandated reporting.
Public Health Reporting: Your health information may be disclosed to public health agencies as required by law.
* Other Areas and Disclosures Require Your Authorization: Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use of disclosure of your information you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.
Information about Treatments: Your health information may be used to send you information on the treatment and management of your medical condition or new technology that you may find to be of interest. We may also send you information describing health-related goods and services that we believe may interest you.
Individual Rights: You have certain rights under the federal privacy standards. These include:
The right to request instructions on the use and disclosure of your protected health information.
The right to receive confidential communications concerning your medical condition and treatment.
The right to inspect and copy your protected health information.
The right to amend or submit corrections to your protected health information.
The right to receive an accounting of how and to whom your protected health information has been disclosed.
The right to receive a printed copy of this notice.
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices. We are also required to abide by the privacy policies and practices that are outlined in this notice. As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next visit. The revised policies and practices will be applied to all protected health information that we maintain.
REQUESTS TO INSPECT PROTECTED HEALTH INFORMATION
As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting Louis Markulin, Privacy Officer. If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to: Louis Markulin, Privacy Office @ P.O. Box 625 Canfield, Ohio 44406 OR to our accrediting agency: The Compliance Team, Inc. PO Box 160 Springhouse, PA 19477.
Restorative Support Systems Co. warrants all products sold by our company for one year. Restorative Support Systems Co. will honor all warranties under applicable law. Restorative Support Systems will repair or replace, free of charge, Medicare-covered equipment that is under warranty. In addition, an owner's manual with warranty information will be provided to beneficiaries for all durable medical equipment where this manual is available.
Medicare Supplier Standards:
The products and/or services provided to you by supplier legal business name or DBA are subject to the supplier standards contained in the Federal regulations shown at 42 Code of Federal Regulations Section 424.57(c). These standards concern business professional and operational matters (e.g., honoring warranties and hours of operation). The full text of these standards can be obtained from the U.S. Government Printing Office website. Upon request we will furnish you a written copy of the standards.
All complaints will be handled professionally. You may file a complaint via telephone with our Compliance Officer @ 330-286-3414 or by submitting a letter specifying your complaint to: Restorative Support Systems Co. , P.O. Box 625 Canfield, Ohio 44406. You will be notified within 5 business days that that the complaint has been received and that it is being investigated. You will receive a written response / resolution to the complaint within 14 business days.
You will receive a "Satisfaction Survey" which we use as tool to better our customer service and product availability. We appreciate your time in providing this information to us.
Patient Rights and Responsibilities:
The patient has the right to considerate and respectful service from each individual representing Restorative Support Systems Co.
The patient has the right to obtain service without regard to race, creed, national origin, sex, age, disability, diagnosis or religious affiliation.
The patient has the right to refuse any and all equipment.
Has the right to ask questions and have them answered in a prompt, correct and courteous manner.
The patient has the right to prompt delivery and to be fully informed of the proper use and care of the equipment provided by Restorative Support Systems Co.
The patient will be instructed on the payment process and may request a detailed itemized statement of their services.
Subject to applicable law, the patient has the right to confidentiality of all information pertaining to his/her medical equipment service. Individuals or organizations not involved in the patient’s care may not have access to the information without the patient’s written consent.
The patient has the right to make informed decisions about his/her care.
The patient has the right to reasonable continuity of care and service.
The patient has the right to voice grievances without fear of termination of service or other reprisal in the service process.
The patient will give accurate and complete health information concerning your past use of equipment and any changes in insurance coverage.
The patient will promptly notify Restorative Support Systems Co. of any equipment failure or damage.
The patient will follow instruction for use and care of equipment and request additional detailed information if you do not fully understand and or all information which has been given to you.
The patient is responsible for any equipment that is lost or stolen while in their possession and should promptly notify Restorative Support Systems Co. in such instances.
The patient should promptly notify Restorative Support Systems Co. of any changes to their address or telephone.
The patient should promptly notify Restorative Support Systems Co. of any changes concerning their physician.
The patient should notify Restorative Support Systems Co. of discontinuance of use.
Except where contrary to federal or state law, the patient is responsible for any equipment rental and sale charges which the patient’s insurance company/companies does not pay.
Additional Important Information:
* Orthotic devices are Single Patient Use Only
* Orthotic devices are provided by prescription only
Restorative Support Systems Co.