Notice of Privacy Practices

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.


Privacy Promise

American Sleep Association understands that your medical and health information is personal. Protecting your health information is important. We follow strict federal and state laws that require us to maintain the confidentiality of your health information.


How We Use Your Health Information

When you receive care from American Sleep Association, we may use your health information for treating you, billing for services, and conducting our normal business known as healthcare operations. Examples of how we use your information include:


Treatment – We keep records of the care and services provided to you. Healthcare providers use these records to deliver quality care to meet your needs. For example, your doctor may share your health information with a specialist who will assist in your treatment.


Payment – We keep billing records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment from you, your insurance company, or other third party. We may also contact your insurance company to verify coverage for your care or to notify them of upcoming services that may need prior notice or approval. For example, we may disclose information about the services provided to you to claim and obtain payment from your insurance company or Medicare.


Healthcare Operations – We use health information to improve the quality of care, train staff and students, provide customer service, manage costs, conduct required business duties, and make plans to better serve our communities. For example, we may use your health information to evaluate the quality of treatment and services provided by our physicians, nurses, and other healthcare workers.


Other Services We Provide

We may also use your health information to:

  • Recommend treatment alternatives;
  • Tell you about health services and products that may benefit you;
  • Share information with third parties who assist us with treatment, payment, and healthcare operations. Our business associated must protect your information by following our privacy practices;
  • Remind you of an appointment (if you do not wish to be reminded, notify the scheduler);

And


More Information

For more information about the practices and rights described in this notice:

  • Visit our website at www.AmericanSleepAssociation.com ;
  • Contact us at 866-620-3670

Sharing Your Health Information

There are limited situations when we are permitted or required to disclose health information without your signed authorization. These situations are:

  • For public health purposes such as reporting communicable diseases, work-related illnesses, or other diseases and injuries permitted by law; reporting births and deaths; and reporting reactions to drugs and problems with medical devices;
  • To protect victims of abuse, neglect, or domestic violence;
  • For health oversight activities such as investigations, audits, and inspections;
  • For lawsuits and similar proceedings;
  • When otherwise required by law;
  • When requested by law enforcement as required by law or court order;
  • To coroners, medical examiners, and funeral directors;
  • For organ and tissue donation;
  • For research approved by our review process under strict federal guidelines;
  • To reduce or prevent a serious threat to public health and safety;
  • For workers’ compensation or other similar programs if you are injured at work; and
  • For specialized government functions such as intelligence and national security.

All other uses and disclosures, not described in this notice, require your signed authorization. You may revoke your authorization at any time with a written statement. However, American Sleep Association may not be able to reverse the use or disclosure of your health information while your authorization was in effect.

Our Privacy Responsibilities

American Sleep Association is required by law to;

  • Maintain the privacy of your health information;
  • Provide this notice that describes the ways we may use and share your health information; and
  • Follow the terms of the notice currently in effect.

We reserve the right to make changes to this notice at any time and make new privacy practices effective for all information we maintain. Current notices will be posted in American Sleep Association facilities and on our website, www.AmericanSleepAssociation.com .  You may also request a copy of any notice from the American Sleep Association Privacy Office.


Your Individual Rights

You have the right to:

  • Request restrictions on how we use and share your health information. We will consider all requests for restrictions carefully but are not required to agree to any restriction;
  • Request that we use a specific telephone number or address to communicate with you;
  • *Request to inspect and copy your health information, including medical and billing records. Fees may apply. Under limited circumstances, we may deny you access to a portion of your health information and you may request a review of the denial;
  • *Request corrections or additions to your health information;
  • *Request an accounting of certain disclosures of your health information made by us. The accounting does not include disclosures made for treatment, payment, and healthcare operations and some disclosures required by law. Your request must state the period of time desired for the accounting, which must be within the six years prior to your request and exclude dates prior to April 14, 2003. The first accounting is free but a fee will apply if more than one request is made in a 12-month period; and
  • Request a paper copy of this notice even if you agree to receive it electronically.

Requests marked with a star ( * ) must be made in writing. Contact the American Sleep Association Privacy Office for the appropriate form for your request.


Our Organization

This notice describes the privacy practices of American Sleep Association, LLC  (referred to as “American Sleep Association” in this Notice) including healthcare facilities and services, as well as the American Sleep Association employees and volunteers at those facilities. This notice also describes the privacy practices of affiliated providers while they are performing services in an American Sleep Association facility, unless they provide you with a notice of their specific privacy practices. Affiliated providers are not employed by American Sleep Association but are either authorized to provide services to patients in an American Sleep Association facility or are approved participants on the panel of SelectHealth’s providers.


Contact Us

If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision that we made about access to your health information, contact:

American Sleep Association
51 E 400 N Bldg 1
866-620-3670
Email: privacy@AmericanSleepAssociation.com

We will investigate all complaints and will not retaliate against you for filing a complaint. You may also file a written complaint with the Office of Civil Rights of the U.S. Department of Health and Human Services.


MEDICARE DMEPOS SUPPLIER STANDARDS

Note: This is an abbreviated version of the supplier standards every Medicare DMEPOS supplier must meet in order to obtain and retain their billing privileges. These standards, in their entirety, are listed in 42 C.F.R. 424.57(c).

1. A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.

2. A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to this information must be reported to the National Supplier Clearinghouse within 30 days.

3. An authorized individual (one whose signature is binding) must sign the application for billing privileges.

4. A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the Medicare program, any State health care programs, or from any other Federal procurement or non-procurement programs.

5. A supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.

6. A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge Medicare covered items that are under warranty.

7. A supplier must maintain a physical facility on an appropriate site.

8. A supplier must permit CMS, or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.

9. A supplier must maintain a primary business telephone listed under the name of the business in a local directory or a toll free number available through directory assistance. The exclusive use of a beeper, answering machine or cell phone is prohibited.

10. A supplier must have comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations.

11. A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from calling beneficiaries in order to solicit new business.

12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of delivery.

13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contacts.

14. A supplier must maintain and replace at no charge or repair directly, or through a service contract with another company, Medicare-covered items it has rented to beneficiaries.

15. A supplier must accept returns of substandard (less than full quality for the particular item) or unsuitable items (inappropriate for the beneficiary at the time it was fitted and rented or sold) from beneficiaries.

16. A supplier must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item.

17. A supplier must disclose to the government any person having ownership, financial, or control interest in the supplier.

18. A supplier must not convey or reassign a supplier number; i.e., the supplier may not sell or allow another entity to use its Medicare billing number.

19. A supplier must have a complaint resolution protocol established to address beneficiary complaints that relate to these standards. A record of these complaints must be maintained at the physical facility.

20. Complaint records must include: the name, address, telephone number and health insurance claim number of the beneficiary, a summary of the complaint, and any actions taken to resolve it.

21. A supplier must agree to furnish CMS any information required by the Medicare statute and implementing regulations.

22. All suppliers must be accredited by a CMS-approved accreditation organization in order to receive and retain a supplier billing number. The accreditation must indicate the specific products and services, for which the supplier is accredited in order for the supplier to receive payment of those specific products and services (except for certain exempt pharmaceuticals). Implementation Date - October 1, 2009

23. All suppliers must notify their accreditation organization when a new DMEPOS location is opened.

24. All supplier locations, whether owned or subcontracted, must meet the DMEPOS quality standards and be separately accredited in order to bill Medicare.

25. All suppliers must disclose upon enrollment all products and services, including the addition of new product lines for which they are seeking accreditation.

26. Must meet the surety bond requirements specified in 42 C.F.R. 424.57(c). Implementation date- May 4, 2009