assurance
Medical Billing Services, LLC
 |  |  |  |
| HIPAA Policy |
I. |
| All Protected |
| Health |
| Information Is |
| Private And |
| Secure! |
I. WHAT IS "PROTECTED HEALTH INFORMATION?"
A patient’s protected health information (PHI) is health information that contains
identifiers, such as:
Their name
Social Security number
Address
Medical Record #
Employer Information
Birth date
These are just some of the items. Our rule is to not provide any information to persons
without their prior consent.
II. ABOUT OUR RESPONSIBILITY TO PROTECT YOUR PHI
1) protect the privacy of each patient’s PHI,
2) tell them about their rights and our legal duties with respect to their PHI, and
3) tell them about our privacy practices and follow our notice currently in effect.
We take these responsibilities seriously and, as in the past, we will continue to take
appropriate steps to safeguard the privacy of all PHI.
In the course of providing medical billing services, we receive various types of PHI from
doctors and other health care providers. The medical information may be used, for
example, evaluate benefits and claims, administer health care coverage, measure
performance (utilization review), detect fraud and abuse, and fulfill legal and regulatory
requirements. The types of PHI that we collect and maintain patients include, for
example:
• Information about their relationship with doctor offices, clinics, ambulatory services,
home care, or other direct health care providers such as: medical services received,
claims history, and information from their benefits plan sponsor or employer about
group health coverage they may have, and
• Information from patients, for example, through online and telephone
communications
III. A PATIENT’S RIGHTS REGARDING THEIR PHI
This section tells a patient about patient rights regarding their PHI, for example, their
medical and billing records. It also describes how they can exercise these rights.
A patient’s right to see and receive copies of their PHI
In general, a patient has a right to see and receive copies of their PHI in designated
record sets such as their medical record or billing records. At Assurance Medical Billing
Services, LLC, our staff only has access to information provided by the health care
provider used in the operation of billing for services received. As such, a patient’s
medical records are not maintained at our location or on our computers. Such
information must be requested directly from the primary care provider. If you need the
address or contact of your doctor, please call our offices at :
Assurance Medical Billing Services, LLC
at 818-678-9494
and we can direct you to your physician. If a patient would like to receive a copy of their
billing record or statement, please write to us at our mailing station:
Assurance Medical Billing Services, LLC:
9420 Reseda Blvd. Unit 651, Northridge, Ca 91324.
After we receive the patient’s written request, we will let them know when and how they
can see or obtain a copy of their billing record. If they agree, we will give them a
summary or explanation of your PHI. If we don't have the record they asked for but we
know who does, we will tell them who to contact to request it. In limited situations, we
may deny some, or all of their request, to see or receive copies of their records, but if
we do, the Privacy Officer will tell them why in writing and explain their right, if any to
have our denial reviewed.
All changes to their privacy information we receive over the phone or e-mail must be
referred to the doctor’s office who will process their paperwork for PHI changes.
A patient’s right to choose how we send PHI to them
A patient may ask us to send their PHI to them at a different address (for example, their
work address) or by different means (for example, fax instead of regular mail). When we
can reasonably and lawfully agree to their request, we will. However, we are permitted
to charge them for any additional cost of sending their PHI to different addresses or by
different means. Once again, they will have to make changes of their address through
their doctor and the doctor will send the changes to Assurance Medical Billing Services,
LLC.
A patient’s right to correct or update their PHI
If a patient believes there is a mistake in their PHI or that important information is
missing, they may request that it be corrected or added to the record. Please contact
your doctor directly for changes. You will have to write to the doctor and tell them what
you are asking for and why they should make the correction or addition. We will
respond in writing after receiving their request. If we approve their request, we will make
the correction or addition to their PHI. If we deny their request, we will tell them why and
explain their right to file a written statement of disagreement. Their statement must be
limited to 250 words for each item in their billing record that they believe is incorrect or
incomplete. The patient must clearly tell us in writing if they want us to include their
statement in future disclosures we make of that part of your record. We may include a
summary instead of your statement.
A patient’s right to an accounting of disclosures of PHI
A patient may ask us for a list of our disclosures of their PHI. Please write to:
Privacy Officer, Assurance Medical Billing Services, LLC
9420 Reseda Blvd. Unit 651, Northridge, Ca 91324 or email
http://privacyofficer@ambs4drs.com.
The list we will provide will include disclosures made in the last six years, unless they
request a shorter time or if less than six years have passed since January 1, 2008.
A patient is entitled to one disclosure accounting in any 12-month period at no charge.
If they request any additional accountings less than 12 months later, we may charge a
fee. An accounting does not include certain disclosures, for example, disclosures to
carry out treatment, payment and health care operations; disclosures that occurred
prior to January 1, 2008; disclosures for which their service provider or Assurance
Medical Billing Services, LLC had a signed authorization; disclosures of their PHI to
them; disclosures for notifications for disaster relief purposes; or disclosures to persons
involved in their care and persons acting on their behalf.
A patient’s right to request limits on uses and disclosures of your PHI
A patient may request that we limit our uses and disclosures of their PHI for treatment,
payment, and health care operations purposes. However, by law, we do not have to
agree to their request. All requests should be forwarded to the Privacy Officer.
A patient’s right to receive a paper copy of this notice
A patient has a right to receive a paper copy of this notice upon request. Please refer
all requests to Privacy Officer, prior to sending.
IV. ASSURANCE MEDICAL SERVICES, LLC SUBJECT TO THIS NOTICE
This notice applies to the Assurance Medical Billing Services which includes: billing
services, medical management, collections, health plan and insurance provider
operations, and our web sites.
To provide our physician clients and patients with the billing services they expect, to
obtain payment for patient care and to conduct our operations, such as quality
assurance, accreditation, licensing and compliance, Assurance Medical Billing Services,
LLC may share patient PHI in compliance with HIPAA regulations with insurance
companies,their health care provider's in house biller, and their staff responsible for
billing of services.
Our personnel has access to a patients PHI as employees, volunteers or persons
working with us as part of their school accreditation externship as they enter information
in our HIPAA secured billing service software, receiving, posting, and handling patient
and insurance invoicing.
V. HOW WE MAY USE AND DISCLOSE A PATIENT’S PHI
Confidentiality of PHI is extremely important to us. Our employees are required to
maintain the confidentiality of the PHI of our clients (medical service providers and their
patients) and we have policies and procedures and other safeguards to help protect
their PHI from improper use and disclosure. Sometimes we are allowed by law to use
and disclose certain PHI without their written permission. We briefly describe these uses
and disclosures below and give some examples. How much PHI is used or disclosed
without their written permission will vary depending, for example, on the intended
purpose of the use or disclosure. Sometimes we may only need to use or disclose a
limited amount of PHI, such as to send you an appointment reminder or to confirm that
they are a health plan member. Other examples, are listed below:
Payment: PHI may be needed to determine your responsibility to pay for, or to
permit us to bill and collect payment for, treatment and health-related services that you
received. For example, we may receive PHI from a health provider. When they or the
provider sends us the bill for health care services, we use and disclose the PHI to
determine how much, if any, of the bill they or their provider are responsible for paying.
Business associates: We may contract with business associates to perform certain
functions or activities on our behalf, such as payment and health care operations.
These business associates must agree to safeguard your PHI.
Required by law: In some circumstances federal or state law requires that we
disclose a patient’s PHI to others. For example, the secretary of the Department of
Health and Human Services may review our compliance efforts, which may include
seeing the PHI.
Lawsuits and other legal disputes: We may use and disclose PHI in responding to a
court or administrative order, a subpoena, or a discovery request. We may also use
and disclose PHI to the extent permitted by law without their authorization, for example,
to defend a lawsuit or arbitration.
VII. HOW PATIENTS CAN CONTACT US ABOUT THIS NOTICE OR TO COMPLAIN
ABOUT OUR PRIVACY PRACTICES
Contact our Privacy Officer:
Privacy Officer
Assurance Medical Billing Services, LLC
9420 Reseda Blvd. Unit 651, Northridge, Ca 91324
818-678-9494
http://privacyofficer@ambs4drs.com.
You may also notify the secretary of the Department of Health and Human Services.
We will not take retaliatory action against a client, patient, or employee, if they
file a complaint about our privacy practices.
IX. EFFECTIVE DATE OF THIS NOTICE: This notice is effective as of January 1,
2008.
A patient’s protected health information (PHI) is health information that contains
identifiers, such as:
Their name
Social Security number
Address
Medical Record #
Employer Information
Birth date
These are just some of the items. Our rule is to not provide any information to persons
without their prior consent.
II. ABOUT OUR RESPONSIBILITY TO PROTECT YOUR PHI
1) protect the privacy of each patient’s PHI,
2) tell them about their rights and our legal duties with respect to their PHI, and
3) tell them about our privacy practices and follow our notice currently in effect.
We take these responsibilities seriously and, as in the past, we will continue to take
appropriate steps to safeguard the privacy of all PHI.
In the course of providing medical billing services, we receive various types of PHI from
doctors and other health care providers. The medical information may be used, for
example, evaluate benefits and claims, administer health care coverage, measure
performance (utilization review), detect fraud and abuse, and fulfill legal and regulatory
requirements. The types of PHI that we collect and maintain patients include, for
example:
• Information about their relationship with doctor offices, clinics, ambulatory services,
home care, or other direct health care providers such as: medical services received,
claims history, and information from their benefits plan sponsor or employer about
group health coverage they may have, and
• Information from patients, for example, through online and telephone
communications
III. A PATIENT’S RIGHTS REGARDING THEIR PHI
This section tells a patient about patient rights regarding their PHI, for example, their
medical and billing records. It also describes how they can exercise these rights.
A patient’s right to see and receive copies of their PHI
In general, a patient has a right to see and receive copies of their PHI in designated
record sets such as their medical record or billing records. At Assurance Medical Billing
Services, LLC, our staff only has access to information provided by the health care
provider used in the operation of billing for services received. As such, a patient’s
medical records are not maintained at our location or on our computers. Such
information must be requested directly from the primary care provider. If you need the
address or contact of your doctor, please call our offices at :
Assurance Medical Billing Services, LLC
at 818-678-9494
and we can direct you to your physician. If a patient would like to receive a copy of their
billing record or statement, please write to us at our mailing station:
Assurance Medical Billing Services, LLC:
9420 Reseda Blvd. Unit 651, Northridge, Ca 91324.
After we receive the patient’s written request, we will let them know when and how they
can see or obtain a copy of their billing record. If they agree, we will give them a
summary or explanation of your PHI. If we don't have the record they asked for but we
know who does, we will tell them who to contact to request it. In limited situations, we
may deny some, or all of their request, to see or receive copies of their records, but if
we do, the Privacy Officer will tell them why in writing and explain their right, if any to
have our denial reviewed.
All changes to their privacy information we receive over the phone or e-mail must be
referred to the doctor’s office who will process their paperwork for PHI changes.
A patient’s right to choose how we send PHI to them
A patient may ask us to send their PHI to them at a different address (for example, their
work address) or by different means (for example, fax instead of regular mail). When we
can reasonably and lawfully agree to their request, we will. However, we are permitted
to charge them for any additional cost of sending their PHI to different addresses or by
different means. Once again, they will have to make changes of their address through
their doctor and the doctor will send the changes to Assurance Medical Billing Services,
LLC.
A patient’s right to correct or update their PHI
If a patient believes there is a mistake in their PHI or that important information is
missing, they may request that it be corrected or added to the record. Please contact
your doctor directly for changes. You will have to write to the doctor and tell them what
you are asking for and why they should make the correction or addition. We will
respond in writing after receiving their request. If we approve their request, we will make
the correction or addition to their PHI. If we deny their request, we will tell them why and
explain their right to file a written statement of disagreement. Their statement must be
limited to 250 words for each item in their billing record that they believe is incorrect or
incomplete. The patient must clearly tell us in writing if they want us to include their
statement in future disclosures we make of that part of your record. We may include a
summary instead of your statement.
A patient’s right to an accounting of disclosures of PHI
A patient may ask us for a list of our disclosures of their PHI. Please write to:
Privacy Officer, Assurance Medical Billing Services, LLC
9420 Reseda Blvd. Unit 651, Northridge, Ca 91324 or email
http://privacyofficer@ambs4drs.com.
The list we will provide will include disclosures made in the last six years, unless they
request a shorter time or if less than six years have passed since January 1, 2008.
A patient is entitled to one disclosure accounting in any 12-month period at no charge.
If they request any additional accountings less than 12 months later, we may charge a
fee. An accounting does not include certain disclosures, for example, disclosures to
carry out treatment, payment and health care operations; disclosures that occurred
prior to January 1, 2008; disclosures for which their service provider or Assurance
Medical Billing Services, LLC had a signed authorization; disclosures of their PHI to
them; disclosures for notifications for disaster relief purposes; or disclosures to persons
involved in their care and persons acting on their behalf.
A patient’s right to request limits on uses and disclosures of your PHI
A patient may request that we limit our uses and disclosures of their PHI for treatment,
payment, and health care operations purposes. However, by law, we do not have to
agree to their request. All requests should be forwarded to the Privacy Officer.
A patient’s right to receive a paper copy of this notice
A patient has a right to receive a paper copy of this notice upon request. Please refer
all requests to Privacy Officer, prior to sending.
IV. ASSURANCE MEDICAL SERVICES, LLC SUBJECT TO THIS NOTICE
This notice applies to the Assurance Medical Billing Services which includes: billing
services, medical management, collections, health plan and insurance provider
operations, and our web sites.
To provide our physician clients and patients with the billing services they expect, to
obtain payment for patient care and to conduct our operations, such as quality
assurance, accreditation, licensing and compliance, Assurance Medical Billing Services,
LLC may share patient PHI in compliance with HIPAA regulations with insurance
companies,their health care provider's in house biller, and their staff responsible for
billing of services.
Our personnel has access to a patients PHI as employees, volunteers or persons
working with us as part of their school accreditation externship as they enter information
in our HIPAA secured billing service software, receiving, posting, and handling patient
and insurance invoicing.
V. HOW WE MAY USE AND DISCLOSE A PATIENT’S PHI
Confidentiality of PHI is extremely important to us. Our employees are required to
maintain the confidentiality of the PHI of our clients (medical service providers and their
patients) and we have policies and procedures and other safeguards to help protect
their PHI from improper use and disclosure. Sometimes we are allowed by law to use
and disclose certain PHI without their written permission. We briefly describe these uses
and disclosures below and give some examples. How much PHI is used or disclosed
without their written permission will vary depending, for example, on the intended
purpose of the use or disclosure. Sometimes we may only need to use or disclose a
limited amount of PHI, such as to send you an appointment reminder or to confirm that
they are a health plan member. Other examples, are listed below:
Payment: PHI may be needed to determine your responsibility to pay for, or to
permit us to bill and collect payment for, treatment and health-related services that you
received. For example, we may receive PHI from a health provider. When they or the
provider sends us the bill for health care services, we use and disclose the PHI to
determine how much, if any, of the bill they or their provider are responsible for paying.
Business associates: We may contract with business associates to perform certain
functions or activities on our behalf, such as payment and health care operations.
These business associates must agree to safeguard your PHI.
Required by law: In some circumstances federal or state law requires that we
disclose a patient’s PHI to others. For example, the secretary of the Department of
Health and Human Services may review our compliance efforts, which may include
seeing the PHI.
Lawsuits and other legal disputes: We may use and disclose PHI in responding to a
court or administrative order, a subpoena, or a discovery request. We may also use
and disclose PHI to the extent permitted by law without their authorization, for example,
to defend a lawsuit or arbitration.
VII. HOW PATIENTS CAN CONTACT US ABOUT THIS NOTICE OR TO COMPLAIN
ABOUT OUR PRIVACY PRACTICES
Contact our Privacy Officer:
Privacy Officer
Assurance Medical Billing Services, LLC
9420 Reseda Blvd. Unit 651, Northridge, Ca 91324
818-678-9494
http://privacyofficer@ambs4drs.com.
You may also notify the secretary of the Department of Health and Human Services.
We will not take retaliatory action against a client, patient, or employee, if they
file a complaint about our privacy practices.
IX. EFFECTIVE DATE OF THIS NOTICE: This notice is effective as of January 1,
2008.
| Notice of Privacy Practices Assurance Medical Billing Services, LLC THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT PATIENTS MAY BE USED AND DISCLOSED AND HOW PATIENTS CAN GET ACCESS TO THIS INFORMATION In this notice we use the terms "we," "us" and "our" to describe Assurance Medical Billing Services, LLC. For more details, please refer to section IV of this notice. |