Notice

This notice describes how your medical information may be disclosed and how you can access this information.

Superior Respiratory & Medical maintains protocols to ensure the security and confidentiality of your personal information. Our building has physical security, passwords to protect databases, compliance audits, and virus detection software. Only those who require your private health information to perform their job within our facility can access it.

Superior Respiratory & Medical is committed to responsibly treating and using your private health information. This Notice of Privacy Policies describes the information we collect and how and when we use or disclose that information. Additionally, it represents your rights as they relate to your protected health information. This Notice is effective December 1, 2022, and applies to all protected health information as defined by federal regulations.

Understanding Your Health Information:

As required by law, Superior Respiratory & Medical maintains a record of your private health information, most often to prove medical necessity to Medicare or other insurance. Typically, this record contains physician orders, progress notes, diagnoses related to your equipment, and additional information about your condition, which determines the appropriate equipment to provide for you. This information serves the following purposes:

Means of communication among the many health professionals who contribute to your care. Legal documents describe the equipment you received. You or a third-party payer can verify that the services billed were provided. Standards by which the medical equipment you received was medically required. Tool by which we can assess and continually work to improve our service.

Your Health Information Rights:

Although your health record is the physical property of Superior Respiratory & Medical, the information belongs to you. You have the right to:

Obtain a paper copy of this notice of privacy practices
Inspect and obtain a copy of your health record. (Reasonable copy fees apply.)
Request confidential communications of your health information.
Request a restriction on specific uses and disclosures of your health information.

Our Responsibilities:

We, as a provider, are required to:

Maintain the privacy notice of your health information.
Provide you with this notice regarding our legal duties and privacy practices concerning the information we collect and maintain.
Abide by the terms of this notice.
Notify you if we are unable to agree to a requested restriction.
Accommodate reasonable requests you may have to communicate your health information.

We reserve the right to change our practices and to make the provisions effective for all protected health information we maintain. We will have available at our facility a copy of the most current notice containing the effective date on the front.

We will not use or disclose your health information in a manner other than described in the section regarding “Examples of Disclosures” without your written authorization, which you may revoke, except to the extent that action has already been taken.

Examples of Disclosures:

We will use your health information to provide you with the correct equipment.
We may provide your medical information to healthcare providers, our company personnel, or third parties coordinating your care.
For example, Information provided by your physician will determine the proper equipment to offer you.
Under certain circumstances, we may coordinate a care plan with you and your physician.
We will use your health information for payment.
We may disclose your information so that we can collect or make payment for the medical equipment we provide you.
For example, Most insurances require us to have on file proof of the medical necessity for your equipment. They periodically request this from us before payment can be made.
We may disclose your health information for our routine operations. The uses are necessary for certain administrative, financial, legal, and quality improvement functions.

For Equipment Coverage

Sometimes your physician will only prescribe your equipment for short periods. After this time has passed, if you still have the equipment, we may use your information to contact you. When we make this contact, we may inform you of the length of need prescribed by your physician and discuss further accommodations.

As Required By Law

This may include reporting a crime, responding to a court order, or other legal proceedings necessary to comply with government regulations and civil laws.

Personal Representative

We may use or disclose information to your representative. (Person legally involved with making your health care decisions.)

To Avert a Serious Threat

We may disclose your information if we believe in good faith that it will prevent a serious threat to your safety. This can include abuse, neglect, domestic violence, or infectious diseases.

CMS Supplier Standards

1. A supplier must comply with all applicable Federal and State licensure and regulatory requirements and cannot contract with an individual or entity to provide licensed services.

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 inventory or contract with other companies to purchase items necessary to supply the demand. A supplier may not contract with any entity currently excluded from the Medicare program, state health care programs, or 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, honor all warranties under applicable State law, and repair or replace free of charge. Medicare-covered items that are under contract.

7. A supplier must maintain a physical facility on an appropriate site. This standard requires that the location is accessible to the public and staffed during posted hours of business. The area must be at least 200 square feet and contain space for storing records.

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 maintain a visible sign and posted hours of operation.

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

10. A supplier must have comprehensive liability insurance of at least $300,000 that covers the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its items, this insurance must 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 contacting a Medicare beneficiary based on a physician’s oral order unless an exception applies.

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

13. A supplier must answer questions, respond to beneficiaries’ complaints, 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 related 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 with any information required by the Medicare statute and implementing regulations.

22. All suppliers must be accredited by a CMS-approved accreditation organization to receive and retain a supplier billing number. The accreditation must indicate the specific products and services for which the supplier is certified for the supplier to accept payment for those particular 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 to bill Medicare.

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

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

27. A supplier must obtain oxygen from a state-licensed oxygen supplier.

28. A supplier must maintain ordering and referring documentation consistent with provisions found in 42 C.F.R. 424.516(f).

29. DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers.

30. DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions.

Rights and Responsibilities

OUR MISSION AND PURPOSE

It is to increase the comfort, freedom, and independence of those we serve. Satisfied customers are our highest priority; we will conduct our business with integrity and ethics. Responding to our customer’s needs, we will continue to provide products of the highest quality and keep up with the rapid technological changes. Our customer focus will guide our daily activities and distinguish us from other home medical equipment providers.

CUSTOMER RIGHTS – YOU HAVE THE RIGHT TO:

Be given timely, appropriate, and quality professional home care services without discrimination.
Be provided with suitable products and services as ordered by a qualified healthcare professional.
Receive products in proper operating condition according to the manufacturer’s specifications.
Receive fair treatment.
Request a detailed explanation of your bill for products and services.
Be communicated with in a way that you can reasonably understand.
Refuse equipment and services, accepting full responsibility for that refusal.
Choose your provider of home care services.
Be assured of confidentiality, review your records, and approve or refuse the release of records.
Have competent and qualified people carry out the services they are responsible for.
Voice your grievances and recommend changes without fear of reprisal.
Report concerns about patient safety without fear of reprisal.
Be given reasonable notice of discontinuation of service.

CUSTOMER RESPONSIBILITIES – IT IS YOUR RESPONSIBILITY:

Dial “911” whenever a life-threatening medical emergency arises.
Provide complete and accurate information regarding your medical history and billing information.
Comply with your physician’s orders and plan of care.
Use and care for the equipment provided and not allow use by anyone other than the authorized patient.
Contact us about equipment malfunction or defect, and let our staff correct the problem.
Please advise us of any changes in your status, including address, medical condition, and billing information.
Assume payment responsibility for services not covered by your insurance carrier, except when not allowed by law.
Maintain a safe home environment for the proper utilization of equipment.
To report,t to us any concerns about patient safety or occurrences of patient falls.
Pay for the replacement costs of any equipment damaged, destroyed, or lost due to misuse, abuse, or neglect.

MEDICARE SUPPLIER STANDARDS

Superior Respiratory & Medical, as a Medicare Provider, abides by and complies with all Supplier Standards set forth by CMS (The Center for Medicare and Medicaid Services). The supplier standards are available to view here.

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