Privacy Policy

Medical Billing & Financial Services, Ltd. (hereafter referred to as “MBFS”) provides medical billing services to various medical providers and health care facilities. State and Federal laws and regulations require MBFS to safeguard the privacy of your individually identifiable health information or protected health information (“PHI”). This Notice will provide you with information regarding its privacy practices. This Notice applies to all of your protected health information created and/or maintained by MBFS, including any information that we receive from other health care providers or facilities. This Notice describes the ways in which MBFS may use or disclose your protected health information. It also describes your rights and our obligations concerning such uses or disclosures.

Protected health information is information that MBFS obtains or creates concerning your medical treatment for billing purposes. This may include information concerning your symptoms, examinations, test results, diagnoses, treatment, and plans for future care and treatment. It also includes billing documents that we generate in order to bill for the professional services provided to you.

Many of MBFS’ medical provider clients participate in Organized Health Care Arrangements at the hospitals or facilities where they practice. Organized Health Care Arrangements are made up of the various physicians and other health care providers who provide you with medical care and treatment while you are at the hospital.

Each of the Organization Health Care Arrangements maintains a Joint Notice of Privacy Practices, which is similar to MBFS’ Notice of Privacy Practices. The Joint Notice of Privacy Practices describes the ways in which the members of the Organized Health Care Arrangement may use or disclose your protected health information, and it describes your rights with respect to that information. Absent an emergent situation, a hospital or facility staff member will provide you or your personal representative with a copy of the Joint Notice of Privacy Practices at the time of registration.

MBFS will abide by the terms of this Notice of Privacy Practices and any Joint Notice of Privacy Practices that is in effect at the hospital or facility where you received medical care and treatment. We reserve the right to change the terms of our Notice of Privacy Practices and to make the revised Notice effective for health information we already have about you as well as information we may receive in the future. We will maintain a copy of our current Notice of Privacy Practices, with its effective date, on our website at www.mbfsonline.com. You may also receive a copy of our Notice of Privacy Practices by mailing a request to our Privacy Officer to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION

Your Authorization. Except as outlined below, MBFS will not use or disclose your protected health information for any purpose unless you have signed a form authorizing the use or disclosure. A HIPAA compliant Authorization is available on the form section of the MBFS website. You have the right to revoke the authorization in writing, unless we have already taken action in reliance on the authorization. To revoke a current authorization on file at MBFS, you should write to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

Uses and Disclosures for Treatment. Covered entities, i.e. Health Plans, Health Care Providers and Health Care Clearing Houses (such as MBFS), are permitted to make uses and disclosures of your protected health information as necessary for your treatment. For instance, doctors, nurses and other health care professionals involved in your care will use information in your medical record and information that you provide about your symptoms to plan a course of treatment for you that may include procedures, medications, lab tests, x-rays, etc. MBFS may also release your protected health information to another health care facility, or to a professional who is not a member of our group, or affiliated in the local Organized Health Care Arrangement but who is or will be providing treatment to you. For instance, your personal physician or a subsequent health care provider may receive information from us in order to assist him or her in treating you once you are discharged from the Emergency Department and/or hospital.

Uses and Disclosures for Payment. MBFS is permitted to make uses and disclosures of your protected health information as necessary for MBFS to process your medical bill and receive payment for the professional service provided to you. MBFS may seek payment from you, an insurance company, or another third party for the health care services you received. For instance, an MBFS representative may forward information regarding your medical treatment to your insurance company to arrange payment for the services provided to you, or may use your information to prepare a bill to send to you or the personal responsible for your payment. This includes information concerning a diagnosis of alcoholism, drug abuse, Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC), or testing for Human Immunodeficiency Virus (HIV).

Uses and Disclosures for Healthcare Operations. MBFS may use and disclose your protected health information as necessary, and as permitted and/or limited by law, for its own health care operations, which includes, but is not limited to, clinical improvement, professional peer review, business management, accreditation and licensing, and other means. For instance, MBFS may use or disclose your protected health information for purposes of improving the clinical treatment and care of patients. If MBFS participates in an Organized Health Care Arrangement at the hospital or facility where you received medical care from us, MBFS may also disclose your protected health information to other members of the Organized Health Care Arrangement for such things as quality assurance and case management, but only if that hospital or facility also has or had a patient relationship with you.

Family and Friends Involved in Your Care. As permitted or limited by law, MBFS may from time to time disclose your protected health information to designated family, friends, and others who are involved in your care or payment for you care. This is to help these individuals care for you or make payments for your care. If you are unavailable, incapacitated or facing an emergency medical situation, MBFS may determine that a limited disclosure is in your best interest. In this case, MBFS may share limited protected health information with such individuals without your approval or consent. MBFS is also permitted to disclose limited protected health information to a public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other persons that may be involved in some aspect of caring for you.

Business Associates. Certain aspects of the billing services provided to our health care provider clients may be performed through contracts with outside persons or organizations. These include electronic billing, auditing, legal and other services. At times, it may be necessary for us to provide your protected health information to one or more of these outside persons or organizations. In all cases, we require these business associates to contract with us and promise us that they have appropriate safeguards in place to protect the privacy of your protected health information.

Other Uses and Disclosures. Covered entities, such as MBFS, are also permitted or required by law to make the following uses and disclosures of your protected health information without your prior consent or authorization:

For any purpose that is required by law.
For public health oversight activities, such as required reporting of disease, injury, birth and death, and for required public health investigation. To the Food and Drug Administration if necessary to report adverse events, product defects, or to participate in product recalls. To your employer when the health care provider has provided medical treatment to you at the request of your employer, in most cases you will receive notice that information is disclosed to your employer. If required by law, to a government oversight agency conducting audits, investigations, or civil or criminal proceedings. If required to do so by a court or administrative order, subpoena or discovery request; in most cases, you will have notice of such release. To law enforcement officials as required by law to report wounds, injuries and crimes. To coroners and/or funeral directors consistent with law. If necessary to arrange an organ or tissue donation from you or a transplant for you. For certain research purposes when such research is approved by an institutional review board with established rules to ensure privacy. If you are a member of the military as required by armed forces services. To others who have also provided care to you. To workers’ compensation agencies if necessary for your workers’ compensation benefit determination.

RIGHTS THAT YOU HAVE

Access to Your Protected Health Information. You have the right to copy or inspect much of the protected health information that is generated when you were provided medical care and treatment. As a medical billing company, MBFS only is has billing records and statements. All requests for access to MBFS records must be made in writing and signed by you or your representative. Because MBFS’ medical provider clients practice within hospitals and other health care facilities, treatment records, test results, and other medical records are maintained by the particular facility where you were treated. Therefore, any Request to Access treatment records should be mailed to both the Medical Records Department at the facility where you received treatment AND to MBFS’ Privacy Officer. Note that requests for MBFS’ billing records should be directed to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

Please be aware that MBFS is permitted by law to charge you a specific amount per page if you request a copy of this information from us. You may also be charged for postage if you request a mailed copy. These charges will be consistent with applicable state laws. We may also charge for preparing a summary of the requested information if you request such a summary.

Amendment to Your Protected Health Information. You have the right to request that the protected health information that MBFS generated and/or maintains about you be amended or corrected. MBFS is not obligated to make requested amendments, but we will give each request careful consideration. All amendment requests must be in writing, signed by you or your personal representative, and must state the detailed reason(s) for the amendment/correction request. If an amendment or correction is accepted, MBFS may also notify others who work with us and have copies of the uncorrected record if we believe such notification is necessary. Your request for an Amendment must be mailed to the Medical Records Department at the hospital or facility where you received treatment AND to Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

Account for Disclosure of Protected Health Information. You have the right to receive an accounting of certain disclosures of your protected health information that were made by MBFS after April 14, 2003. This does not include any disclosures of your protected health information that we made pursuant to legal requirements or for purposes of treatment, payment or our health care operations. Requests must be made in writing and signed by you or your personal representative. The first accounting in any 12-month period is free. You may be charged a fee for each subsequent accounting you request within the same 12-month period. Your Request for an Accounting must be sent to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

Restrictions on Use and Disclosure of Your Protected Health Information. You have the right to request restrictions on certain uses and disclosures of your protected health information for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your restriction request, but we will attempt to accommodate reasonable requests when appropriate. We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by MBFS, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to-restriction that we have not already relied upon. Your Request for a Restriction must be made in writing by you or your personal representative and sent to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

Requests to Receive Confidential Communications by Other Means or at Another Location. You have the right to request that we communicate with you or you personal representative regarding your protected health information by alternative means or at another location other than your primary residence. We will not request an explanation from you concerning the reason for your request. For instance, if you would like us to use a different address from the address you provided at the time you registered for treatment, we will accommodate reasonable requests. You must request such confidential communications in writing and send your request to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718.

Complaints. If you believe that your privacy rights have been violated, you can file a complaint in writing with us. It must be sent to: Medical Billing & Financial Services, Ltd., Attention: Privacy Officer, 4535 Dressler Road NW, Canton, Ohio 44718. You may also file a complaint with the Secretary of the United States Department of Health and Human Services in Washington, DC in writing within 180 days of suspected violation of your rights. There will be no retaliation for filing a complaint.

FOR FURTHER INFORMATION

If you have questions or need further assistance regarding this Notice, you may contact the office of MBFS’ Privacy Officer at 330-493-4443 or via facsimile at 330-491-4089. As a patient, you retain the right to obtain a paper copy of this Notice of Privacy Practices, even if you have requested such a copy by e-mail or other electronic means.

EFFECTIVE DATE

This Notice of Privacy Practices is effective April 14, 2003. Revised December 17, 2008