Notice of Privacy Practices (HIPAA)

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Commitment to Privacy:

Appy Medical is dedicated to maintaining the privacy of your healthcare information and we are required by law to maintain the confidentiality of information that identifies you. Any use of healthcare information beyond the uses described below requires your individual written authorization. The Health Insurance Portability and Accountability Act (HIPAA) obligates Appy Medical to provide you with a copy of our Notice of Privacy Practices, outlining our privacy practices and how we safeguard your health information. Appy Medical abides by the terms of this Notice of Privacy Practices currently in effect and reserves the right to revise or amend this Notice of Privacy Practices, as needed. We also maintain a Privacy Policy regarding use of personal information obtained from your use of our website.

In this notice, when we use “your information” or “health information” we’re referring to information that identifies you and relates to your health or condition, your health care services, or payment for those services. It includes health information, like diagnosis and treatment plans. It also includes demographic information like your name, address, phone number and date of birth.

Your Health Information Rights and Appy Medical’s Responsibilities:

When it comes to your information and privacy, you have important rights under state and federal law. This section explains those rights. Ask us about them and we’ll explain the process:

Request a restriction on certain uses and disclosures of your information: You can ask us not to use or share certain health information for treatment, payment, or health care operations. We are not required to agree to your request, and we may decline if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or health care operations with your health insurer. We will approve unless a law requires us to share that information.

Obtain a paper copy of this notice of privacy practices: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Ask to inspect and/or receive a paper or electronic copy of health information we may have about you: We will provide a copy or summary of your health information, usually within 30 days of your request.

Obtain an accounting of disclosures of your health information: You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Request for confidential communication: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will approve all reasonable requests.

Ask us to amend health information about you that you think is incorrect or incomplete: We may decline your request, but we’ll tell you why in writing within 60 days.

Choose someone to act for you by submitting a written request: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights have been violated: You can report a complaint if you feel we have violated your rights by contacting us using the contact information provided below in this Notice of Privacy Practices. Appy Medical is a Board of Certification Accredited DMEPOS Medical Supplier. You have the right to file a complaint with this Medicare governing body. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/ hipaa/complaints/. We will not retaliate against you for filing a complaint. All rights requests must be submitted in writing to the contact information provided in this Notice of Privacy Practices.

Your Choices Regarding Your Health Information and Appy Medical’s Responsibilities: If you have a clear preference for how we share your information in the situations described below, let us know. Tell us what you want us to do, and we will follow your instructions.

In the following cases, you have the right and choice to tell us not to: Share information with your family, close friends, or others involved in your care. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In the following cases, we never share your information unless you give us written authorization:

Marketing purposes
Sale of your information

You have the right to revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Appy Medical does not: create or manage a hospital directory, conduct fundraising activities, and does not manage or create psychotherapy notes.

How We Use or Share Your Health Information: We typically use or share your health information in the following ways:

We will use your health information for treatment – Information obtained by our company will be documented in your healthcare record and will be used to provide you with durable medical equipment and supplies. The prescription that your physician has ordered will be part of the record and will determine the durable medical equipment and supplies that you receive.

We will use your health information for payment – Appy Medical will use or share your health information to bill and get payment from you, health plans, or other entities. The health information that identifies you, your diagnosis, and your durable medical equipment and supplies may be included on any bill or other communications regarding payment for services provided by Appy Medical.

Other Uses and Disclosures:

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. These purposes include, but are not limited to:

Public Health – We may use or share your health information to public health or legal authorities charged with preventing disease, helping with product recalls, reporting adverse reactions or events to medications or medical devices, reported suspected abuse, neglect or domestic violence, preventing or reducing a serious threat to anyone’s health or safety.

Health Oversight Activities – We may disclose health information to health oversight agencies for activities authorized by law, including surveys, audits, and compliance inspections. This includes the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Worker’s Compensation – We may release your health information to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

There are other times where Appy Medical may be allowed or required to share your information, for example, to law enforcement for purposes required by law. For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials- forconsumers/index.html

Appy Medical is required to:

Maintain the privacy and security of your protected health information.

Let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

Provide you with a copy of our Notice of Privacy Practices, which describes our legal duties and privacy practices with respect to health information we collect and maintain about you.

Not use or share your information other than as described herein unless you tell us we can in If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Appy Medical reserves the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will notify you and make available a revised Notice of Privacy Practices. We will not use or disclose your health information without your authorization, except for treatment, payment, and health care operations. Appy Medical also reserves the right to create a collection of information that is deidentified so that it does not contain unique personal identifiers and no longer can be linked to you.

For More Information or to Contact Appy Medical:

Please contact Appy Medical’s Privacy Officer if you require additional information or want to pursue your rights:

Privacy Officer
8789 South Redwood Road, Suite 250
West Jordan UT, 84088
info@appymedical.com

(801)-697-9437

Effective Date: June 1, 2023