Notice of Privacy Practices
Effective date: January 1, 2021 | Provider: Quantum Prosthetics & Orthotics
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.
Our pledge regarding your health information
Quantum Prosthetics & Orthotics is committed to protecting the privacy of your protected health information (PHI) — information that identifies you and relates to your past, present, or future health, care, or payment for care. We are required by law to keep your PHI private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
How we may use and disclose your health information
We may use and disclose your PHI, without your separate authorization, for the following purposes:
Treatment. To provide, coordinate, and manage your prosthetic and orthotic care — for example, sharing information with your physician, surgeon, or therapist involved in your care.
Payment. To bill and obtain payment from you, an insurer, Medicare/Medicaid, or another responsible party, including verifying coverage and obtaining prior authorization.
Health care operations. To support the business activities of our practice, such as quality review, staff training, accreditation, and care coordination.
Appointment reminders & care. To contact you about appointments, device fittings, follow-up, or treatment alternatives that may be of interest to you.
People involved in your care. With your agreement, to a family member, caregiver, or other person you identify as involved in your care or payment.
As required by law & for safety. When required by federal, state, or local law, and to public health or safety authorities to prevent a serious threat.
Business associates. To vendors who perform services for us and have signed a Business Associate Agreement requiring them to safeguard your PHI.
Uses and disclosures that require your written authorization
Most uses and disclosures of psychotherapy notes (if any), uses and disclosures for marketing, and any sale of PHI require your written authorization. Any other use or disclosure not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
Your rights regarding your health information
Inspect and copy your PHI in our records; request an amendment if you believe it is incorrect or incomplete; receive an accounting of certain disclosures we have made; request restrictions on certain uses and disclosures; request confidential communications (for example, that we contact you only at a certain phone number); and obtain a paper copy of this notice on request. To exercise any of these rights, contact our Privacy Officer in writing.
Our responsibilities
We are required to maintain the privacy of your PHI, notify affected individuals following a breach of unsecured PHI, abide by the terms of the notice currently in effect, and not use or disclose your information other than as described here without your authorization.
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for PHI we already have as well as information we receive in the future. The current notice will be posted at our clinics and on quantumpo.com, with its effective date.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.
Contact
Privacy Officer, Quantum Prosthetics & Orthotics — 9050 W 81st St, Ste 300, Justice, IL 60458 · 312.300.4472 · info@quantumpo.com.
This consumer website does not collect medical information; the consultation form requests contact details only.