Notice of Privacy Practices
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. If you have any questions about this notice or matters covered by this notice, please contact our Privacy Compliance Officer at 1-877-902-9726 ext. 62016.

About this Notice
Byram Healthcare Centers, Inc. is required by law to maintain the privacy of your health information, to provide you with a notice of its legal duties and privacy practices, and to follow the information practices that are described in this notice.

This notice explains how your health information may be used and disclosed.  You have a right to request and receive a paper copy of this notice.  Byram Healthcare Centers, Inc. will not use or disclose your health information except as described in this notice.  

This notice applies to all the health information obtained by Byram Healthcare Centers, Inc. and kept in your patient file. 

Understanding Your Health Record and Personal Health Information
Each time you or someone else on your behalf, orders supplies from us, a medical record is made.  Typically, this record contains a list of your supplies, a prescription for your supplies, your name, address, phone number, date of birth, social security number, insurance information, evaluations, test results, diagnoses, and prognoses. This information, often referred to as your health or medical record, serves as a:
• Basis for planning your care and treatment
• Means of communication among health professionals contributing to
   your care
• Legal document describing the services you received
• Means to verify services billed were actually ordered and provided
• Source of information for public health officials
• Source of data for facility planning and marketing
• Tool to assess the service we render and the outcomes we achieve

Treatment
We may use health information about you to provide you with medical treatment (supplies or services).  We may disclose health information about you to doctors, nurses, technicians, office staff, or other personnel who are involved in your care or health care decisions.

For example: Information provided by your physician or other member of your health care team will be recorded in your record and used to determine the supplies or services that should work best for you. We may provide your physician or a subsequent health care provider with copies of protected health information that should assist him or her in making decisions regarding your care.

Payment
We may use and disclose health information about you so that the supplies and/or services you receive from this center may be billed to and payment may be collected from you, an insurance company or a third party.

For example: A bill may be sent to you or a third-party payer.  The bill may include information that identifies you, your diagnosis, procedures, and supplies used.

Health Operations
We may use and disclose health information about you in order to run our business and make sure that you and our other customers receive quality care. We also may contact you as part of our efforts to assess and continually work to improve the services we render and the outcomes we achieve.

For example: We may use your information to conduct cost-management and business planning activities for our company. We may contact you to assure the quality of our service, to verify your order, to inform you of any issues relating to your order or services requested, confirm receipt & delivery of supplies, to remind you of the need to re-order supplies, and communicate potential product recalls.

We routinely make out-bound calls to coordinate service to customers.

Other Uses and Disclosures
We also may use and disclose your health information without your consent to meet special reporting requirements to facilitate continuity of care or for other purposes. Such uses and disclosures include:
• Family and friends who are involved in your medical care.
• Business Associates of ours, with whom we contract for services.
  (Examples include: consultants, accountants, lawyers, entities that ship
   orders on our behalf,   custom fitting manufacturers, and third-party
   billing companies.) We require these Business Associates to protect
   the confidentiality of your health information.
• The Food and Drug Administration, such as to report adverse events.
• Data for health oversight activities, such as auditing and licensing.
• Reports on communicable diseases.
• Reports to employers for work-related illness or injuries.
• Reports on abuse, neglect, or domestic violence.
• To avert a serious threat to public health or safety, or to prevent
   serious harm to an individual.
• As required by law, such as for law enforcement or in response to
   a subpoena or court order.
• Coroners and medical examiners, as necessary, to carry out their duties.
• Organ procurement organizations, to the extent allowed by law.
• Research projects that are subject to a special approval process.
   Your permission is required if the
  researcher will have access to information that reveals who you are.
• Specialized government functions; for example, as required by military
   authorities.
• Workers compensation
• Marketing.  We may provide you with information about product
   alternatives or other services that
  may be of interest to you.
• If you are an inmate, your health information may be released to the
   correctional facility or agents.

All other uses and disclosures will be made only with your written authorization, which you have the right in most cases to revoke.

Special Authorizations
There are federal and state laws that provide special protection for certain kinds of personal health information, such as information about sexually transmitted and other communicable diseases, drug and alcohol abuse, and certain mental health services.  These laws may require specific authorizations from you to disclose this information.  In such cases, to comply with these laws, we will contact you to request the necessary authorizations.

Your Rights
You have individual rights over the use and disclosure of your personal health information, including the rights listed below. You may exercise any of these rights by submitting your request in writing.  Please contact your Customer Service Center (for the address and phone number of the center nearest you please call 1-877-902-9726) to obtain the applicable request form. We will evaluate each request and communicate to you in writing whether or not we can honor the request.  We may also charge a reasonable fee for cost associated with your request. We will notify in advance of the cost, and you may withdraw your request before you incur any cost.

Restrict use
You may request, in writing, restrictions on certain uses and disclosures of your information.  We will consider your request but are not legally required to accept it.  After careful review of your request, we will notify you of our determination in writing.

Receive confidential communications
You have the right to receive confidential communications by alternative means or at alternative locations.  This includes an alternative mailing address, e-mail address, or telephone number.

Inspect and copy
In most cases, you have the right to request in writing access to, or a copy of, your health information.

Request corrections
You have the right to request in writing that we correct information in your record that you believe is incorrect or add information that you believe is missing.

Know about disclosures
You have the right to an accounting of instances where we have disclosed your personal health information for purposes other than for treatment, payment, healthcare operations, or that you specifically authorized.  Your request must be made in writing and may be for disclosures made up to 6 years before the date of your request, but not for disclosures made before April 14, 2003.

File complaints
If you are concerned that we have violated your privacy or disagree with a decision we made about access to your record, you may file a written complaint with our Privacy Officer at the address below:
Byram Healthcare
Attn: Privacy Compliance Officer
120 Bloomingdale Road, Suite 301
White Plains, NY 10605

For more information on how to file a written complaint, call our Privacy Compliance Officer at 1-877-902-9726 ext. 62016 or e-mail: jgiandur@byramhealthcare.com. You also may file a written complaint with the Secretary of the U.S. Department of Health and Human Services. You will not be penalized nor retaliated against if you file a complaint.

Changes to this Notice
This notice is effective as of April 14, 2003.  We may change the terms of our notice at anytime.  The new notice will be effective for all personal health information that we maintain. The revised notice will be posted at our places of service and on our Web site at www.byramhealthcare.com.  To request a copy of the current notice call our Privacy Officer at 1-877-902-9726 ext. 62016.

Revised: November 20, 2008