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Dear Next Step Physical Therapy, LLC and Mynumi
Group, LLC Health Insurance Customer:
This is your Health Information Privacy
Notice from Next Step Physical Therapy, LLC .
Please read it carefully. Mynumi Group, LLC and each member
of the Mynumi Group, LLC family of companies (an "Affiliate")
strongly believe in protecting the confidentiality and security
of information we collect about you. This notice refers to
Mynumi Group, LLC by using the terms "us," "we," or "our."
This notice describes how we protect the
personal health information we have about you which relates to
your Mynumi Group, LLC Health insurance coverage ("Personal Health Information"),
and how we may use and disclose this information. Personal
Health Information includes individually identifiable information
which relates to your past, present or future health, treatment
or payment for health care services. This notice also describes
your rights with respect to the Personal Health Information
and how you can exercise those rights.
We are required to provide this Notice
to you by the Health Insurance Portability and Accountability
Act ("HIPAA").
For additional information regarding our HIPAA Medical Information
Privacy Policy or our general privacy policies, please see
the privacy notices contained at our website, www.Mynumi Group,
LLC.com. You may submit questions to us there or you may write
to us directly at Mynumi Group, LLC, Institutional Business
HIPAA Privacy Office, P.O. Box 6896 Bridgewater, NJ 08807-6896.
We are required by law to maintain the privacy
of your Personal Health Information; provide you this notice
of our legal duties and privacy practices with respect to your
Personal Health Information; and follow the terms of this notice.
We protect your Personal Health Information from inappropriate
use or disclosure. Our employees, and those of companies that
help us service your Mynumi Group, LLC Health Insurance, are
required to comply with our requirements that protect the confidentiality
of Personal Health Information. They may look at your Personal
Health Information only when there is an appropriate reason to
do so, such as to administer our products or services.
We will not disclose your Personal Health Information to any
other company for their use in marketing their products to
you. However, as described below, we will use and disclose
Personal Health Information about you for business purposes
relating to your Health Insurance coverage.
The main reasons for which we may use and may disclose your
Personal Health Information are to evaluate and process any
requests for coverage and claims for benefits you may make
or in connection with other health-related benefits or services
that may be of interest to you. The following describe these
and other uses and disclosures, together with some examples.
For Payment: We may use and disclose Personal Health Information
to pay for benefits under your Health Insurance coverage. For
example, we may review Personal Health Information contained
on claims to reimburse providers for services rendered. We
may also disclose Personal Health Information to other insurance
carriers to coordinate benefits with respect to a particular
claim. Additionally, we may disclose Personal Health Information
to a health plan or an administrator of an employee welfare
benefit plan for various payment-related functions, such as
eligibility determination, audit and review or to assist you
with your inquiries or disputes.
We may also use and disclose Personal Health Information for
our insurance operations. These purposes include evaluating
a request for Health Insurance products or services, administering
those products or services, and processing transactions requested
by you. We may also disclose Personal Health Information to
Affiliates, and to business associates outside of the Mynumi
Group, LLC family of companies, if they need to receive Personal
Health Information to provide a service to us and will agree
to abide by specific HIPAA rules relating to the protection
of Personal Health Information. Examples of business associates
are: billing companies, data processing companies, or companies
that provide general administrative services. Personal Health
Information may be disclosed to reinsurers for underwriting,
audit or claim review reasons. Personal Health Information
may also be disclosed as part of a potential merger or acquisition
involving our business in order to make an informed business
decision regarding any such prospective transaction.
We disclose Personal Health Information when required by federal,
state or local law. Examples of such mandatory disclosures
include notifying state or local health authorities regarding
particular communicable diseases, or providing Personal Health
Information to a governmental agency or regulator with health
care oversight responsibilities. We may also release Personal
Health Information to a coroner or medical examiner to assist
in identifying a deceased individual or to determine the
cause of death.
We may disclose Personal Health Information
to avert a serious threat to someone’s health or safety.
We may also disclose Personal Health Information to federal,
state or local agencies engaged in disaster relief as well as
to private disaster relief or disaster assistance agencies to
allow such entities to carry out their responsibilities in specific
disaster situations.
We may use Personal Health Information to provide you with
information about benefits available to you under your current
coverage or policy and, in limited situations, about health-related
products or services that may be of interest to you.
We may disclose Personal Health Information in
response to a request by a law enforcement official made through
a court order, subpoena, warrant, summons or similar process. We
may disclose Personal Health Information about you to federal
officials for intelligence, counterintelligence, and other
national security activities authorized by law.
If you or your estate are involved in a lawsuit
or a dispute, we may disclose Personal Health Information about
you in response to a court or administrative order. We may also
disclose Personal Health Information about you in response
to a subpoena, discovery request, or other lawful process
by someone else involved in the dispute, but only if efforts
have been made to tell you about the request or to obtain
an order protecting the Personal Health Information requested.
We may disclose Personal Health Information to any governmental
agency or regulator with whom you have filed a complaint
or as part of a regulatory agency examination.
Other uses and disclosures of Personal Health
Information not covered by this notice and permitted by the laws
that apply to us will be made only with your written authorization
or that of your legal representative. If we are authorized to
use or disclose Personal Health Information about you, you
or your legally authorized representative may revoke that
authorization, in writing, at any time, except to the extent
that we have taken action relying on the authorization or
if the authorization was obtained as a condition of obtaining
your Health Insurance coverage. You should understand that
we will not be able to take back any disclosures we have
already made with authorization.
The following are your various rights as a consumer under
HIPAA concerning your Personal Health Information. Should you
have questions about a specific right, please write to the
administrator of your Health Insurance coverage as follows:
Right to Inspect and Copy Your Personal Health Information:
In most cases, you have the right to inspect and obtain a copy
of the Personal Health Information that we maintain about
you. To inspect and copy Personal Health Information, you
must submit your request in writing to the applicable administrator
listed above. To receive a copy of your Personal Health Information,
you may be charged a fee for the costs of copying, mailing
or other supplies associated with your request. However,
certain types of Personal Health Information will not be
made available for inspection and copying. This includes
psychotherapy notes; and also includes Personal Health Information
collected by us in connection with, or in reasonable anticipation
of any claim or legal proceeding. In very limited circumstances
we may deny your request to inspect and obtain a copy of
your Personal Health Information. If we do, you may request
that the denial be reviewed. The review will be conducted
by an individual chosen by us who was not involved in the
original decision to deny your request. We will comply with
the outcome of that review.
If you believe that your Personal Health Information
is incorrect or that an important part of it is missing, you have
the right to ask us to amend your Personal Health Information
while it is kept by or for us. You must provide your request
and your reason for the request in writing, and submit it
to the applicable administrator listed above. We may deny
your request if it is not in writing or does not include
a reason that supports the request.
In addition, we may deny your request if you ask us to amend
Personal Health Information that: is accurate and complete;
was not created by us, unless the person or entity that created
the Personal Health Information is no longer available to make
the amendment; is not part of the Personal Health Information
kept by or for us; or is not part of the Personal Health Information
which you would be permitted to inspect and copy.
You have the right to request a list of the disclosures we
have made of Personal Health Information about you. This list
will not include disclosures made for treatment, payment, health
care operations, for purposes of national security, made to
law enforcement or to corrections personnel or made pursuant
to your authorization or made directly to you. To request this
list, you must submit your request in writing to the applicable
administrator listed above. Your request must state the time
period from which you want to receive a list of disclosures.
The time period may not be longer than six years and may not
include dates before February 26, 2003. Your request should
indicate in what form you want the list (for example, on paper
or electronically). The first list you request within a 12-month
period will be free. We may charge you for responding to any
additional requests. We will notify you of the cost involved
and you may choose to withdraw or modify your request at that
time before any costs are incurred.
You have the right to request a restriction or
limitation on Personal Health Information we use or disclose about
you for treatment, payment or health care operations, or that
we disclose to someone who may be involved in your care or
payment for your care, like a family member or friend. While
we will consider your request, we are not required to agree
to it. If we do agree to it, we will comply with your request.
To request a restriction, you must make your request in writing
to the applicable administrator listed above. In your request,
you must tell us (1) what information you want to limit;
(2) whether you want to limit our use, disclosure or both;
and (3) to whom you want the limits to apply (for example,
disclosures to your spouse or parent). We will not agree
to restrictions on Personal Health Information uses or disclosures
that are legally required, or which are necessary to administer
our business.
You have the right to request that we communicate with you
about Personal Health Information in a certain way or at a
certain location if you tell us that communication in another
manner may endanger you. For example, you can ask that we only
contact you at work or by mail. To request confidential communications,
you must make your request in writing to the applicable administrator
listed above and specify how or where you wish to be contacted.
We will accommodate all reasonable requests.
Changes to This Notice: We reserve the right to change the
terms of this notice at any time. We reserve the right to make
the revised or changed notice effective for Personal Health
Information we already have about you as well as any Personal
Health Information we receive in the future. The effective
date of this notice and any revised or changed notice may be
found on the last page, on the bottom right hand corner of
the notice. You will receive a copy of any revised notice from
Mynumi Group, LLC by mail or by e-mail, but only if e-mail
delivery is offered by Mynumi Group, LLC and you agree to such
delivery.
You may have additional rights under other applicable laws.
For additional information regarding our HIPAA Medical Information
Privacy Policy or our general privacy policies, please contact
us at info@mynumi.com or write to us.
If you have questions relating to your current coverage, please
contact the administrator of your Health Insurance coverage
listed above.
For questions regarding any of our Privacy Policies
please contact us at our offices during normal busienss hours.
 
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