Notice of Privacy Policy

This notice describes how medical information about you may be used and disclosed and how you can have access to this information. Active Medical & Mobility, Inc. recognizes the need to protect and respect the privacy of your personal and health information. However, to provide you with the equipment and services requested for you, we must obtain and maintain health and personal information as part of your medical records. We must also be able to pursue payment from those parties who are responsible for payment of the equipment and services provided to you.

Active Medical & Mobility, Inc. acknowledges their responsibility to protect your health information against deliberate or inadvertent misuse or disclosure. We will take every precaution to protect your privacy. During their initial orientation, during periodic staff meetings, and annually thereafter, Active Medical & Mobility, Inc. personnel are instructed and held accountable to uphold the confidentiality of patient information and records as follows:

  • All patient information is considered confidential and access to medical records is on a need-to-know basis only.
  • Unnecessary conversation or communication relative to confidential patient information is prohibited.

If you believe your rights have been violated, you may file a written complaint with Lorraine Buckner at Active Medical & Mobility, Inc. You may also contact Lorraine Buckner the Medical Records Custodian at (321) 225-8960. As a result of filing a complaint, there will be no retaliation or retribution. You may also file a complaint with the Department of Health and Human Services, Office of Civil Rights.

You also have the right to obtain a clear written explanation of how Active Medical & Mobility, Inc. will use, store, and disclose medical record information. Additional rights are listed as follows:

  • The right to request restrictions of disclosure of your health information.
  • The right to see a copy of your health records.
  • The right to request a correction and/or amendment of your health records.
  • The right to obtain documentation of disclosures of your health information for reasons other than claim payment, internal operations, quality review and medical treatment.
  • The right to request confidential communication of protected health information.

Your Rights as a Patient of Active Medical & Mobility

In accordance with HIPAA you have the following rights in relation to your protected health information.

  1. You may request, in writing, additional restrictions to the use or disclosure of your protected health information; however, Active Medical & Mobility is not required to agree to the request for restrictions.
  2. You have the right to request amendments to your medical record.
  3. You have the right to obtain a copy of this Notice of Uses.
  4. You have the right of access to inspect and obtain a copy of your medical record, subject to certain limitations.
  5. You have the right to obtain an accounting of disclosures of your medical record for purposes other than treatment, payment and healthcare operations.
  6. You have the right to request communications of your medical record by alternative means (i.e. electronically) or at alternative locations.
  7. You have the right to revoke authorization to use or disclose your protected health information except to the extent that action has already occurred.

Responsibilities of Active Medical & Mobility

In accordance with HIPAA, Active Medical & Mobility is required to:

  1. Maintain the confidentiality of your protected health information. Your state laws may provide more protection than the federal laws and, in that case, we will abide by the more restrictive statute.
  2. Provide you with the notice of our legal obligations and privacy practices regarding information it may accumulate about you and is obligated to abide by the terms of this notice.
  3. Notify you if it is unable to agree to a requested restriction, and make every effort to accommodate reasonable requests for communication of health information by alternative means.
  4. Post its Notice of Uses on its website at __________________________.
  5. Please be advised that in addition to these responsibilities, Active Medical & Mobility reserves the right to change the terms of its Notice of Uses and make those changes applicable to all protected health information maintained at that time. If there is a change to its Notice of Uses, it will provide you with a revised notice to the most recent address you have supplied to Active Medical & Mobility.

Active Medical & Mobility will not use or disclose your protected health information without your authorization, except as described in this notice.

For More Information or to Report a Problem

If you have questions, would like additional information or, if you suspect misuse of your protected health information and believe that your rights have been violated, you may, without fear of retaliation, contact:

The Office of Civil Rights

U.S. Department of Health & Human Services
200 Independence Avenue
Room 509F HHH Building
Washington D.C., 20201
Phone: 1 (800) 368-1019

Active Medical & Mobility

3554 S Hopkins Ave, Suite B
Titusville, FL 32780
Phone: (321) 225-8960