Notice of Privacy Practices

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Right to Inspect and Copy
You have the right to inspect, request a summary, and obtain a copy of your medical information about you or your care. To inspect and obtain a copy of medical information about you or your care, you must submit your request in writing to: Rotech’s Privacy Officer, Attn: Compliance Department, 6251 Chancellor Drive, Suite 119, Orlando, Florida 32809 or corporate@rotech.com. To obtain the request form, contact the Compliance Department at (877) 603-7840. If you request a physical copy of the information, we may charge a reasonable, cost-based fee for copying, mailing, and using office supplies in connection with your request. If you request an electronic copy of your medical information, our fee will not exceed our labor costs in responding to your request for the electronic copy (or summary or explanation), the costs of the electronic media (such as a CD or zip drive), and postage, if mailed. We may deny your request to inspect and obtain a copy under limited circumstances only. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by us will review your request and the denial. The person conducting the review will not be the same person who denied your request. We will comply with the outcome of the review.

Right to Amend
If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for us. To request an amendment, your request must be made in writing and submitted to: Rotech’s Privacy Officer, Attn: Compliance Department, 6251 Chancellor Drive, Suite 119, Orlando, Florida 32809 or corporate@rotech.com. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may also deny your request if you ask us to amend information (i) that was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (ii) is not part of the medical information kept by or for us; (iii) is not part of the information which you would be permitted to inspect and copy; or (iv) is accurate and complete. If we deny your request to amend, we will tell you why in writing within 60 days.

Right to an Accounting of Disclosures
You have the right to request an accounting of disclosures. This accounting is a list of the disclosures we made of medical information about you and will detail who we shared such information with and why. This list will not include disclosures made for treatment, payment, or Rotech’s health care operations; disclosures that you have previously authorized us to make; or other disclosures specifically exempted from the disclosure accounting requirements by the federal government. To request this list or accounting of disclosures, you must submit your request in writing to: Rotech’s Privacy Officer, Attn: Compliance Department, 6251 Chancellor Drive, Suite 119, Orlando, Florida 32809 or corporate@rotech.com. Your request must state a timeframe, which may not be longer than 6 years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list, such as on paper or electronically. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the reasonable costs of providing the list. 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.

Right to Request Restrictions
You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. However, we are not required to agree to your request, and we may deny your request if it would affect your care. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request unless the disclosure is to a health plan for a payment or health care operation purpose and the medical information relates solely to a health care item or service for which we have been paid out-of-pocket in full. If we do agree, we will comply with your request unless the information is necessary to provide you emergency treatment. To request restrictions, you must make your request in writing to: Rotech’s Privacy Officer, Attention: Compliance Department, 6251 Chancellor Drive, Suite 119, Orlando, Florida 32809 or corporate@rotech.com. 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.

Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. 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: Rotech’s Privacy Officer, Attention: Compliance Department, 6251 Chancellor Drive, Suite 119, Orlando, Florida 32809 or corporate@rotech.com. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to receive a paper copy. You may obtain a copy of this notice at our website www.rotech.com. To request a paper copy of this notice, submit a request in writing to: Rotech’s Privacy Officer, Attn: Compliance Department, 6251 Chancellor Drive, Suite 119, Orlando, Florida 32809 or corporate@rotech.com.

Right to Choose Someone to Act on Your Behalf
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.