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Notice of Privacy Practice

This Notice of Privacy Practices (“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.

Overview

Alpaca Audiology is part of the Sonova Audiological Care family (collectively, “AC US”, “we”, “our”, or “us”). At AC US, we strive to provide the best service to our patients. As partners in your health care, we are committed to maintaining the privacy and security of your health information and to informing you of your rights regarding such information.

This Notice describes our Privacy Practices, including how we may use and disclose health information for treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your right to access and control your protected health information. Protected health information generally includes information that we create or receive that identifies you and relates to your past, present or future health status or care or the provision of or payment for that care. Any hearing care professional authorized to enter information into your record, as well as all employees, staff and other members of our workforce, will follow the terms of this Notice.

Our Responsibilities Regarding your Health Information

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will provide you with notice if there is a breach of your unsecured protected health information for which we are aware.
  • We will not use or share your information other than as described in this Notice unless you tell us we can do so in writing.
  • We will abide by the terms of this Notice as of the effective date below.
  • We will offer you a copy of this Notice.

Please note, we reserve our right to change our Privacy Practices and the terms of this Notice in the future. As described at the end of this Notice, we will communicate any material change to our Notice and Privacy Practices.

How We Use or Disclose your Health Information

Without an Authorization. We may use or disclose your health information without an authorization for the following purposes:

For Treatment: We may use and/or disclose your protected health information, including hearing test findings, in order to ensure that you receive proper medical treatment. For example, we may share your protected health information with another physician or health care provider involved in your care. We may also contact you about treatment alternatives and options.

AC US may keep your information electronically using electronic medical record systems and other databases related to patient care. In some cases, you may be asked to give permission to allow the sharing of your health information between hearing professionals.

For Payment: We may use and/or disclose your protected health information to obtain payment for services that were provided to you. For example, we may share your protected health information with your health plan so it will pay us or reimburse you for your hearing care services. We may also contact your health plan about a treatment you may receive to determine whether your plan will pay part of the cost of your hearing care device.

For Health Care Operations: We may use and/or disclose your information for operational purposes. “Health care operations” are activities that are necessary to run our offices, maintain licensure, and to make sure that our visitors receive quality information on services and products. For example, we may:

  • need to discuss your health information with companies and individuals necessary to complete your requests for information about hearing care devices and for the purpose of consultation and recommendation;
  • contact you or your personal representative with a reminder postcard, email or telephone message that it is time for you to call our office and schedule an appointment; or
  • use your health information to communicate with you about treatment alternatives and other health-related benefits and services that may be of interest to you.

For Other Purposes: We may also use and/or disclose your health information without your written authorization for other purposes, as permitted or required by law. This includes:

  • Public Health Activities:  We are permitted to share your health information for certain purposes that have been determined to benefit the public as a whole. For example, we may disclose your information to the United States Food and Drug Administration, to a state or local health department, or to law enforcement agencies if the disclosure will prevent or control disease, or prevent serious threat to the health and safety of an individual or the public.
  • Health or Safety: We may disclose your health information to avert a serious threat to someone’s health or safety, including the disclosure of your health information to government or disaster relief or agencies to allow such agencies to carry out their responsibilities in response to specific disaster situations.
  • Judicial and Administrative Proceedings: We may disclose your health information pursuant to a court ordered subpoena or discovery request, or for law enforcement purposes as permitted by law once all administrative requirements and any applicable state law requirements have been met.
  • Government Functions: We may disclose your health information to various departments of the government such as the U.S. military, or the U.S. Department of State, as required by law.
  • Parents & Guardians: AC US may share a minor’s health information with his or her parents or guardians unless such disclosure is otherwise prohibited by law. For example, a minor’s parents may discuss medical treatment with his or her audiologist. Note, however, that if a minor is emancipated, married, pregnant or a parent, we may not be permitted to share information with the minor’s parents or guardians.
  • Workers’ Compensation: We may release your health information for workers’ compensation or similar programs that provide benefits for work related injuries or illness as required or permitted by law if you are injured at work.
  • Research: AC US and its other partners in the Sonova Group strive each day to develop the next generation of hearing technology. Research is an important part of that process. We may use or disclose your health information for such research purposes. For example, we may use or disclose your health information to:
    • Plan for research studies and determine whether such studies can be carried out or would be useful.
    • Identify and contact you regarding taking part in a specific research study. Your participation in the study can only start after you have been told about the study, are given a chance to ask questions and have shown your willingness to participate in the study by signing a consent form. If you prefer not to be contacted for research purposes, you can indicate this on your intake form, or contact AC US to be removed from this list.
    • Remove information that identifies you. Anonymized data may be shared for internal analysis.
    • Gather and analyze information that might be used to publish an article—although your identity or identifiable information about you will never be released in the article without your authorization.

All research projects for which AC US shares health information are carefully reviewed by an institutional review board or privacy board to protect the safety, welfare and confidentiality of AC US patients. If you have questions regarding the above, please contact privacy@sonova.com and specify the study you are taking part in or wish to take part in.

  • Business Associates: At times, we may provide your health information to outside vendors (business associates) that provide services to AC US. For example, we may provide your name, address, and other information to a company that helps us mail important health communications to you. These business associates are required to adhere to federal and state laws regarding the protection of your health information; they are also under contractual obligations with us to maintain the privacy and security of your health information.
  • To Work with a Coroner, Medical Examiner, or Funeral Director:  We  may share health information with a corner, medical examiner, or funeral director when an individual dies while in our care.
  • Compliance with Law: We may also use and/or disclose your health information, including to the Secretary of the U.S. Department of Health and Human Services, when required to investigate or determine our compliance with applicable laws.
  • To Parents and/or Legal Guardians of Minors: Unless otherwise prohibited by law, AC US may share a minor patient’s health information with their parents and/or legal guardian.

Your Choices for Certain Uses and Disclosures

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will make a good faith effort to follow your instructions. In these cases, you have both the right and choice to tell us to:

  • Share your Information with Individuals Involved in Your Care or Payment for Your Care. With your authorization, we may discuss your hearing care with family members, friends, or other individuals involved in your medical care or payment for that care. We encourage you to identify persons involved in your care that you wish information to be shared with.
  • Share your Information in a Disaster Relief Situation.
  • With Written Authorization: For situations not generally described in this Notice in the “without Authorization” section above, we will not use or disclose your health information without first obtaining your written authorization to do so. The form will describe what information will be disclosed, to whom, for what purpose, and when. These situations can include:
    • uses and disclosures for marketing purposes, including marketing communications paid for by third parties; and
    • disclosures that constitute a sale of health information.

You have the right to revoke your authorization, in writing, at any time, except to the extent we have taken action in reliance upon it. The revocation will only be effective after we receive it.

Your Rights in Connection with your Health information

You have the following rights regarding the health information we create, obtain, receive, and/or maintain about you. Any request to exercise your rights as described below should be made in writing and submitted to the appropriate Privacy Office (the “Privacy Office”).

If you have questions, you may contact the Privacy Office.

  • Get an electronic or paper copy of your medical record: You may ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
  • Ask us to correct or amend your medical record: You can ask us to correct or amend health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we will tell you why in writing, usually within 60 days of your request.
  • Request confidential communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
  • Ask us to limit what we use or share: You can ask us not to use or share certain health information for treatment, payment, or our operations. For example, if you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. You may also request a restriction on what health information we may disclose to someone who is involved in your care, such as a family member or friend. We are not required to agree to these requests. For example, we may say “no” if it would affect your care. Additionally, any restriction request that we may approve will not affect any use or disclosure that we are legally required or permitted to make under the law.
  • Obtain a list of those with whom we’ve shared your information: You can ask us for a list (accounting) of the instances we have shared your health information for six years prior to the date you ask, with whom we shared it, and why. We will include all the disclosures except for those related to treatment, payment, or healthcare operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting per year for free but may charge a reasonable, cost-based fee if you ask for another one within 12 months.
  • Get a copy of this Notice: You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will provide you with a paper copy promptly.
  • Choose someone to act for you: If you have given someone healthcare power of attorney or if someone is your legal guardian, they can exercise your rights and make choices about your health information. If someone has been appointed to act for you, a copy of the document appointing that person must be provided to us. We will make reasonable efforts to ensure the person has this authority and can act for you before we take any action.
  • File a complaint: You can file a complaint if you feel your rights have been violated. Additional information on how to file a complaint is provided below.

State Law

Some states provide additional privacy protections under state law. We are committed to complying with applicable laws when we use and/or disclose your medical information. 

Concerns and Complaints

Protecting your confidential information is important to us. If you have questions or feel we have violated your rights, please contact us using the information below:

Sonova Audiological Care
Attn: Compliance & Privacy Office
750 N Common Dr, Ste 200
Aurora, IL  60504
privacy@sonova.com  

For certain types of requests, you may be required to complete a form and mail it to us; we will make this form available to you.

Contact a Government Agency: If you believe we have violated your privacy rights, you may also file a complaint with the Office for Civil Rights of the United States Department of Health and Human Services (“OCR”). Your complaint can be sent by email, fax, or mail. For more information, go to the OCR website.

We will not retaliate against you or end our services to you if you file a complaint with us or OCR.

WE MAY MAKE CHANGES TO THIS NOTICE IN THE FUTURE, AND ANY OF THE TERMS OF THIS NOTICE THAT ARE CHANGED WILL APPLY TO ALL OF YOUR HEALTH INFORMATION. IF WE MAKE A MATERIAL CHANGE TO OUR NOTICE, YOU MAY OBTAIN A COPY OF THE REVISED NOTICE AT YOUR LOCAL AC US CLINIC, ON OUR WEB SITE, OR UPON REQUEST TO THE AC US PRIVACY OFFICE AS DESCRIBED ABOVE.

Effective Date: This Notice is effective as of September 20, 2013, and updated as of May 8, 2024.

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