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MaximaCare LLC
3740 N. Josey Lane #100A
Carrollton, TX 75007
Tel: (972) 471-1111
Fax: (972) 692-6936

Branch Office:
MaximaCare LLC
1211 East Sixth St., #200
Bonham, TX 75418
Tel: (903) 640-9000
Fax: (903) 640-9001

Medicare Certified
Home Disclaimer


The contents of this web site are provided for informational purposes only. Nothing contained in this web site is intended, or should be construed, as an endorsement or recommendation of any unrelated organization, society or any entity, which may be referenced in this site. Further, nothing is intended to furnish medical advice and opinions on diagnosis, treatment or care of an individual patient and/or a condition, all of which should be discussed with and obtained by consulting a physician.
We accept patients for care regardless of age, race, color, national origin, religion, sex, disability, being a qualified disabled veteran, or any other category protected by law, or decisions regarding advanced directives.

A. OUR COMMITMENT TO YOUR PRIVACY
Our organization is dedicated to maintaining the privacy of your identifiable health information. In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We are also required by law to provide you with this notice of our legal duties and privacy practices concerning your identifiable health information. By law, we must follow the terms of the notice of privacy practices that we have in effect at the time.
To summarize, this notice provides you with the following important information:
  • How we may use and disclose your identifiable health information.
  • Your privacy rights in your identifiable information.
  • Our obligations concerning the use and disclosure of your identifiable health information.
The terms of this notice apply to all records containing your identifiable health information that are created or retained by our agency. We reserve the right to revise or amend our notice of privacy practices. Any revision or amendment to this notice will be effective for all your records our organization has created or maintained in the past and for any of your records we may create or maintain in the future. Our organization will post a copy of our current notice in our offices in a prominent location and you may request a copy of our most current notice during any office visit.
B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
Stacy Shillan HIPAA Privacy Officer at (888) 878 8060
C. WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION IN THE FOLLOWING WAYS:

1. Provision of care. Our organization may use your identifiable health information in order to provide care for you. Many of the people who work for our organization may use or disclose your identifiable health information in order to plan and provide care to you. Additionally, we may disclose your identifiable health information to others who may assist in your care, such as your physician, therapists, spouse, children or parents.

2. Payment. Our organization may use and disclose your identifiable health information in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits) and we may provide your insurer with details regarding your treatment to determine if your insurer will cover or pay for your treatment. We also may use and disclose your identifiable health information to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your identifiable health information to bill you directly for services and items.

3. Health Care Operations. Our organization may use and disclose your identifiable health information to operate our business. As examples of the ways in which we may use and disclose your information for our operations, our organization may use your health information to evaluate the quality of care you received from us or to conduct cost-management and business planning activities for our organization.

4. Disclosures Required by Law. Our organization will use and disclose your identifiable health information when we are required to do so by federal, state or local law.
D. USE AND DISCLOSURE OF YOUR IDENTIFIABLE HEALTH INFORMATION IN CERTAIN SPECIAL CIRCUMSTANCES.

The following categories describe unique scenarios in which we may use or disclose your identifiable health information:

1. Public Health Risks.
Our organization may disclose your identifiable health information to public health authorities that are authorized by law to collect information for the purpose of:
  • Maintaining vital records, such as births and deaths.
  • Reporting child abuse or neglect.
  • Preventing or controlling disease, injury or disability.
  • Notifying a person regarding potential exposure to a communicable disease.
  • Notifying a person regarding a potential risk for spreading or contracting a disease or condition.
  • Reporting reactions to drugs or problems with products or devices.
  • Notifying individuals if a product or device they may be using has been recalled.
  • Notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information.
  • Notifying your employer under limited circumstances related primarily to workplace injury, illness or medical surveillance.
2. Health Oversight Activities. Our organization may disclose your identifiable health information to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

3. Lawsuits and Similar Proceedings. Our organization may use and disclose your identifiable health information in response to a court or administrative order if you are involved in a lawsuit or similar proceeding. We also may disclose your identifiable health information in response to a discovery request, subpoena or other lawful process by another party involved in the dispute but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

4. Law Enforcement. We may release identifiable health information if asked to do so by a law enforcement official:
  • Regarding a crime victim in certain situations, if we are unable to obtain the person's agreement.
  • Concerning a death we believe might have resulted from criminal conduct.
  • Regarding criminal conduct at our offices.
  • In response to a warrant, summons, court order subpoena or similar legal process.
  • To identify/locate a suspect, material witness, fugitive or missing person.
  • In an emergency, to report a crime (including the location or victim(s) of the crime or the description, identity or location of the perpetrator).
5. Serious Threats to Health or Safety. Our organization may use and disclose your identifiable information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public.
6. Worker's Compensation. Our organization may release your identifiable health information for workers' compensation and similar programs.
E. YOUR RIGHTS REGARDING YOUR IDENTIFIABLE HEALTH INFORMATION
You have the following rights regarding the identifiable health information that we maintain about you:

1. Confidential Communication. You have the right to request that our organization communicate with you about your health related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than at work. In order to request a type of confidential communication, you must make a written request to the HIPAA Privacy Office.

You must specify the requested method of contact or the location where you wish to be contacted. Our organization will accommodate reasonable requests. You do not need to give a reason for your request.
2.Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your identifiable health information for treatment, payment or health care operations. Additionally, you have the right to request that we limit our disclosure of your identifiable health information to individuals involved in your care or the payment for your care, such as family members and friends.

We are not required to agree to your request
; however if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your identifiable health information, you must make your request in writing to the HIPAA Privacy Office.

Your request must describe in a clear and concise fashion: (a) the information you wish restricted; (b) whether you are requesting to limit our practice's use, disclosure or both; and (c) to whom you want the limits to apply.

3. Inspection and Copies. You have the right to inspect and obtain a copy of the identifiable health information that may be used to make decisions about you, including patient medical records and billing records but not including psychotherapy notes. In order to inspect and/or obtain a copy of your identifiable health information, you must submit your request in writing to the HIPAA Privacy Office.

Our organization may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Our organization may deny your request to inspect and/or copy in certain limited circumstances; however you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews.

4.  Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our organization. To request an amendment, your request must be made in writing and submitted to the HIPAA Privacy Office.

You must provide us with a reason that supports your request for amendment. Our organization will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is: (a) accurate and complete; (b) not part of the identifiable health information which you would be permitted to inspect and copy; or (d) not created by our organization, unless the individual or entity that created the information is not available to amend the information.

5. Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain disclosures our organization has made of your identifiable health information. In order to obtain an “accounting of disclosures”, you must submit your request in writing to HIPAA Privacy Office.

All requests for an “accounting of disclosures” must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12 month period is free of charge but our organization may charge you for additional lists within the same 12 month period. Our organization will notify you of the costs involved with additional requests and you may withdraw your request before you incur any costs.

6. Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our organization or with the Secretary of the Department of Health and Human Services. To file a compliant with our organization, contact:

Neeta Samani
MaximaCare LLC
3740 N Jose Lane, Suite 100A
Carrolton , TX 75007
Tel: (972) 471-1111

Webmaster
MaximaCare LLC
3740 N Jose Lane, Suite 100A
Carrolton , TX 75007
Tel: (972) 471-1111

All complaints must be submitted in writing.
You will not be penalized for filing a complaint.

7. Right to Provide an Authorization for Other Uses and Disclosures.  Our organization will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your identifiable health information may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your identifiable health information for the reasons described in the authorization. Please note, we are required to retain records of your care

Summation:
If you have any questions about this privacy statement or the practices of this site, please Contact Us.
 
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