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NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. 

PLEASE REVIEW IT CAREFULLY. 

This Notice of Privacy Practices covers Sound Access, LLC and all healthcare providers and staff therein. 

OUR PLEDGE REGARDING HEALTH INFORMATION: 
Sound Access, LLC understands that health information about you is personal and we are committed to protecting your health information. Protected Health Information (PHI) is defined as your past, present, or future physical or mental health or condition; the provision of your healthcare, including medical procedures, testing, and treatment; medications; symptoms; test results; diagnoses; and past, present, and future payment for the provision of your healthcare. PHI further includes, individually identifiable health information which includes your street number and name; city, state, and zip code of residence; your date of birth; your phone number; your fax number (if obtained); your e-mail address; your social security number (if obtained); your medical records numbers (if applicable); your health insurance member number (if obtained); and internal account numbers. We create a record of the care and services you receive with Sound Access, LLC. The record is needed in order to provide you with quality care and to comply with certain legal requirements. This notice applies to all medical records pertaining to your health care in possession by Sound Access, LLC. 

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
The following categories describe different ways that we may use and disclose your health information. Not every use or disclosure in a category will be listed. 
1. General Uses and Disclosures. Under the Privacy Rules, we are permitted to use and disclose your health information for the following purposes, without obtaining your permission or authorization: 

  • Treatment: We may use and disclose your health information to provide medical treatment or services. For example, disclosure of your health information to your primary care provider, consulting providers and to other health care personnel who need such information for your care and treatment. 
  • Health Care Operations: We may use and disclose your health information for our health care operations. These include but are not limited to: quality assurances, auditing, licensing, credentialing, training, planning future operations, and resolving grievances. 
  • Payment: We may use health information about you to obtain payment for healthcare services that you received. We may disclose health information about you to others (such as insurers, collection agencies, and consumer reporting agencies) for purposes of collecting payment. We may use and disclose your health information to party entities that are paying for services and/or products on your behalf. 
  • As Required By Law: We may use and disclose your health information when required to do so by law, including, but not limited to: reporting abuse, neglect and domestic violence; in response to judicial and administrative proceedings; in responding to a law enforcement request for information; or in order to alert law enforcement to criminal conduct on our premises.  
  • Public Health Activities: We may disclose your health information for public health reporting, including, but not limited to: child abuse and neglect; reporting communicable diseases and vital statistics; product recalls and adverse events; or notifying person(s) who may have been exposed to a disease or are at risk of contracting or spreading a disease or condition. 
  • Health Oversight Activities: We may disclose your health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. 
  • Judicial and Administrative Proceedings: We may disclose your health information in judicial and administrative proceedings, as well as in response to an order of a court, administrative tribunal, or in response to a subpoena, summons, warrant, discovery request, or similar legal request. 
  • Threat to Health or Safety: We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. 
  • Specialized Government Functions: If you are a member of the U.S. Armed Forces, we may release your health information as required by military command authorities. We may also disclose your health information to authorized federal officials for national security reasons and the Department of State for medical suitability determinations. 
  • Health Oversight Activities: We may disclose your health information to health oversight agencies (agencies responsible for overseeing the healthcare system or certain government programs). 
  •  Workers’ Compensation: We can release your health information to your employer to the extent necessary to comply with Missouri law relating to workers’ compensation or other similar programs. 
  •  Business Associates: We may disclose your health information to business associates who provide services to us. Our business associates are required to protect the confidentiality of your health information. 
  • Manufacturers and Affiliates: We may disclose your health information to manufacturers and affiliates who provide services to us as deemed necessary for the purpose of treatment and/or fulfillment of product orders. Our manufacturers and affiliates are required to protect the confidentiality of your health information. 
  • Psychotherapy Notes: We will not use of disclose your psychotherapy notes without a written authorization except as specifically permitted by law. 
  • Sale of Information: We will not sell your health information without your written authorization, including notification of the payment we will receive. 
  • Marketing: We will not use or disclose your information for marketing purposes, other than fact-to-face communications with you or promotional gifts of nominal value, without your written authorization. 
  • Appointment Reminders and/or Treatment Alternatives: We may use and disclose your health information to contact you as a reminder of an appointment for treatment or medical care or to tell you about or recommend possible treatment options or alternative. This may include communication by unencrypted text or e-mail messaging as detailed in our Policy Notice. 
  • Other Uses and Disclosures: In addition to the reasons outlined above, we may use and disclose your health information for other purposes permitted by the Privacy Rules. For example, if reasonable precautions are taken to minimize the chance that others who may be nearby accidentally overhear your health information, the following practices are permissible under the Privacy Rules, because they are considered incidental disclosures: health care professionals may discuss a client’s condition over the phone with the client, a provider, or a family member; a health care professional may discuss test results with a client or other provider in a joint treatment area; a healthcare provider may discuss a client’s condition or treatment in a semi-private room. 


2. Uses and Disclosures, Which Require You the Opportunity to Verbally Agree or Object. Under the Privacy Rules, we are permitted to use and disclose your health information: (i) for the creation of facility directories, (ii) to disaster relief agencies, and (iii) to family members, close personal friends or any other person identified by you, if the information is directly relevant to that person’s involvement in your care or treatment.

3. Use and Disclosures Which Require Your Authorization. Except as provided above, we will obtain your written authorization prior to disclosure of your information for any other purpose. Specifically, written authorization is required prior to the disclosure of your information. 

YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU 

  • Right to Inspect and Copy: Upon written request, you have the right to inspect and copy your own health information contained in a designated record set, maintained by or for us. A “designated record set” contains medical, billing, and any other records that we use for making decisions about you. However, we are not required to provide you access to all the health information we maintain. For example, this right of access does not extend to information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative proceeding. If you request a copy or summary of explanation of your health information, we may charge you a reasonable fee for copying costs, including the cost of supply and labor, postage and any other associated costs in preparing the summary of explanation. 
  • Right to Access Electronic Health Record: If we maintain your health information in an electronic health record, we are required to make that record available to you in an electronic format upon your written request. 
  • Right to Request an Amendment of Your Health Information: If you feel that health 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 of your health information if the information is kept by or for Sound Access, LLC. We may deny your request if we determine you have asked us to amend information that: was not created by us, unless the person that created the information is no longer available; is not health information maintained by or for us; is health information that you are not permitted to inspect or copy; or we determine the health information is accurate and complete. We will provide you with a written explanation of the reasons for the denial. 
  • Right to Request Restrictions on the Use and Disclosure of Your Health Information: You have the right to request restrictions on the use and disclosure of your health information for treatment, disclosures to a health plan with respect to health care you have paid out-of-pocket and in full, payment and health care operations, as well as disclosures to persons involved in your care or the payment for your care, like a family member or close friend. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. Request are to be made in writing to Sound Access. 
  • Right to Accounting of Disclosure We Have Made: You have the right to receive an accounting of disclosures that we have made for the previous 6 years. You may submit a written request to Sound Access. The disclosures will not include several types of disclosures, including disclosures for treatment, payment, or healthcare operations. 
  • Right to Alternative Communications: You have the right to receive confidential communications of your health information by a different means or at a different location than currently provided. For example, you may request that we only contact you at home or by mail. We will accommodate all reasonable requests. 
  •  Right to Receive Notification of a Breach of Your Unsecured Health Information: You have a right to, and will be notified if there is a breach of your secured health information. 
  • Right to a Paper Copy of this Notice of Privacy Practices: You have the right to a paper copy of this notice at any time upon request. In addition, a copy of this Notice is available in each patient care areas of our clinic at all times. 


OUR DUTIES

  • We are required by law to maintain the privacy of Protected Health Information (PHI) and to provide individuals with this Notice of our legal duties and privacy practice regarding health information. 
  • We are required to notify you if there is a breach of your unsecured PHI. 
  • We are required to follow the terms of the current Notice. 


CHANGES TO THIS NOTICE 
We may change the terms of this Notice. The revised Notice will apply to all health information in our possession as well as any information we receive in the future. If we make changes to the Notice, we will have copies of the new Notice in patient care areas for review and have copies of the new Notice available upon request from our Privacy Officer at 314-313-2289. 

BY SIGNING THE SEPARATE POLICY NOTICE YOU ACKNOWLEDGE YOU HAVE BEEN GIVEN OPPORTUNITY TO READ/HAVE READ TO YOU, REVIEW, AND CONSIDER THIS NOTICE OF PRIVACY PRACTICES.

QUESTIONS
If, at any time, you have questions about information in this Notice or about Sound Access’s privacy policies, procedures, or practices, you can contact our Privacy Officer at 314-313-2289. 

REPORT A PRIVACY RIGHTS VIOLATION 
If you believe your privacy rights have been violated or that we have violated our own privacy practice, you may file a complaint with us, Sound Access, LLC. You may also file a complaint with the Secretary of the U. S. Department of Health and Human Services. There will be no retaliation for filing a complaint. 

If you want to exercise any of these rights, please contact:  Sound Access, LLC, 10097 Manchester Road, Suite 105, St. Louis, MO 63122. All requests must be submitted to us in writing.

You may file a written complaint with the federal government: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Ave, S.W., Room 509F, HHH Building, Washington, D.C., 20201

The effective date of this notice is December 7, 2023. 

Practice policies

PAYMENT POLICY

RETURN AND CANCELLATION POLICY

Notice of privacy policy

NO SURPRISE ACT - GOOD FAITH ESTIMATE

NOTICE: AVAILABILITY OF GOOD FAITH ESTIMATE

You may have the right to receive a “Good Faith Estimate” explaining how much your health care will cost

If you are uninsured, or you do not wish to submit a bill for your care to your insurance plan for your care, then you have a right to receive an estimate of your bill before receiving any health care items or services.

When scheduling your appointment, we will ask you if you have insurance or how you wish to pay. If you do not have insurance, or if you wish to pay on your own without insurance, then you will be given a good faith estimate for the costs of the services we anticipate providing to you.

The estimate will include the total expected cost for all items or services that we reasonably expect to provide to you at the time of scheduling.
If you schedule at least 10 days in advance, we will deliver a good faith estimate to you within 3 days of scheduling. If you schedule at least 3 days in advance, we will deliver a good faith estimate to you within 1 day of scheduling. If you schedule less than 3 days in advance, you may not receive a good faith estimate prior to your appointment.

You may also request an estimate at any time. We will return a good faith estimate within 3 days of your request. 

Make sure to save a copy or picture of your estimate and the bill.

If you receive a bill that is at least $400 more than your estimate, you can dispute the bill by visiting www.cms.gov/nosurprises/consumers.

For questions or more information about your right to a good faith estimate, please visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1- 800-985-3059.

4872-8429-5190, v. 1

We appreciate your business!

Return Policy: Product(s), excluding prescription hearing aids, may not be returned after the receipt of the product(s) by the buyer. Repair, adjustment, remake, replacement, or exchange of product(s) will be completed if the product(s) are defective and the requirements of the product(s)'s warranty are met. For hearing aids, please refer to your Hearing Instrument Purchase Agreement for details regarding our return policy. 


Cancellation Policy: Product orders may not be cancelled after the order for the product(s) is received by Sound Access unless Sound Access consents in writing to such cancellation. Cancellation will be granted only on terms indemnifying Sound Access against any loss resulting from such action and on such terms determined by Sound Access. At minimum, the buyer will be liable for all costs incurred on the order of the product(s) through the cancellation date. 

Fees are payable at time of service and/or product purchase. Payment is required at the time a product order is placed and/or at the time any services are rendered unless exclusion, at the sole discretion of an official representative of Sound Access, is otherwise expressed by the representative in advance. For products delivered by certified mail, title and risk of loss in all goods sold shall pass to buyer upon Sound Access's delivery to the carrier at shipping point. The order is not final until approved and accepted by the home office of Sound Access. All prices are subject to change without notice. 


Other than traditional Medicare, Sound Access does not participate with any insurance companies and will be considered out-of-network.  You will be responsible for filing claims to any insurance, other than traditional Medicare, if desired.  Because Sound Access is out-of-network, your insurance may pay less or not cover the services provided in our clinic.  You should contact your insurance company with any questions regarding claims or coverage.


Sound Access accepts the following types of payment:

Visa, Master, Discover, American Express, CareCredit, check, or cash. 

Practice policies