Understanding Your Health Information

As required by law, Diamond Medical Equipment & Supply maintains a record of your private health information, most often to prove medical necessity to Medicare or other insurances. Typically, this record contains physician orders, progress notes, diagnoses related to your equipment, and other various information relating to your condition which determines the appropriate type of equipment to provide for you. This information serves the following purposes:

• Means of communication among the many health professionals who contribute to your care.
• Legal documents describing the equipment you received.
• Means by which you or a third-party payer can verify that services billed were actually provided.
• Means by which the medical equipment you received was medically required.
• Tool by which we can assess and continually work to improve the service we provide.

Your Health Information Rights

Although your health record is the physical property of Diamond Medical Equipment & Supply, the information belongs to you. You have the right to:

• Obtain a paper copy of this notice of privacy practices
• Inspect and obtain a copy of your health record. (Reasonable copy fees apply.)
• Request confidential communications of your health information.
• Request a restriction on certain uses and disclosures of your health information.

Our Responsibilities

We, as a provider, are required to:

• Maintain the privacy notice of your health information.
• Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain.
• Abide by the terms of this notice.
• Notify if you if we were unable to agree to a requested restriction.
• Accommodate reasonable requests you may have to communicate your health information.

We reserve the right to change our practices and to make the provisions effective for all protected health information we maintain. We will have available at our facility a copy of the most current notice containing the effective date on the front.

We will not use or disclose your health information in a manner other than described in the section regarding “Examples of Disclosures”, without your written authorization, which you may revoke, except to the extent that action has already been taken.

More Information or To Report a Problem

If you have a question and would like additional information, you may contact our facility’s privacy officer by writing to: Diamond Medical Equipment & Supply, Attention: Compliance Officer, 300 South Rodney Parham, Suite 19, Little Rock, AR 72205.

Examples of Disclosures:

• We will use your health information to assist us in providing you with the correct equipment.
• We may provide your medical information to health care providers, our company personnel, or third parties who are involved with the coordination of your care.
• For example: Information provided to us by your physician will determine the proper equipment to provide you with.
• We may, under certain circumstances, coordinate a plan of care with you and your physician.
• We will use your health information for payment.
• We may disclose your information so that we can collect or make payment for the medical equipment we provide you.

For example: Most insurances require us to have on file proof of medical necessity for your equipment. They periodically request this from us before payment can be made.

We may disclose your health information for our routine operations. The uses are necessary for certain administrative, financial, legal, and quality improvement functions.

For Equipment Coverage

Sometimes your physician will only prescribe your equipment for short periods of time. After this time has passed, if you still have the equipment, we may use your information to contact you. When we make this contact, we may inform you of the length of need prescribed by your physician, and discuss further accommodations.

As Required By Law

This may include reporting a crime, responding to a court order, or other legal proceedings necessary to be in compliance with government regulations and civil laws.

Personal Representative

We may use or disclose information to your personal representative. (Person legally involved with making your health care decisions.)

To Avert a Serious Threat

We may disclose your information if we believe in good faith it will prevent a serious threat to your safety or another. This can include abuse, neglect, domestic violence, or highly infectious diseases.

CMS Supplier Standards

1. A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements and cannot contract with an individual or entity to provide licensed services.
2. A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to this information must be reported to the National Supplier Clearinghouse within 30 days.
3. An authorized individual (one whose signature is binding) must sign the application for billing privileges.
4. A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the Medicare program, any State health care programs, or from any other Federal procurement or non-procurement programs.
5. A supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.
6. A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge. Medicare covered items that are under warranty.
7. A supplier must maintain a physical facility on an appropriate site. This standard requires that the location is accessible to the public and staffed during posted hours of business. The location must be at least 200 square feet and contain space for storing records.
8. A supplier must permit CMS, or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.
9. A supplier must maintain a primary business telephone listed under the name of the business in a local directory or a toll free number available through directory assistance. The exclusive use of a beeper, answering machine, answering service or cell phone during posted business hours is prohibited.
10. A supplier must have comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations.
11. A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from contacting a Medicare beneficiary based on a physician’s oral order unless an exception applies.
12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of delivery.
13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contacts.
14. A supplier must maintain and replace at no charge or repair directly, or through a service contract with another company, Medicare-covered items it has rented to beneficiaries.
15. A supplier must accept returns of substandard (less than full quality for the particular item) or unsuitable items (inappropriate for the beneficiary at the time it was fitted and rented or sold) from beneficiaries.
16. A supplier must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item.
17. A supplier must disclose to the government any person having ownership, financial, or control interest in the supplier.
18. A supplier must not convey or reassign a supplier number; i.e., the supplier may not sell or allow another entity to use its Medicare billing number.
19. A supplier must have a complaint resolution protocol established to address beneficiary complaints that relate to these standards.
20. A record of these complaints must be maintained at the physical facility.
21. Complaint records must include: the name, address, telephone number and health insurance claim number of the beneficiary, a summary of the complaint, and any actions taken to resolve it.
22. A supplier must agree to furnish CMS any information required by the Medicare statute and implementing regulations.
23. All suppliers must be accredited by a CMS-approved accreditation organization in order to receive and retain a supplier billing number. The accreditation must indicate the specific products and services, for which the supplier is accredited in order for the supplier to receive payment of those specific products and services (except for certain exempt pharmaceuticals). Implementation Date- October 1, 2009
24. All suppliers must notify their accreditation organization when a new DMEPOS location is opened.
25. All supplier locations, whether owned or subcontracted, must meet the DMEPOS quality standards and be separately accredited in order to bill Medicare.
26. All suppliers must disclose upon enrollment all products and services, including the addition of new product lines for which they are seeking accreditation.
27. Must meet the surety bond requirements specified in 42 C.F.R. 424.57(c). Implementation date- May 4, 2009
28. A supplier must obtain oxygen from a state-licensed oxygen supplier.
29. A supplier must maintain ordering and referring documentation consistent with provisions found in 42 C.F.R. 424.516(f).
30. DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers.
31. DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions.

Rights and Responsibilities

Our Mission and Purpose

It is to increase the comfort, freedom, and independence of those we serve. Satisfied customers are our highest priority and as such, we will conduct our business with integrity and the highest of ethics. Responding to our customer’s needs, we will continue to provide products of the highest quality and keep up with the rapid changes in technology. Our customer focus will guide our daily activities and distinguish us from other home medical equipment providers.

Customer Information

Diamond Medical  provides 24 hour/7 days per week ON-CALL services. If you have an emergency that cannot wait until normal business hours, an answering service answers the company’s phone after normal business hours. Please call 800-775-6101. Only equipment requiring emergency maintenance or replacement (i.e., oxygen) will be serviced after hours. Should a life threatening situation arise, it is suggested that the customer or caregiver dial “911” for professional emergency services.

Customer Complaints

Any customer who feels his/her rights have been denied, who desires further clarification of rights, or who desires to lodge a complaint or express contentment with any aspect of service or equipment, including concerns about patient safety and the risk of falls, should contact us through our main telephone number, without fear of reprisal by the company or by any of its employees. If the issue cannot be resolved via a telephone call with a customer service representative, the matter will automatically be forwarded to the appropriate corporate manager. Customers who feel they have been exploited, or taken advantage of have the right to file a complaint with the Arkansas Department of Human Services, NEED ADDRESS AND CONTACT DATA. You may also contact the Joint Commission to report concerns about patient safety and quality of care at (800) 994-6610.

Customer Rights – You Have The Right To:

• Be given timely, appropriate, and quality professional home care services without discrimination.
• Be provided with proper products and services as ordered by a qualified health care professional.
• Receive products in proper operating condition according to the manufacturer’s specifications.
• Receive fair treatment.
• Request a detailed explanation of your bill for products and services.
• Be communicated with in a way that you can reasonably understand.
• Refuse equipment and services, accepting full responsibility for that refusal.
• Choose your provider of home care services.
• Be assured of confidentiality, to review your records, and to approve or refuse the release of records.
• Have competent and qualified people carry out the services for which they are responsible.
• Voice your grievances and recommend changes without fear of reprisal.
• Report concerns about patient safety without fear of reprisal.
• Be given reasonable notice of discontinuation of service.

Customer Responsibilities – It Is Your Responsibility

• Dial “911” whenever a life threatening medical emergency arises.
• Provide complete and accurate information regarding your medical history and billing information.
• Comply with your physician’s orders and plan of care.
• Use and care for the equipment provided and not allow use by anyone other than the authorized patient.
• Contact us about any equipment malfunction or defect, and allow our staff to correct the problem.
• Advise us of any changes in your status, including address, medical condition, and billing information.
• Assume payment responsibility for services not covered by your insurance carrier, except when not allowed by law.
• Maintain a safe home environment for the proper utilization of equipment.
• To report to us any concerns about patient safety or occurrences of patient falls.
• Pay for the replacement costs of any equipment damaged, destroyed, or lost due to misuse, abuse, or neglect.

Medicare Supplier Standards

Diamond Medical Equipment & Supply, as a Medicare Provider, abides by and complies with all Supplier Standards as set forth by CMS (The Center for Medicare and Medicaid Services).

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