THIS 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.

During your treatment at reNew Hearing® ("reNew Hearing"), reNew Hearing and members of its staff may gather information about your medical history and your current health. This notice explains how that information may be used and shared with others. It also explains your privacy rights regarding this kind of information. The terms of this notice apply to health information created or received by reNew Hearing. We are required by law to: make sure that medical information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; and follow the terms of the notice that is currently in effect.

Your medical information may be used and disclosed for the following purposes:

• Treatment: We may use your information to provide, coordinate, and manage your care and treatment. For example, a reNew Hearing staff member may share your medical information with another health care provider for a consultation or a referral.
• Payment: We may use and disclose medical information about you so that the treatment and services you receive may be billed to, and payment may be collected from, you, an insurance company, or another third party. For example, we may need to give your health plan information about treatment you received at reNew Hearing so your health plan will pay us or reimburse you for the treatment.
• Health Care Operations: We may use and disclose medical information about you for reNew Hearing’s health care operations. Health care operations are the uses and disclosures of information that are necessary to run reNew Hearing and to make sure that all of our customers receive quality care. For example, we may use medical information to evaluate the performance of our staff in caring for you.
• Appointment Reminders and Other Health Information: We may use your medical information to send you reminders about future appointments. We may also contact you with information about new or alternative treatments or other health care services.
•  To People Assisting in Your Care. reNew Hearing will only disclose medical information to those taking care of you, helping you to pay your bills, or other close family members of friends if these people need to know this information to help you, and then only to the extent permitted by law. We may, for example, provide limited medical information to allow a family member to pick up a hearing device for you. If you are able to make your own health care decisions, reNew Hearing will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, reNew Hearing will disclose relevant medical information to family members or other responsible people if we feel it is in your best interest to do so, including in an emergency situation.

Right to Inspect and Copy: You have the right to inspect and receive a copy of your medical information that is used to make decisions about your care. Usually, this includes medical and billing records maintained by reNew Hearing.

If you wish to inspect and copy medical information, you must complete and return a Request to Inspect and Copy Form (a copy of which is available upon request). If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request, to the extent permitted by state and federal law. We may deny your request to inspect and copy your information in certain very limited circumstances. For example, we may deny access if your physician believes it will be harmful to your health, or could cause a threat to others. If you are denied access to medical information, you may request that the denial be reviewed. Another health care provider chosen by reNew Hearing will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Request Amendment: If you believe that medical information we have about you is incorrect or incomplete, you have the right to ask us to change the information. You have the right to request an amendment for as long as the information is kept by or for reNew Hearing. To request a change to your information, you must complete and return a Request for Amendment Form (click here for a copy). In addition, you must provide a reason that supports your request. reNew Hearing may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• Was not created by reNew Hearing, unless the person or entity that created the information is no longer available to make the amendment;
• Is not part of the medical information kept by or for reNew Hearing;
• Is not part of the information which you would be permitted to inspect and copy; or
• Is accurate and complete.

Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you. This list will not include disclosures for treatment, payment, and health care operations; disclosures that you have authorized or that have been made to you; disclosures for facility directories; disclosures for national security or intelligence purposes; disclosures to correctional institutions or law enforcement with custody of you; disclosures that took place before April 14, 2003; and certain other disclosures.

To request this list of disclosures, you must complete and return a Request for Accounting of Disclosures Form (click here for a copy). Your request must state a time period for which you would like the accounting. The accounting period may not go back further than six years from the date of the request, and it may not include dates before December 1, 2008. You may receive one free accounting in any 12-month period. We will charge you for additional requests.