© 2019 CalMed Hawaii | Privacy Policy | Terms and Use

Privacy Statement

For each visitor to our Web page, our Web server automatically recognizes no information regarding the domain or e-mail address. We collect the e-mail address of those who communicate with us via e-mail, aggregate information on what pages consumers access or visit, user specific information on what pages consumer’s access or visit and information volunteered by the consumer, such as survey information and/or site registrations.

The information we collect is used for internal review and is then discarded, used to improve the content of our Web page, used to customize the content and/or layout of our page for individual consumer and used by us to contact consumers for marketing purposes.

If you do not want to receive e-mail from us in the future, please let us know by sending an e-mail, calling or writing, and telling us that you do not want to receive e-mail from our company.

We can be reached at 808-691-9973 or info@calmedhawaii.com

DME Patient Rights

At CalMed Hawaii, we believe that our patients have rights and responsibilities and we are committed to ensuring that we care for people respectfully, safely, and in a quality manner.

As a patient of CalMed Hawaii, you have the right to (which includes but is not limited to) the following:

  1. Be given information about your rights for receiving homecare services.

  2. Receive a timely response from CalMed Hawaii, regarding your request for homecare services.

  3. Be given information about CalMed Hawaii, policies, procedures, and charges for services.

  4. Choose your homecare providers.

  5. Be given appropriate and professional quality homecare services without discrimination against your race, color, creed, religion, sex, national origin, sexual orientation, disability, or age.

  6. Be treated with courtesy and respect by all who provide homecare services to you.

  7. Be free from physical and mental abuse and/or neglect.

  8. Be given proper identification by name and title of everyone who provides homecare services to you.

  9. Be given the necessary information regarding treatment and choices concerning rental or purchase options for durable medical equipment, so you will be able to give informed consent for your service prior to the start of any service.

  10. Be given complete and current information concerning your diagnosis, treatment, alternatives, risks and prognosis as required by your physician’s legal duty to disclose in terms and language you can reasonably be expected to understand.

  11. A plan of service that will be developed to meet your unique service needs.

  12. Participate in the development of your plan of care/service.

  13. Be given an assessment and update of your developed plan of care/service.

  14. Be given data privacy and confidentiality.

  15. Review your clinical record at your request.

  16. Be given information regarding anticipated transfer of your homecare service to another healthcare facility and/or termination of homecare service to you.

  17. Voice grievance with and/or suggest a change in homecare services and/or staff without being threatened, restrained and discriminated against.

  18. Refuse treatment within the confines of the law.

  19. Be given information concerning the consequences of refusing treatment.

  20. Have an advance directive for medical care, such as a living will or the designation of a surrogate decision maker, respected to the extent provided by the law.

  21. Participate in the consideration of ethical issues that arise in your care.

  22. We are committed to providing you with quality service that meets your homecare needs and exceeds your expectations. If you have a complaint or suggestion about products, equipment, or services provided by CalMed Hawaii,, please contact us at 808-691-9973 or on our website at info@calmedhawaii.com

Medicare DMEPOS Supplier Standards

Note: This is an abbreviated version of the supplier standards every Medicare DMEPOS supplier must meet in order to obtain and retain their billing privileges. These standards, in their entirety, are listed in 42 C.F.R. 424.57(c).

 

  1. A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.
     

  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. A supplier must have an authorized individual (whose signature is binding) sign the enrollment application for billing privileges.
     

  4. A supplier must fill orders from its own inventory, or contract with other companies for the purchase of items necessary to fill orders. A supplier may not contract with any entity that is currently excluded from the Medicare program, any State health care programs, or 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 and must maintain a visible sign with posted hours of operation. The location must be 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.
     

  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 is prohibited from direct solicitation to Medicare beneficiaries. For complete details on this prohibition see 42 CFR § 424.57 (c) (11).
     

  12. A supplier is responsible for delivery of and must instruct beneficiaries on the use of Medicare covered items, and maintain proof of delivery and beneficiary instruction.
     

  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 cost either directly, or through a service contract with another company, any 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 standards to each beneficiary it supplies a Medicare-covered item.
     

  17. A supplier must disclose 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. A record of these complaints must be maintained at the physical facility.
     

  20. 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.
     

  21. A supplier must agree to furnish CMS any information required by the Medicare statute and regulations.
     

  22. 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 for those specific products and services (except for certain exempt pharmaceuticals).
     

  23. All suppliers must notify their accreditation organization when a new DMEPOS location is opened.
     

  24. All supplier locations, whether owned or subcontracted, must meet the DMEPOS quality standards and be separately accredited in order to bill Medicare.
     

  25. All suppliers must disclose upon enrollment all products and services, including the addition of new product lines for which they are seeking accreditation.
     

  26. A supplier must meet the surety bond requirements specified in 42 CFR § 424.57 (d).
     

  27. A supplier must obtain oxygen from a state-licensed oxygen supplier.
     

  28. A supplier must maintain ordering and referring documentation consistent with provisions found in 42 CFR § 424.516(f).
     

  29. A supplier is prohibited from sharing a practice location with other Medicare providers and suppliers.
     

  30. A supplier must remain open to the public for a minimum of 30 hours per week except physicians (as defined in section 1848(j) (3) of the Act) or physical and occupational therapists or a DMEPOS supplier working with custom made orthotics and prosthetics.

 

Medicare DMEPOS Supplier Standards

DMEPOS suppliers have the option to disclose the following statement to satisfy the requirement outlined in Supplier Standard 16 in lieu of providing a copy of the standards to the beneficiary.

 

The products and/or services provided to you by ( supplier legal business name or DBA) are subject to the supplier standards contained in the Federal regulations shown at 42 Code of Federal Regulations Section 424.57(c). These standards concern business professional and operational matters (e.g. honoring warranties and hours of operation). The full text of these standards can be obtained at http://ecfr.gpoaccess.gov. Upon request we will furnish you a written copy of the standards.

HIPAA and Privacy

Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) of 1996 to:

  • Combat waste, fraud and abuse

  •  Improve portability of health insurance coverage

  • Simplify health care administration

Who must comply with HIPAA?

All military and civilian health care plans, health care clearinghouses and health care providers who electronically conduct financial and administrative transactions must comply with HIPAA. TRICARE, military hospitals and clinics, providers, regional contractors, subcontractors and other business associate relationships fall within these categories. HIPAA's Privacy Rule and Security Rule relate specifically to the privacy and security of your protected health information (PHI).

How the Privacy Rule Protects You

The HIPAA Privacy Rule lets medical staff use and disclose your PHI for treatment, payment and health care operations without written authorization. Your permission is required for most other uses and disclosures.

 

Under the Privacy Rule, you have the right to:

  • Receive a copy of the Military Health System Notice of Privacy Practices

  • Request access to PHI

  • Request amendment of PHI

  • Request an accounting of PHI disclosures

  • Request restriction on PHI use and disclosure

  • File a complaint regarding privacy infractions.

Privacy Officers

Each military hospitals and clinic has a privacy officer who ensures health care information remains private, but available to you and your provider. The privacy officer can answer any questions you may have about HIPAA rules. The Defense Health Agency (DHA) also has a privacy office you can contact for information or assistance. In addition, your regional contractor has valuable information about privacy on its website.

What if my privacy is violated?

If you think your privacy rights have been violated, you may submit a written complaint to your military hospital or clinic or DHA privacy officer. You may call the general information number at your local military hospitals or clinic, visit their Web site.

 

Notice of Privacy Practices

When you receive treatment at a military hospitals or clinic, you will be given a copy of the Notice of Privacy Practices. This document details how your medical information may be used and with whom it may be shared. If you see civilian TRICARE-authorized providers, they may have their own privacy practices guidelines that they will share with you at the time of your appointment. It's important that you carefully read any information about privacy practices.

This section gives you information about how to access your medical records and how HIPAA regulations relate to you.

Rights and Responsibilities

As a TRICARE beneficiary, you have rights regarding your health care and responsibilities for participating in your health care decisions.

 

Patient Rights

As a patient in the Military Health System, you have the right to:

  • Easy-to-understand information about TRICARE

  • A choice of health care providers that is sufficient to ensure access to appropriate high-quality health care

  • Emergency health care services when and where you need it

  • Review information about the diagnosis, treatment and progress of your condition

  • Fully participate in all decisions related to your health care or to be represented by family members, conservators or other duly appointed representatives if you are unable to fully participate in treatment decisions.

  • Considerate, respectful care from all members of the health care system without discrimination based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information or source of payment.

  • Communicate with health care providers in confidence and to have the confidentiality of your health care information protected.

  • Review, copy and request amendments to your medical records.

  • A fair and efficient process for resolving differences with your health plan, health care providers and the institutions that serve them.

 

Patient Responsibilities

As a patient in the Military Health System, you have the responsibility to:

  • Maximize healthy habits, such as exercising, not smoking and maintaining a healthy diet.

  • Be involved in health care decisions, which means working with providers in developing and carrying out agreed-upon treatment plans, disclosing relevant information and clearly communicating your wants and needs.

  • Be knowledgeable about TRICARE coverage and program options, including covered benefits; limitations; exclusions; rules regarding use of network providers; coverage and referral rules; appropriate processes to secure additional information; and appeals, claims and grievance processes.

  • Be respectful of other patients and health care workers.

  •  Make a good-faith effort to meet financial obligations.

  • Follow the claims process and to use the disputed claims process when you have a disagreement concerning your claims.

  • Report any wrongdoing or fraud to the appropriate resources or legal authorities.