Orthotic Solutions, Inc. is a privately owned company with the objective of providing patients with a comprehensive array of orthotics, diabetic footwear and positioning devices to all of our patients regardless of race, creed, sec, color, religion, method of payment, or medical diagnosis, whether at home or in a health care facility.
Our normal business hours are Monday-Friday from 8:00 am - 2:30 pm. A voice message system will answer the Orthotic Solutions, Inc.’s phones after normal business hours. However, most services will be performed during normal service hours. If your call is an emergency and cannot wait until normal business hours, it is suggested that the patient or caregiver dial “911” for professional emergency services. In home evaluations and fittings are by appointment only.
Any patient 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 Orthotic Solutions, Inc. or by any of its employees. If the issue cannot be resolved via a telephone call with a patient service representative, the matter will automatically be forwarded to the President/CEO.
The public may contact the Joint Commission’s Office of Quality Monitoring to report any concerns or register complaints about a Joint Commission-accredited health care organization by either calling 1-800-994-6610 or emailing email@example.com.
PATIENT RIGHTS – YOU HAVE THE RIGHT TO:
• Be given timely, appropriate, and quality professional health 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, including honoring cultural, spiritual, and personal preferences.
• 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 health 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.
PATIENT RESPONSIBILITIES – IT IS YOUR RESPONSIBILITY TO:
• 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.
Orthotic devices and home medical equipment provided by Orthotic Solutions, Inc. carries a one (1) year manufacturer’s warranty. Therapeutic Footwear provided by Orthotic Solutions, Inc. carries a thirty (30) day manufacturer’s warranty. Orthotic Solutions, Inc. notifies all Medicare beneficiaries of the warranty coverage and we honor all warranties under applicable State law. Orthotic Solutions, Inc. will repair or replace, free of charge any Medicare covered item that is under warranty.
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Commitment to Privacy:
Orthotic Solutions, Inc. is dedicated to maintaining the privacy of your healthcare information and we are required by law to maintain the confidentiality of information that identifies you. Any use of healthcare information beyond the uses described below requires your individual written authorization. The Health Insurance Portability and Accountability Act (HIPAA) obligates Orthotic Solutions, Inc. to provide you with a copy of our Privacy Notice, outlining our privacy practices and how we safeguard your health information. Orthotic Solutions, Inc. abides by the terms of the Privacy Notice currently in effect, and reserves the right to revise or amend the notice, as needed.
Your Health Information Rights:
Although your health record is the physical property of the healthcare facility that compiled it, the information belongs to you. You have the right to:
Request a restriction on certain uses and disclosures of your information;
Obtain a paper copy of the notice of privacy practices;
Inspect and copy your health care record;
Obtain an accounting of disclosures of your health information;
Request confidential communication;
Amend your healthcare record;
Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
Orthotic Solutions, Inc. is required to:
Maintain the privacy of your health information;
Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you;
Abide by the terms of this notice;
Notify you if we are unable to agree to a requested restriction;
Accommodate reasonable requests you my have to communicate health information by alternative means.
Orthotic Solutions, Inc. reserves the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to your address on file. We will not use or disclose your health information without your authorization, except for treatment, payment, and healthcare operations.
Examples of Disclosure for Treatment, Payment, and Healthcare Operations:
We will use your health information for treatment. Information obtained by our company will be documented in your healthcare record and will be used to provide you with durable medical equipmentand/or supplies. The prescription that your physician has ordered will be part of the record and will determine the equipment and supplies that you receive.
We will use your health information for payment. In order to determine your eligibility for equipment and/or supplies, Orthotic Solutions, Inc. may contact your insurance company and disclose healthcare related information. Also, Orthotic Solutions, Inc. will bill you or a third-party payer for services that you receive from our company. The health information that identifies you, your diagnosis, equipment, and supplies may be included on this bill.
We will use your health information for healthcare operations. Orthotic Solutions, Inc. may use your health information to evaluate the quality of care you receive from us, to conduct cost management assessments, and to plan business activities. This information is used in an effort to continually improve the quality and effectiveness of the healthcare services we provide.
Other Uses or Disclosures:
Business Associates: There are some individuals who are under contract with Orthotic Solutions, Inc. and, from time to time, are engaged in the improvement or financial enhancement of our business. So that your health information is protected, however, we require any business associate to appropriately safeguard your information.
Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Law Enforcement: We may disclose health information for law enforcement purposes as required by law, or in response to a valid subpoena.
Health Oversight Activities: We may disclose health information to health oversight agencies for activities authorized by law, including surveys, audits, and compliance inspections.
Worker’s Compensation: We may release your health information to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
For More Information:
Please contact Orthotic Solution, Inc’s President/CEO at (508) 224-3510, if you require additional information and/or want to pursue your rights, including:
Inspecting and copying your record;
Securing an accounting of disclosures;
Requesting additional disclosures;
Revoking authorizations at any time;
Filing a complaint
If you believe your privacy rights have been violated, you may contact the company’s President/CEO. You may also file a complaint with the Secretary of Health and Human Services (Office of Civil Rights). There will be no retaliation for filing a complaint.
HCFA MEDICARE DMEPOS SUPPLIER STANDARDS
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. 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.
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 or cell phone 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 calling beneficiaries in order to solicit new business.
12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of
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. 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 implementing 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 of 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. All DMEPOS suppliers must obtain a surety bond in order to receive and retain a supplier
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 C.F.R. 424.516(f).
29. DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers.
30. DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions.