Medical Terms of Service

Last Updated: Oct 26, 2022

Peninsula Sleep Center

Peninsula Sleep Center is a medical practice focused on sleep medicine and the diagnosis and treatment of sleep disorders. Services include office visits, sleep studies, and a variety of treatments. Our office handles many responsibilities, such as scheduling, answering questions, referral coordination, provides services, collects co-pays, and submits claims to insurance companies.

Sleep medicine is an elective service. If anyone’s life is in danger, please call 911 or go to the nearest Emergency Room or Urgent Care Center.

1. HIPAA and Confidentiality

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

Peninsula Sleep Center (PSC) is dedicated to maintaining the privacy or 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 PSC to provide you with a copy of our Privacy Notice, outlining our privacy practices and how we safeguard your health information. We abide 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 healthcare record;

  • Obtain an accounting of disclosures of your health information;

  • Request confidential communication;

  • Amend your health record;

  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities: PSC 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 may have to communicate health information by alternative means.

PSC 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 practice will be documented in your healthcare record and will be used to provide you with care. The prescription or referral form that your referring physician has sent to us, will become part of your health record.

We will use your health information for payment-   In order to determine your eligibility for consultations or diagnostics, PSC may contact your insurance company and disclose healthcare related information. Also, PSC will bill you, or may bill a third party payer for services that you receive from our company. The health information that identifies you, your diagnosis,  and any treatment supplies may be included on this bill.

We will use your health information for healthcare operations-  PSC  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 of Disclosures

Business Associates- There may be individuals who are under contract with PSC and, from time to time, are engaged in improvement or financial enhancements to 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 purpose 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.

2. Financial Responsibility

Peninsula Sleep Center is in-network with majority of PPO insurances. 

Medicare has specific rules as far as covered medical care and medical necessity. Some services many not be covered by Medicare if their rules are not strictly followed. In those cases we will issue an Advanced Beneficiary Notice (ABN) to you informing you of non-coverage.  

Your financial responsibility are the following:

Authorizing Peninsula Sleep Center physicians to release information necessary to your insurance according to US and California regulations. 

You give authorization for payment of insurance benefits directly to Peninsula Sleep Center for any professional services rendered.

You are financially responsible for charges, co-insurance amounts, deductibles, and items and services that are denied by the insurance.

It is your responsibility to know your insurance rules and policies and to verify Peninsula Sleep Center is in-network with your insurance.

You are responsible for delinquent balances.

Comprehensive polysomnograms are covered by insurance if done at the sleep center. Such tests are not covered by insurances if conducted at home.

3. Missed Appointments

For appointment cancellation: Your doctors has dedicated a time slot to you and prevented other pateints from booking an appointment in that particular time. A cancellation fee of $35 for any un-kept doctor’s appointment or failure to provide cancellation notice of at least 24 hours. 

For overnight sleep testing cancellation: A sleep technician time is dedicated to you for your sleep study.  You are responsible for a cancellation fee of $100 for any un-kept sleep study appointment or failure to provide cancellation notice of at least 24 hours.

4. Service Termination

While we welcome the opportunity to take part in your sleep care, we reserve the right to refuse to care to patients who:

– are disrespectful to our staff and/or other patients.

– mistreat others in our office.

– require that PSC requests assistance from local law enforcement services.

 

5. Consent to Electronic Communications

Patient care portal: Our patient care portal is part of our electronic medical records. You consent sending health care messages if you sign up with that portal. The portal is https://MHO.sutterhealth.org for Sutter Health. For Stanford it is https://myhealth.stanfordhealthcare.org

We do not recommend using email for health care-related communications.

.

6. The Federal Open Payment Program

The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here.  The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars  ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

7. Telehealth Services & Permission

Your permission is required before video or phone visits.