Notice of Privacy Practices
Effective Date: 8/23/25
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.
Our Responsibilities
Momentum Mobility, Inc. (“Momentum Mobility,” “we,” “our,” or “us”) is required by law to:
Maintain the privacy of your protected health information (“PHI”).
Provide you with this Notice of our legal duties and privacy practices.
Notify you if a breach of your unsecured PHI occurs.
Follow the terms of this Notice currently in effect.
How We May Use and Share Your PHI Without Your Written Permission
Treatment
We may use and share your PHI to provide you with medical equipment and services. For example, we may share PHI with your physician, therapist, or hospital to coordinate delivery of a wheelchair or other mobility device.
Payment
We may use and share your PHI to bill and collect payment for the equipment and services we provide. For example, we may share information with Medicare, Medicaid, or your insurance company to obtain prior authorization or reimbursement.
Health Care Operations
We may use and disclose your PHI to support quality improvement, accreditation, staff training, and business operations. For example, we may review PHI to evaluate staff performance and service outcomes.
Treatment Alternatives & Services
We may contact you with information about treatment alternatives, mobility products, or related services that may benefit you.
Business Associates
We may share PHI with third parties that provide services on our behalf (such as billing, auditing, or IT vendors). These business associates are required to protect your PHI under written agreements.
Public Health & Safety
We may disclose your PHI when required for public health purposes, such as reporting disease, suspected abuse, or threats to health and safety.
Legal Requirements
We may use or disclose your PHI as required by law, including:
In response to a court order, subpoena, or administrative proceeding.
To comply with workers’ compensation laws.
To assist law enforcement or national security activities as permitted by law.
To a coroner, medical examiner, or funeral director as necessary.
For organ or tissue donation if you are an organ donor.
Family, Friends, and Caregivers
We may share PHI with family members or others involved in your care or payment for your care, unless you object.
Disaster Relief
We may disclose PHI to authorized organizations to assist in disaster response efforts.
Uses and Disclosures Requiring Your Written Permission
We will obtain your authorization before:
Using or disclosing your PHI for marketing purposes.
Selling your PHI.
Sharing your PHI with life insurance companies or for other purposes not described in this Notice.
You may revoke your authorization at any time in writing. The revocation will not affect any disclosures already made in reliance on your permission.
Your Rights Regarding Your PHI
Right to Inspect & Copy: You may request to see and receive a copy of your PHI. Reasonable fees may apply.
Right to Amend: You may request corrections to your PHI if you believe it is inaccurate or incomplete.
Right to an Accounting of Disclosures: You may request a list of certain disclosures of your PHI for the past six years.
Right to Request Restrictions: You may ask us to restrict certain uses or disclosures of your PHI. While we are not required to agree in all cases, we must honor requests to restrict disclosures to your health plan if you paid out-of-pocket in full.
Right to Confidential Communications: You may request that we contact you in a specific way (e.g., by phone, mail, or alternate address).
Right to a Paper Copy: You are entitled to a paper copy of this Notice upon request.
Right to Designate a Representative: If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights regarding your PHI.
Changes to This Notice
We reserve the right to change this Notice at any time. The revised Notice will apply to all PHI we maintain and will be posted at our office and on our website.
Questions or Complaints
If you have questions about this Notice or believe your privacy rights have been violated, you may contact us without fear of retaliation:
Privacy Officer
Momentum Mobility, Inc.
1 W. Deer Valley Rd. Ste 122
Phoenix, AZ 85027
Tel: (888) 995-0806
Fax: (480) 281-5211
Email: Support@MomentumMobility.Ai