Notice of Privacy Practices
BiliMed, L.L.C.
345 Doucet Road, Suite 200E, Lafayette, LA 70503 · (337) 509-1818 · info@bilimed.com
Effective date: August 18, 2026
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.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get a copy of your health record.
You can ask to see or get a copy of the health information we have about you and your child. We will provide a copy or a summary, usually within 30 days of your request. If we need more time, we will tell you in writing within the first 30 days and give you the date you can expect our response. The first copy is free. If you ask for additional copies, we may charge a reasonable, cost-based fee, and we will tell you the amount before we provide them.
Ask us to correct your health record.
You can ask us to correct health information you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing, usually within 60 days.
Request confidential communications.
You can ask us to contact you in a specific way (for example, home or cell phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
Ask us to limit what we use or share.
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information.
You can ask for a list (accounting) of the times we’ve shared your health information for the six years before the date you ask, who we shared it with, and why. We will include all disclosures except those about treatment, payment, and health care operations, and certain other disclosures. We’ll provide one accounting a year for free but may charge a reasonable, cost-based fee if you ask for another within 12 months.
Get a copy of this privacy notice.
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide a paper copy promptly.
Choose someone to act for you.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. As a parent or legal guardian, you may act on behalf of your child. We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated.
You can complain if you feel we have violated your rights by contacting us using the information at the top of this notice.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
● Share information with your family, close friends, or others involved in your child’s care;
● Share information in a disaster relief situation.
If you are not able to tell us your preference — for example, if you are unavailable — we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
We never share your information for marketing purposes and never sell your information.
How We Typically Use or Share Your Health Information
We typically use or share your health information in the following ways.
To provide the rental and treatment support.
We use your health information to provide and coordinate your equipment rental. Example: We use the physician’s order and your child’s diagnosis to dispense the correct phototherapy unit and settings, and we may share information with the ordering physician’s office.
To run our organization.
We can use and share your health information to run our business, improve your service, and contact you when necessary. Example: We use your information to schedule delivery and pickup, to arrange cleaning and servicing of returned equipment, and to contact you about your rental.
To bill and receive payment.
We can use and share your health information to bill and get payment. Example: If you request an itemized superbill to submit to your health plan, it will include your information, the equipment code, and the diagnosis. You pay BiliMed directly; we do not file claims to insurers on your behalf.
With people and companies who help us provide the service.
We may share your information with people who perform services for us — for example, someone who delivers equipment to and from your home. Anyone working under our direction is trained and signs a confidentiality acknowledgment before handling your information. We may also use a transportation service that carries sealed packages to and from your home without access to your health information. Where a company performs services for us that require access to your health information, we have a written business associate agreement with that company.
How Else Can We Use or Share Your Health Information?
We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
● Help with public health and safety issues — such as reporting to the FDA regarding equipment safety, preventing disease, or reporting suspected abuse or neglect.
● Comply with the law — when required by federal or state law, including with the U.S. Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
● Respond to organ and tissue donation requests or work with a medical examiner or funeral director (rarely applicable to our service).
● Address workers’ compensation, law enforcement, and other government requests as permitted by law.
● Respond to lawsuits and legal actions — in response to a court or administrative order, or a subpoena.
Substance Use Disorder Records
In the ordinary course of our business, BiliMed does not create or receive substance use disorder (SUD) treatment records subject to 42 CFR Part 2. If we ever receive such records, we will treat them with the additional protections that law requires, including obtaining your consent before using or sharing them except as the law allows.
Our Responsibilities
● We are required by law to maintain the privacy and security of your protected health information.
● We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
● We must follow the duties and privacy practices described in this notice and give you a copy of it.
● We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by letting us know in writing.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Questions & Privacy Official
If you have questions about this notice, want more information, or want to file a complaint, contact our Privacy Official:
Anne Orsak, Owner · BiliMed, L.L.C. · 345 Doucet Road, Suite 200E, Lafayette, LA 70503 · (337) 509-1818 · info@bilimed.com
Acknowledgment of Receipt
By signing (or by electronically confirming at checkout), you acknowledge that you have received or been offered a copy of BiliMed’s Notice of Privacy Practices. For electronic orders, your online acknowledgment serves as your written acknowledgment of receipt.
Last updated: August 2026
Your Right to a Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost
Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.
● You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
● If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
● If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
How This Works at BiliMed
BiliMed, L.L.C. operates on a cash-pay basis. We do not bill private insurance directly, and we do not bill Medicare or Medicaid, so every family we serve is entitled to a Good Faith Estimate. You will receive one in writing before your rental begins, and you may request one at any time before scheduling.
Our rate is $95 per calendar day plus 9% Louisiana sales tax, or $103.55 per day. Optional delivery, return pickup, and the optional damage waiver are itemized separately on your estimate and also subject to tax. On request we will also provide an itemized superbill you may submit to your insurer for possible reimbursement.
Please keep your Good Faith Estimate — save a copy or take a picture of it. You will need it if you ever want to compare it against a bill or start a dispute. You will never be penalized for asking about cost, requesting an estimate, or disputing a bill.
Contact
BiliMed, L.L.C. · 345 Doucet Road, Suite 200E, Lafayette, LA 70503
(337) 509-1818 · info@bilimed.com
Notice posted in accordance with the federal No Surprises Act (Public Health Service Act § 2799B-6). Required notice text follows the CMS model notice, revision date 8/2023.
Last updated: August 2026