The OraStretch press Product Information
The OraStretch press jaw motion rehab system is a handheld unit designed to stretch a user's jaw to treat trismus, dysfunction and hypomobility. The device uses passive motion to stretch the user's jaw, joint and facial tissues for increased mobility, flexibility, and function.
The OraStretch press device provides a curved, anatomically correct stretch for patients to treat or rehabilitate their jaw and temporomandibular joint. The OraStretch press can be used for stretching, passive motion, and muscle strengthening. By utilizing the OraStretch press, a user can increase their range-of-motion, improve their jaw and joint function, and reduce swelling and pain.
Equipment Warranty Information
Every product sold by our company carries at least a 1-year manufacturer’s warranty. We will notify all patients of the warranty coverage, and we will honor all warranties under applicable law. CranioRehab will repair or replace, free of charge, covered equipment that is under warranty. In addition, an owner’s manual with warranty information is included with the product. CranioRehab does not warranty any issues caused by normal wear-and-tear or patient abuse or neglect.
Routinely Purchased Items Notification
The OraStretch press is only sold as a single-patient-use item and is a routinely purchased item. The OraStretch press cannot be returned after it has been opened or used. I have received instructions and agree to purchase the equipment as a NEW routinely purchased item.
OraStretch press Instructions
The OraStretch press is a jaw motion rehab system, which prevent and treat trismus, temporomandibular joint (TMJ) disorder, and facial trauma; and are used for rehabilitation of the jaw after surgery. Jaw motion rehab systems use passive motion to mobilize the joint and stretch the tissues of the jaw and face.
Instructions for Therapy:
• Insert mouthpieces between the teeth.
• Squeeze the handle and hold to press the mouth and jaw open
• Release and pause.
• Repeat squeeze and release as instructed in the user’s protocol.
• To end: Remove, rinse mouthpieces and allow to dry.
• Relax, and don’t stretch too hard. Overstretching can tear or damage tissue. Stretch slow and easy.
• Stop immediately and contact your doctor if you experience any sharp pain during use.
• Apply the pads one hour before use to set the adhesive.
• Use it every day. Your recover depends on your commitment to rehabilitation.
Please see the OraStretch Press Instruction Manual included with the device for more information on usage, care, cleaning, cautions, warnings, and warranty information. Also, feel free to call us with any questions on use or care of your OraStretch press jaw motion rehab system.
Your Health Information Rights
The health record we maintain and billing records are the physical property of the practice. The personal protected health information (PHI) in it, however, belongs to you. You have a right to:
• Request a restriction on certain uses and disclosures of your PHI, which we may or may not grant.
• Request to inspect/copy your health and billing record or to amend for incomplete or incorrect information ;
• Appeal a denial of access to your PHI, and have any denied amendment be attached in all future disclosures of your PHI;
• Obtain a disclosure report by written request to our office, which does not include internal uses of PHI for treatment, payment, or operations; or disclosures made to you, at your request, to family, or friends in the course of providing care;
• Request communications with PHI be made by alternative means or at an alternative location; and,
• Revoke future authorization to use or disclose information except by writing.
To exercise any of the above rights, please contact us in writing. We will assist you to exercise your rights. To request information, file a complaint or want to report a problem regarding the handling of your information, contact our office.
Review this Notice before signing authorization to use and disclosure your PHI for treatment, payment, and health care purposes. If you believe your privacy rights have been violated, send a written complaint to our address. You may also file a complaint by mailing it or e-mailing it to the Secretary of Health and Human Services (HHS). We cannot require you to waive the right to file a complaint with the Secretary of HHS; and will not retaliate against you for filing a complaint with the Secretary of HHS.
This office and its agents are required to:
• Maintain the privacy of your health information as required by law;
• Provide you with a notice of our duties and privacy practices as to the information we collect and maintain about you;
• Abide by the terms of this Notice;
• Notify you if we cannot accommodate a requested restriction or request; and
• Accommodate your reasonable requests regarding methods to communicate health information with you.
We reserve the right to add, amend, change, or eliminate provisions in our privacy and access practices regarding the PHI we maintain. An updated policy may be requested by calling or visiting our office, and is available from our website.
Other Disclosures and Uses
Notification: Unless you object, PHI may be disclosed to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.
Communication with Family: Using our best judgment, PHI may be disclosed to a family member, relative, close personal friend, or any other person you identify, as relevant to that person’s involvement in your care if you do not object or in an emergency.
Legal Requirements and Public health: PHI may be disclosed: to FDA relating to adverse events with respect to products and product defects, or surveillance information to enable product recalls, repairs, or replacements; to bill and comply with laws relating to Workers Compensation; to legal and health oversight authorities for controlling disease, injury, or disability; to public authorities as allowed by law to report abuse or neglect: to institutions of inmates for health and safety: as required by law, such as by court order, in felony prosecutions, or those in custody; or in judicial/administrative proceeding as consented, allowed or required by law or court.
Other Uses: Other uses and disclosures besides those identified in this Policy will be made only as otherwise authorized by law or with your written authorization and you may revoke the authorization as previously provided.
Assignment of Benefits
I authorize the following:
1. The Assignment of Medicare, Medicaid, Medicare Supplemental or other insurance benefits to CranioMandibular Rehab, Inc. for medical supplies and/or medication furnished to me by CranioMandibular Rehab, Inc.
2. Direct billing to Medicare, Medicaid, Medicare Supplemental or other insurer(s).
3. Release of my medical information to Medicare, Medicaid, Medicare Supplemental or other insurers and their agents and assigns.
4. CranioMandibular Rehab, Inc. to obtain medical or other information necessary in order to process my claim(s), including determining eligibility and seeking reimbursement for medical supplies and/or medication(s) provided.
5. CranioMandibular Rehab, Inc. to contact me by telephone or mail regarding my medical supplies and/or medication(s) order.
I agree to pay all amounts that are not paid by my insurer(s), including applicable co-payments and/or deductibles for which I am responsible.
I request that payment of Medicare, Medicaid, Medicare Supplemental or other insurance benefits be made on my behalf to CranioMandibular Rehab, Inc. for any medical supplies and/or medications furnished to me by CranioMandibular Rehab, Inc. I authorize any holder of medical information about me to release to CranioMandibular Rehab, Inc., my physician(s), caregiver, CMS, its agents and to my primary and/or other medical insurer any information needed to determine or secure eligibility information and/or reimbursement for covered services.
This agreement and assignment supersedes any and all contracts or agreements. If any provision of this document is invalid or unenforceable, it shall not limit the application of any remaining provisions.