HEALTH SCAN
IMAGING
NOTICE OF PRIVACY
PRACTICES
EFFECTIVE DATE:
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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. |
UNDERSTANDING YOUR HEALTH RECORD/INFORMATION
Each
time you visit a hospital, radiologist, physician, dentist, or other healthcare
provider, a record of your visit is made. Typically, this record contains your
symptoms, examination and test results, diagnoses, treatment, and a plan for
future care or treatment. This information
often referred to as your health or medical record, serves as a basis for
planning your care and treatment and serves as a means of communication among
the many health professionals who contribute to your care. Understanding what is in your record and how
your health information is used helps you to ensure its accuracy, better
understand who, what, when, where, and why others may access your health
information, and helps you make more informed decisions when authorizing
disclosure to others.
YOUR HEALTH INFORMATION RIGHTS
Unless
otherwise required by law, your health record is the physical property of the
healthcare practitioner or facility that compiled it. However, you have certain rights with respect
to the information. You have the right
to:
1.
Receive a copy of this Notice of Privacy
Practices from us upon enrollment or upon
request.
2.
Request restrictions on our uses and
disclosures of your protected health information for treatment, payment and health care operations. However, we reserve the right not to agree
to the requested restriction.
3.
Request to receive communications of protected
health information in confidence.
4.
Inspect and obtain a copy of the protected
health information contained in your medical
and billing records and in any other Practice records used by us to make
decisions about you. A reasonable
copying charge may apply.
5.
Request an amendment to your protected health
information.
However, we may deny your request for an amendment, if we determine that
the protected health information or record that is the subject of the request:
·
was not created by
us, unless you provide a reasonable basis to believe that the originator of the
protected health information is no longer available to act on the requested
amendment;
·
is not part of
your medical or billing records;
·
is not available
for inspection as set forth above; or
·
is accurate and complete.
In any event, any agreed
upon amendment will be included as an addition to, and not a replacement of,
already existing records.
6.
Receive an accounting of disclosures of
protected health information made by us to
individuals or entities other than to you, except for disclosures:
·
to carry out
treatment, payment and health care operations as provided above;
·
to persons
involved in your care or for other notification purposes as provided by law;
·
to correctional
institutions or law enforcement officials as provided by law;
·
for national
security or intelligence purposes;
·
that occurred
prior to the date of compliance with privacy standards (
·
incidental to
other permissible uses or disclosures;
·
that are part of a
limited data set (does not contain protected health information that directly
identifies individuals);
·
made to patient or
their personal representatives;
·
for which a
written authorization form from the patient has been received
7.
Revoke your authorization to use or disclose
health information except to the extent that we
have already been taken action in reliance on your authorization, or if the
authorization was obtained as a condition of obtaining insurance coverage and
other applicable law provides the insurer that obtained the authorization with
the right to contest a claim under the policy.
HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED
This organization may use
and/or disclose your medical information for the following purposes:
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Treatment: We
may use and disclose protected health information in the provision,
coordination, or management of your health care, including consultations
between health care providers regarding your care and referrals for health
care from one health care provider to another. Payment: We
may use and disclose protected health information to obtain reimbursement for
the health care provided to you, including determinations of eligibility and
coverage and other utilization review activities. Regular Healthcare
Operations: We may use and disclose
protected health information to support functions of our practice related to
treatment and payment, such as quality assurance activities, case management,
receiving and responding to patient complaints, physician reviews, compliance
programs, audits, business planning, development, management and
administrative activities. Appointment Reminders: We may use and disclose protected health information
to contact you to provide appointment reminders. Treatment Alternatives: We may use and disclose protected health
information to tell you about or recommend possible treatment alternatives or
other health related benefits and services that may be of interest to you Health-Related Benefits
and Services: We may use and
disclose protected health information to tell you about health-related
benefits, services, or medical education classes that may be of interest to
you. Individuals Involved in
Your Care or Payment for Your Care:
Unless you object, we may disclose your protected health information to your
family or friends or any other individual identified by you when they are
involved in your care or the payment for your care. We will only disclose the
protected health information directly relevant to their involvement in your
care or payment. We may also disclose your protected health information to
notify a person responsible for your care (or to identify such person) of
your location, general condition or death. Business
Associates: There may be some
services provided in our organization through contracts with Business
Associates. Examples include
physician services in the emergency department and radiology, certain
laboratory tests, and a copy service we use when making copies of your health
record. When these services are
contracted, we may disclose some or all of your health information to our
Business Associate so that they can perform the job we have asked them to do.
To protect your health information, however, we require the Business
Associate to appropriately safeguard your information. Organ and Tissue
Donation: If you are an organ donor,
we may release medical information to organizations that handle organ
procurement or organ, eye or tissue transplantation or to an organ donation
bank, as necessary to facilitate organ or tissue donation and
transplantation. Worker's Compensation: We may release protected health information about
you for programs that provide benefits for work related injuries or illness. Communicable Diseases: We may disclose protected health information to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. |
Health Oversight
Activities: We may disclose
protected health information to federal or state agencies that oversee our
activities. Law Enforcement: We may disclose protected health information as
required by law or in response to a valid judge ordered subpoena. For example in cases of victims of abuse or
domestic violence; to identify or locate a suspect, fugitive, material
witness, or missing person; related to judicial or administrative
proceedings; or related to other law enforcement purposes. Military and Veterans: If you are a member of the armed forces, we may
release protected health information about you as required by military
command authorities. Lawsuits and Disputes: We may disclose protected health information about
you in response to a court or administrative order. We may also disclose
medical information about you in response to a subpoena, discovery request,
or other lawful process. Inmates: If you are an inmate of a correctional institution
or under the custody of a law enforcement official, we may release protected
health information about you to the correctional institution or law
enforcement official. An inmate does
not have the right to the Notice of Privacy Practices. Abuse or Neglect: We may disclose protected health information to
notify the appropriate government authority if we believe a patient has been
the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree
or when required or authorized by law. Fund raising: Unless you notify us you object,
we may contact you as part of a fund raising effort for our practice. You may opt out of receiving fund raising
materials by notifying the practice’s privacy officer at any time at the
telephone number or the address at the end of this document. This will also be documented and described
in any fund raising material you receive. Coroners, Medical
Examiners, and Funeral Directors: We
may release protected health information to a coroner or medical examiner.
This may be necessary to identify a deceased person or determine the cause of
death. We may also release protected health information about patients to
funeral directors as necessary to carry out their duties. Public Health Risks: We may disclose your protected health information
for public health activities and purposes to a public health authority that
is permitted by law to collect or receive the information. The disclosure
will be made for the purpose such as controlling disease, injury or disability.
Serious Threats: As permitted by applicable law and standards of
ethical conduct, we may use and disclose protected health information if we,
in good faith, believe that the use or disclosure is necessary to prevent or
lessen a serious and imminent threat to the health or safety of a person or
the public. Food and Drug
Administration (FDA): As required by
law, we may disclose to the FDA health information relative to adverse events
with respect to food, supplements, product and product defects, or post
marketing surveillance information to enable product recalls, repairs, or
replacement. Research (inpatient): We may disclose information to researchers when an
institutional review board that has reviewed the research proposal and
established protocols to ensure the privacy of your health information has
approved their research. |
OUR RESPONSIBILITIES
We
are required to maintain the privacy of your health information. In addition, we are required to provide you
with a notice of our legal duties and privacy practices with respect to
information we collect and maintain about you.
We must abide by the terms of this notice. We reserve the right to change our practices
and to make the new provisions effective for all the protected health
information we maintain. If our
information practices change, a revised notice will be mailed to the address
you have supplied upon request. If we
maintain a Web site that provides information about our patient/customer
services or benefits, the new notice will be posted on that Web site. Your health information will not be used or
disclosed without your written authorization, except as described in this
notice. Except as noted above, you may revoke your authorization in writing at
any time.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions about
this notice or would like additional information, you may contact our Privacy
Officer, Kathy Provo, at the telephone or address below. If you believe that your privacy rights have
been violated, you have the right to file a complaint with the Privacy Officer
at Health Scan Imaging or with the Secretary of the Department of Health and
Human Services. We will take no
retaliatory action against you if you make such complaints.
The contact information for
both is included below.
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Office of the Secretary Tel: (202) 619-0257 Toll Free: 1-877-696-6775
http://www.hhs.gov/contacts |
HEALTH
SCAN IMAGING Kathy Provo Privacy Officer 72-980 Fred Waring Drive, Suite A Tel: (760) 776-8001 Fax: (760) 776-9636
kathy@healthscanimaging.com |
NOTICE
OF PRIVACY PRACTICES AVAILABILITY
This
notice will be prominently posted in the office where registration occurs. You will be provided a hard copy, at the
time we first deliver services to you. Thereafter, you may obtain a copy upon
request, and the notice will be maintained on the organization’s Web site (if
applicable Web site exists) for downloading.