NOTICE OF PRIVACY PRACTICES
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.
If you have any questions about this Notice, please contact our Privacy Officer at
The Imaging Center
Attn: Privacy Officer
235 Dunn Road
Florissant, Missouri 63031
314-837-2882
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you that may identify you and that relates to your past, present or future physical or mental health condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices by calling the office and requesting a copy be sent to you in the mail, or by asking for one at your next appointment.
This Notice will be followed by all employees and physicians who perform services for The Imaging Center.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at The Imaging Center. We need this record to provide you with quality care and to comply with certain legal requirements. This Notice applies to all of the records of your care generated by The Imaging Center. You hospital or physician office may have different policies or notices regarding their use and disclosure of your medical information created by them.
We are required by law to:
· make sure that medical information that identifies you is kept private
· make available to you this Notice of our legal duties and privacy practices with respect to medical information about you
· follow the terms of the Notice that is currently in effect
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose medical information. For each category of uses of disclosures we prove examples, but not every use or disclosure in a category is listed. However, all of the ways we are permitted to use and disclose information will fall within on of the categories.
For Treatment: We may use medical information about you to provide you with medical treatment of services. We may disclose medical information about you to doctors, nurses, technicians, or other hospital or physician office personnel who are involved in taking care of you. For example, we will fax and mail the report of your diagnostic study to the ordering physician and any other physicians designated by you to receive that information.
For Payment: We may use and disclose medical information about you so that the treatment and services you receive at The Imaging Center may be bill and payment collected from you, an insurance company or a third party. This may include contacting your health plan regarding your eligibility or coverage for insurance benefits and precertification for diagnostic studies. We may disclose information about you to a collection agency to obtain payment. We may also need to contact any third party payor to ensure they have claimed full responsibility for payment of your bill. For example, we may call an attorney’s office to authorize that they are representing you and accepting the responsibility for payment and send them a billing statement and lien for that service.
For Healthcare Operations. We may use and disclose medical information about you for The Imaging Center operations. These uses and disclosures are necessary to run The Imaging Center and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what additional services The Imaging Center should offer and what services are not needed. We may share this information with other personnel to get permission to perform additional services at The Imaging Center. We may remove information that identifies you from this set of medical information, so others may use it to study health care and health care delivery without learning who the specific patients are. There may be incidental disclosures of you medical information if our computer system requires servicing and there is a need to backup or retrieve your medical information.
Appointment Reminders. We may use and disclose information to contact you as a reminder that it is time to make an appointment for your regular testing at The Imaging Center.
Health-Related Benefits and Services. We may use and disclose medical information to tell you about or recommend additional screening tests or services that may be of interest to you.
Individuals involved in Your Care or Payment for Your Care. We may release information about you to someone who is involved in your care or who helps to pay for your care, such as attorney or workers compensation claims adjuster. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort, so that you family can be notified about your condition, status and location.
As required by Law. We will disclose medical information about you in the situations described under “SPECIAL SITUATIONS” above.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorizations. A form for those authorizations, both those that you request and those that we request, is available from our medical records clerk at the location noted on the first page of this Notice. If you give us an authorization, you may later revoke that permission in writing, at any time, if you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. In that case, however, we will be unable to take back any disclosure we have already made with your permission, and we will still be required to retain our records of the care that we provided to you.
SPECIAL SITUATIONS
Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities or, some cases if needed to determine benefits, to the Department of Veteran Affairs. We may also release medical information about foreign military personnel to appropriate foreign military authority.
Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
Public Health Risks. We may disclose medical information about your for public health activities. These activities generally include the following:
· to prevent of control disease, injury or disability
· to report births and deaths
· to report child abuse or neglect
· to report reactions to medications or problems with products
· to notify people of recalls of products they may be using
· 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
· 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.
Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with the civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose medical 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 by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement. We may release medical information if asked to do so by a law enforcement official.
· In response to a court order, subpoena, warrant, summons or similar process.
· To identify or locate a suspect, fugitive, material witness, or missing person.
· About the victim of a crime if, under limited circumstances, we are unable to obtain the person’s agreement
· About a death believed to have been the result of criminal conduct
· In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime
National Security, Intelligence and Federal Protective Service Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law, and to authorized federal officials where required to provide protection to the President of the United States, other authorized persons or foreign heads of state or conduct special investigations.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official where necessary to provide you with health care, to protect your health and safety or the health and safety of others; or for the safety and security of the correctional institution.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding medical information we maintain about you:
· Right to Inspect and Copy. You have the right to inspect and copy medical information that be used to make decisions about your health care. Usually this includes medical and billing records, but does not include psychotherapy notes. You must submit any request to inspect and copy your medical information to the Medical Records Department at the location noted on the first page of this Notice, in writing. (A form for that request is available from that office.) If you request a copy of your information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request in very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed. The person conducting the review will not be the person that denied your request. We will comply with the outcome of that review.
· Right to Amend. If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment as long as the information is kept by The Imaging Center. You must submit a request in writing to our Medical Records Department at the location noted on the first page of this Notice. Your written request must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
o Was not created by us, unless the person or entity that created the information is no longer able to make the amendment
o Is not part of the medical information kept by or for The Imaging Center
o Is not part of the information which you are permitted to inspect and copy
o Is already accurate and complete
· Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we have made of medical information about you, with some exceptions. The exceptions are governed by federal health privacy law and include (1) routine disclosures for treatment, payment and operations and (2) disclosures to you. You must submit a request in writing for an account of your disclosures to the Medical Records Department at the location noted on the first page of this Notice. your written request must state a time period. which may not be longer than six years and may not include dates before February 1, 2003, when current federal health privacy laws became effective for The Imaging Center. (Your request should indicate whether you want the report electronically or on paper) The first report you request within a 12 month period of time will be free. For additional reports, we may charge you for the costs of providing the report. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
· Right to Request Restrictions. You have the right to request a restriction or limitation the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone is involved in your care or the payment for your care. like a family member or friend. For example, you could ask that we not use or disclose information about a diagnostic test you had performed in the past. Please note that we are not required to agree to your request. However, if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. You must submit a request in writing for an accounting of you disclosures to the Medical Records Department at the location noted on the first page of this Notice. your written request must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
· Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or certain location. For example, you can ask that we only contact you at work or by mail. You must submit a request in writing for an accounting of you disclosures to the Medical Records Department at the location noted on the first page of this Notice. Your written request must tell us how or where you wish to be contacted. We will not ask you the reason for your request. We will accommodate all reasonable requests.
· Right to a Paper Copy of This Notice. You may ask us to give you a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically, by contacting our Medical Records Department at the location noted on the first page of this Notice.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. When we do, we may make the changed Notice effective for medical information we already have about you then, as well as any information we receive in the future. We will post a copy of the current Notice in the Waiting Room and at the Registration Des. Each Notice will contain on the first page, tap right-hand corner, its effective date. Also, each time you register at The Imaging Center for diagnostic services, you may request a copy of the current Notice in effect.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with The Imaging Center or with the Secretary of the Department of Health and Human Services. To file a complaint with The Imaging Center, contact the Privacy Officer at the location noted on the first page of this Notice. All complaints must be submitted in writing. YOU WILL NOT BE PENALIZED FOR FILING A COMPLAINT.
This notice was published and became effective on March 1, 2003.