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PATIENT PRIVACY
As a patient you want to feel secure in knowing that your health
and medical information is private and protected and who has access
to this information. Federal law protects your rights:
Providing you privacy rights over your health information.
Establishing rules and limits on whom has access to your
health information.
These rights are important for you to know. You can exercise these
rights, ask questions about them, and file a complaint if you think
your rights are being denied or your health information is not
being protected.
The following sections and categories describe different ways
The Center for Medical Imaging may use and disclose health-care
information about you. To assist you in understanding your rights,
for each section we explain and give an example of the use or disclosure
of your medical information.
HIPAA NOTICE OF PATIENT PRIVACY PRACTICES
Section A: Who Will Follow This Notice?
This notice describes The Center for Medical Imaging’s practices
and that of:
Any health care professional authorized to enter information
into your medical chart.
All employees, staff and other personnel of The Center
for Medical Imaging.
Section B: 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 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 or maintained
by The Center for Medical Imaging, whether made by The Center for Medical Imaging
personnel or your personal doctor. Your personal doctor may have different
policies or notices regarding the doctor's use and disclosure of your medical
information created in the doctor's office or clinic.
This notice will tell you about the ways in which we may use and disclose medical
information about you. We also describe your rights and certain obligations
we have regarding the use and disclosure of medical information.
We are required by law to:
Use our best efforts to keep medical information that identifies you private;
Give you this notice of our legal duties and privacy practices with respect
to medical information about you; and
Follow the terms of the notice that is currently in effect.
Section C: 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 or disclosures we will explain what
we mean and try to give some examples. Not every use or disclosure in a category
will be listed. However, all of the ways we are permitted to use and disclose
information will fall within one of the categories.
Treatment. We may use medical information about you to provide you with medical
treatment or services. We may disclose medical information about you to doctors,
nurses, technicians or other Center for Medical Imaging personnel who are involved
in taking care of you. We also may disclose medical information about you to
people outside The Center for Medical Imaging who may be involved in your medical
care after you leave, such as family members or others we use to provide services
that are part of your care.
Payment. We may use and disclose medical information about you so that the
services you receive at The Center for Medical Imaging may be billed to and
payment may be collected from you, an insurance company or a third party. For
example, we may need to give your health plan information about services you
received at The Center for Medical Imaging so your health plan will pay us
or reimburse you for the services you received.
Health Care Operations. We may use and disclose medical information
about you for The Center for Medical Imaging’s operations.
These uses and disclosures are necessary to run The Center for
Medical Imaging and make sure that all of our patients receive
quality care. For example, we may use medical information to review
our 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 Center for Medical Imaging
should offer. We may also disclose information to doctors, nurses,
technicians and other Center for Medical Imaging personnel for
review and learning purposes. We may also combine the medical information
we have with medical information from other entities to compare
how we are doing and see where we can make improvements in the
care and services we offer. 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.
Appointment Reminders. We may use and disclose medical
information to contact you as a reminder that you have
an appointment at The Center for Medical Imaging.
As Required By Law. We will disclose medical information
about you when required to do so by federal, state or local
law.
To Avert a Serious Threat to Health or Safety. We may
use and disclose medical information about you when necessary
to prevent a serious threat to your health and safety or
the health and safety of the public or another person.
Any disclosure, however, would only be to someone able
to help prevent the threat.
Section D: Special Situations
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.
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.
We may also release medical information about foreign military personnel to
the 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 illness.
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 civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a 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 certain limited circumstances, we are
unable to obtain the person's agreement;
About a death we believe may be the result of criminal conduct;
About criminal conduct at The Center for Medical Imaging; and
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 and Intelligence Activities. We may release medical information
about you to authorized federal officials for intelligence, counterintelligence,
and other national security activities authorized by law.
Protective Services for the President and Others. We may disclose medical
information about you to authorized federal officials so they may provide protection
to the President, 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. This release
would be necessary (1) for the institution to provide you with health care;
(2) to protect your health and safety or the health and safety of others; or
(3) for the safety and security of the correctional institution.
Section E: 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 some of
the medical information that may be used to make decisions about your care.
Usually, this includes medical and billing records. If you request a copy of
the information, we may charge a fee for the costs of copying, mailing or other
supplies associated with your request.
We may deny your request to inspect and copy medical information in certain
circumstances. If you are denied access to medical information, in some cases,
you may request that the denial be reviewed. Another licensed health care professional
chosen by the Center will review your request and the denial. The person conducting
the review will not be the person who denied your request. We will comply with
the outcome of the review.
Right to Amend. If you feel that 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 for as long as the information is kept by
or for the Center. In addition, you 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:
Was not created by us, unless the person or entity that created the information
is
no longer available to make the amendment;
Is not part of the medical information kept by or for the Center;
Is not part of the information which you would be permitted to inspect and
copy; or
Is 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 made of medical
information about you. Your request must state a time period, which may not
be longer than six years and may not include dates before April 14, 2003. Your
request should indicate in what form you want the list (for example, on paper,
electronically). The first list you request within a 12-month period will be
free. For additional lists, we may charge you for the costs of providing the
list. 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 on 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 who 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
service you had.
In your request, you 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.
We are not required to agree to your request. If we do agree, we will comply
with your request unless the information is needed to provide you emergency
treatment.
Right to Request Confidential Communications. You have the right to request
that we communicate with you about medical matters in a certain way or at a
certain location. For example, you can ask that we only contact you at work
or by mail. We will not ask you the reason for your request. We will accommodate
all reasonable requests. Your request must specify how or where you wish to
be contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy
of this notice. You may ask us to give you a copy of this notice at any time.
Even if you have agreed to receive this notice electronically, you are still
entitled to a paper copy of this notice.
Section F: Changes To This Notice.
We reserve the right to change this notice. We reserve the right to make
the revised or changed notice effective for medical information we already
have about you as well as any information we receive in the future. We will
post a copy of the current notice at The Center for Medical Imaging. The notice
will contain on the first page, in the top right hand corner, the effective
date. In addition, each time you register at the Center, we will offer you
a copy of the current notice in effect.
Section G: Complaints
If you believe your privacy rights have been violated, you may
file a complaint with the Center or with the Secretary of the Department
of Health and Human Services. To file a complaint with The Center
for Medical Imaging, contact Florida Hospital Waterman’s
privacy officer at 352-253-3529. To file a complaint with the Department
of Health and Human Services, use the following address:
Region IV, Office for Civil Rights 404-562-7886
U.S. Dept of Health and Human Services 404-562-7881 (Fax)
Atlanta Federal Center, Suite 3B70 404-331-2867 (TDD)
61 Forsyth St., SW
Atlanta, GA 30303-8909.
All complaints must be submitted in writing. You will not be penalized
for filing a complaint.
Section H: 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 permission. If you provide us permission to use or
disclose medical information about you, you may 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. You understand that
we are unable to take back any disclosures we have already made
with your permission, and that we are required to retain our records
of the care that we provided to you.
Section I: Organized Health Care Arrangement
The Center for Medical Imaging, the independent contractor members
of its Medical Staff (including your radiologist), and other health
care providers affiliated with The Center for Medical Imaging have
agreed, as permitted by law, to share your health infomation among
themselves for purposes of your treatment, payment or health care
operations. This enables us to better address your health care
needs.
The Center for Medical Imaging
is operated by The Medical Imaging Professionals, P.A.
and is an affiliate of Florida Hospital Waterman
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