Patient Privacy Policy
IMAGING ASSOCIATES OF CANTON
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.
OUR PLEDGE REGARDING YOUR HEALTH INFORMATION.
We understand that information about you and your health is personal. We are committed to protecting your health information. We create a record of the care and services you receive at our practice, as well as records regarding payment for those services. This notice applies to all of the records concerning your care generated by our practice doctors and/or personnel. This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations that we have regarding the use and disclosure of medical information.
We are required by law to:
• Make sure that medical information that identifies you is kept private;
• Give you this notice of our legal duties and privacy practices with respect to medical information; and
• Follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
• For Treatment. We may use health information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you.
• For Payment. We may use and disclose health information about you so that the treatment and services you receive at our practice may be billed and that payment may be collected from you, an insurance company or another third party. We may also need to disclose information prior to treating you in order to obtain prior approval from your health plan or another third party.
• For Health Care Operations. We may use and disclose medical information about you for the practice’s health care operations. These uses and disclosures are necessary to run our practice and make sure that all patients receive quality care. We may also compile your information with that of other patients to determine what services we should offer to patients in the future or whether certain treatments are effective. We may also disclose your health information to doctors, nurses, technicians, medical students, residents, and other practice personnel for review and training. We may also disclose your information in conducting or arranging other business activities of the practice such as attorneys, accountants, or other business associates or service providers. We may also disclose your information as a part of a sale, transfer, merger or consolidation of our practice to another entity covered by the Privacy Rule. 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.
• Appointment Reminders. We may disclose information, if necessary, to contact you to remind you about appointments.
• Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
• Health-Related Benefits and Services. We may disclose medical information to tell you about health-related benefits or services that may be of interest to you.
• Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. We may also use our professional judgment and experience to make reasonable decisions in allowing a person to act on your behalf to pick up films or prep medications. We may also disclose information to an entity assisting in disaster relief so that your family can be informed about your condition and location.
• 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.
SPECIAL SITUATIONS
• Research. We may use your records when conducting medical research, but only if a legally authorized review board gives us permission to use your information and provided that the researcher says he will use safeguards to protect your information.
• Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement, including tissue donation, in order to facilitate a donation or 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 use and disclose information to the Department of Veterans Affairs to determine whether you are eligible for certain benefits.
• Worker’s Compensation. We may release medical information about you for worker’s compensation or similar programs. These programs provide benefits for work-related injuries and illnesses.
• Public Health Risks. We may disclose medical information about you for public health activities. This may include situations that prevent or control disease, injury or disability; to report deaths; to report reactions to medications or problems with products; to notify people of recalls of products they may be using; to notify a person or may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and to notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence as required by the law.
• Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. This may include audits, investigations, inspections, and licensure necessary for the government to monitor the health care system, government programs, and ensure 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, a subpoena, a discovery request, or other lawful process by someone else involved in the dispute. We will only do so, however, if we receive satisfactory assurances that the party seeking the information has made efforts to tell you about the request, allowing you to obtain an order protecting the information.
• 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; about a death we believe may be the result of criminal conduct; or in an emergency to report a crime, the location of a crime or victims, or the identity, description, or location of a person who committed a crime.
• Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner, medical examiner, and funeral director to assist them in their job.
• National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities as 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 to state.
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 may be used to make decisions about your care. To do so, you must submit your request in writing to our Privacy Officer. 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 to inspect and copy in very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed if the denial is made for certain reasons. Another licensed health care professional chosen by our practice will review your request and the subsequent denial. The person conducting the review will not be the person who initially 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 our practice. To do so, your request must be made in writing and submitted to our Privacy Officer, and you must provide a reason that supports your request. 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 our practice; is not part of the information which you would be permitted to inspect and copy; or if the information 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 certain disclosures we made of medical information about you. To do so, you must submit your request in writing to our Privacy Officer. Your request must state a time period which may not start more than six years in the past and may not include dates before April 14, 2003. The first list you request will be provided free of cost. We may charge you for additional list, but will notify you of this cost before the list is produced.
• 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 purposes. You may also request a limit on the medical information we disclose about you to someone who is involved in your care or the payment of your care. We are not, however, 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. To request restriction, please notify our Privacy Officer in writing with (1) what information you want limited; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply.
• 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. To do so, you must make your request in writing to our Privacy Official how, when, or where you wish to be contact, and no reason for your request is required. We will accommodate your request if reasonable.
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 in our practice, with the effective date on the first page.
COMPLAINTS AND WRITTEN REQUESTS
If you believe your privacy rights have been violated, or if you wish to file a written request, please submit them to our Privacy Official at:
200 Oakside Lane, Suite A
Canton, Georgia 30114
You may also file complaints with the Secretary of the Department of Health and Human Services. You will not be penalized in any way for filing a complaint.
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 provided to you.
