Independent Diagnostic Radiology
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.
How INDEPENDENT DIAGNOSTIC RADIOLOGY May Use or Disclose Your Health Information
For Treatment. Independent Diagnostic Radiology may use your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a physician, nurse, or other person providing health services to you, will record information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.
For Payment. Independent Diagnostic Radiology may use and disclose your health information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payor, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.
For Health Care Operations. Independent Diagnostic Radiology may use and disclose health information about you for operational purposes, for example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:
Facility Directory. Unless you notify us in writing that you object, we will include certain limited information about you in the facility directory while you are a patient at Independent Diagnostic Radiology This information may include your name, location in the facility, your general condition (e.g., fair, stable, etc.) and your religious affiliation. The directory information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name. This is so your family, friends and clergy can visit you or generally know how you are doing.
Appointments. Independent Diagnostic Radiology may use your information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to the individual.
Required By Law. Independent Diagnostic Radiology may use and disclose information about you as required by law. For example, Independent Diagnostic Radiology may disclose information for the following purposes:
· For judicial and administrative proceedings pursuant to legal authority;
Public Health. Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability, or for other health oversight activities.
Decedents. Health information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.
Organ/Tissue Donation. Your health information may be disclosed to avert a serious threat to the health and safety of you or any other person pursuant to applicable law.
Research. Independent Diagnostic Radiology may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved the research.
Patient Education. Independent Diagnostic Radiology may use your information to contact you about treatment options and other health related topics. These include disease-management programs.
Health and Safety. Your health information may be disclosed to avert a serious threat to the health and safety of you or any other person pursuant to applicable law.
Fundraising Efforts. We may use or disclose your name, address, and dates that you received treatment for Independent Diagnostic Radiology. supported fundraising efforts. Letters addressed to you will note what to do so as not to receive future communications.
Government Functions. Your health information may be disclosed to specialized governmental functions such as protection of public officials or reporting to various branches of the armed services that may require use or disclosure of your health information.
Workers Compensation. Your health information may be used or disclosed in order to comply with laws and regulation related to Workers Compensation.
Your Health Information Rights
You have the right to:
· Request a restriction on certain uses and disclosures or your information as provided by 45 CFR §164.522; however, Independent Diagnostic Radiology is not required to agree to a requested restriction;
· Obtain a paper copy of the Notice of Privacy Practices upon request;
· Inspect and obtain a copy of your health record as provided for in 45 CFR §164.524;
· Amend your health record as provided for in 45 CFR §164.526;
· Request communications of your health information by alternative means or at alternative locations;
· Revoke your authorization to use or disclose health information except to the extent that action has already been taken; and
· Receive an accounting of disclosures made of your health information as provided by 45 CFR §164.528.
Independent Diagnostic Radiology will not require you to waive your above mentioned rights in order to provide treatment to you. If you feel your rights have been violated, see the Complaint Section that follows.
Independent Diagnostic Radiology is required to:
· Maintain the privacy of protected health information;
· Provide you with this notice of its legal duties and privacy practices with respect to your health information;
· Abide by the terms of this notice;
· Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
· Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations; and
· Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted under law.
Independent Diagnostic Radiology reserves the right to change its information practices and to make the new provisions effective for all protected health information it maintains. Revised notices will be made available to you upon request and will be available on the Independent Diagnostic Radiology website, www.independent-dr.com.
You may complain to Independent Diagnostic Radiology and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint. To file a complaint with Independent Diagnostic Radiology, contact Cheryl Castano, our Privacy Officer at (727) 327-5006. To file a complaint by mail, send it to the following address:
Independent Diagnostic Radiology
You may also file an anonymous complaint by contacting Independent Diagnostic Radiology by telephone at (727) 327-5006 or by fax at (727) 327-3077.