Privacy Notice
Our goal is to take appropriate steps to attempt to safeguard any
medical or other personal health information (PHI) that is provided
to us. We are required to: (i) maintain the privacy of medical information
provided to us; (ii) provide notice of our legal duties and privacy
practices; and (iii) abide by the terms of our Notice of Privacy
Practices currently in effect.
WHO WILL FOLLOW THIS NOTICE
This notice describes the practices of the employees and staff
of Windsor Radiology and any of its affiliated employers.
INFORMATION
COLLECTED ABOUT YOU
In the ordinary course of receiving
treatment and health care services from us, you will be providing
us with personal health information (PHI) such as, but not limited
to:
* Your name, address, phone number, SS number
* Information relating to your medical history
* Your insurance information and coverage
* Information concerning your doctor, nurse or other medical
providers
In addition, we will gather certain medical information about you
and will create a record of the care provided to you. Some information
also may be provided to us by other individuals or organizations
that are part of your "circle of care"- such as the referring
physician, your other doctors, your health plan, and close friends
or family members.
HOW WE MAY USE AND DISCLOSE INFORMATION ABOUT YOU
We may use and
disclose personal and identifiable health information about you in
different ways. All of the ways in which we may use and disclose
information will fall within one of the following categories, but
not every use or disclosure in a category will be listed.
For Treatment.
We will use health information about you to furnish services and
supplies to you, in accordance with our policies and procedures.
For example, we will use your medical history, such as any presence
or absence of heart disease, to assess your health and perform requested
imaging or oncologic services.
For Payment.
We will use and disclose health information about you to bill for
our services and to collect payment from you or your insurance company.
For example, we may need to give a payer information about your current
medical condition so that it will pay us for the imaging or oncologic
examinations or other services that we have furnished you. We may
also need to inform your payer of the tests that you are going to
receive in order to obtain prior approval or to determine whether
the service is covered.
For Health Care Operations.
We may use and disclose information about you for the general operation
of our business. For example, we sometimes arrange for accreditation
organizations, auditors or other consultants to review our practice,
evaluate our operations, and tell us how to improve our services.
Public Policy Uses and Disclosures.
There are a number of public policy reasons why we may disclose
information about you.
We may disclose health information about you when we are required
to do so by federal, state, or local law.
We may disclose protected health information about you in connection
with certain public health reporting activities. For instance, we
may disclose such information to a public health authority authorized
to collect or receive PHI for the purpose of preventing or controlling
disease, injury or disability, or at the direction of a public health
authority, to an official of a foreign government agency that is
acting in collaboration with a public health authority. Public health
authorities include state health departments, the Center for Disease
Control, the Food and Drug Administration, the Occupational Safety
and Health Administration and the Environmental Protection Agency,
to name a few.
We are also permitted to disclose protected health information to
a public health authority or other government authority authorized
by law to receive reports of child abuse or neglect. Additionally
we may disclose protected health information to a person subject
to the Food and Drug Administration's power for the following activities:
to report adverse events, product defects or problems, or biological
product deviations, to track products, to enable product recalls,
repairs or replacements, or to conduct post marketing surveillance.
We may disclose your protected health information in situations
of domestic abuse or elder abuse.
We may disclose protected health information in connection with
certain health oversight activities of licensing and other agencies.
Health oversight activities include audit, investigation, inspection,
licensure or disciplinary actions, and civil, criminal, or administrative
proceedings or actions or any other activity necessary for the oversight
of 1) the health care system, 2) governmental benefit programs for
which health information is relevant to determining beneficiary eligibility,
3) entities subject to governmental regulatory programs for which
health information is necessary for determining compliance with program
standards, or 4) entities subject to civil rights laws for which
health information is necessary for determining compliance.
We may release personal health information to a coroner or medical
examiner to identify a deceased person or determine the cause of
death. We also may release personal health information to organ procurement
organizations, transplant centers, and eye or tissue banks. We may
release your personal health information to workers' compensation
or similar programs. Information about you also will be disclosed
when necessary to prevent a serious threat to your health and safety
or the health and safety of others.
We may use or disclose certain personal health information about
your condition and treatment for research purposes where an Institutional
Review Board or a similar body referred to as a Privacy Board determines
that your privacy interests will be adequately protected in the study.
We may also use and disclose your protected health information to
prepare or analyze a research protocol and for other research purposes.
If you are a member of the Armed Forces, we may release personal
health information about you as required by military command authorities.
We also may release personal health information about foreign military
personnel to the appropriate foreign military authority.
We may disclose your protected health information for legal or administrative
proceedings that involve you. We may release such information upon
order of a court or administrative tribunal. We may also release
protected health information in the absence of such an order and
in response to a discovery or other lawful request, if efforts have
been made to notify you or secure a protective order.If you are an
inmate, we may release protected health information about you to
a correctional institution where you are incarcerated or to law
enforcement officials.
Finally, we may disclose protected health information for national
security and intelligence activities and for the provision of protective
services to the President of the United States and other officials
or foreign heads of state.
Our Business Associates
We sometimes work with outside individuals
and businesses who help us operate our business successfully. We
may disclose your health information to these business associates
so that they can perform the tasks that we hire them to do. Our business
associates must guarantee to us that they will respect the confidentiality
of your personal and identifiable health information
Individuals Involved in Your Care or Payment for Your Care
We may disclose information to individuals involved in your care
or in the payment for your care, but we will obtain your agreement
before doing so. This includes people and organizations that are
part of your "circle of care" -- such as your spouse, your
other doctors, or an aide who may be providing services to you. Although
we must be able to speak with your other physicians or health care
providers, you can let us know if we should not speak with other
individuals, such as your spouse or family.
Appointment Reminders
We may use and disclose medical information to contact you as a
reminder that you have an appointment or that you should schedule
an appointment.
Treatment Alternatives
We may use and disclose your personal health information in order
to tell you about or recommend possible treatment options, alternatives
or health-related services that may be of interest to you.
OTHER USES AND DISCLOSURES OF PERSONAL INFORMATION
We are required to obtain written authorization from you for any
uses and disclosures of medical information other than those described
above. If you provide us with such permission, you may revoke that
permission, in writing, at any time. If you revoke your permission,
we will no longer use or disclose personal information about you
for the reasons covered by your written authorization. We will
be unable to take back any disclosures already made based upon
your original permission.
OTHER USES AND DISCLOSURES OF PERSONAL INFORMATION
You have the right
to ask for restrictions on the ways in which we use and disclose
your medical information beyond those imposed by law. We will consider
your request, but we are not required to accept it.
You have the right to request that you receive communications containing
your protected health information from us by alternative means or
at alternative locations. For example, you may ask that we only contact
you at home or by mail.
Except under certain circumstances, you have the right to inspect
and copy medical and billing records about you. If you ask for copies
of this information, we may charge you a fee for copying and mailing.
If you believe that information in your records is incorrect or
incomplete, you have the right to ask us to correct the existing
information or correct the missing information. Under certain circumstances,
we may deny your request.
You have a right to ask for a list of instances when we have used
or disclosed your medical
information for reasons other than your treatment, payment for services
furnished to you, our health care operations, or disclosures you
give us authorization to make. If you ask for this
information from us more than once every twelve months, we may charge
you a fee.
You have the right to a copy of this Notice in paper form. You may
ask us for a copy at any time.
To exercise any of your rights, please write to the HIPAA Compliance
Officer at Windsor Medical Commons, Building A, Suite 101, 300 Princeton-Hightstown
Road, East Windsor, NJ 08520.
CHANGES TO THIS NOTICE
We are required to obtain written authorization from you for any
uses and disclosures of medical information other than those described
above. If you provide us with such permission, you may revoke that
permission, in writing, at any time. If you revoke your permission,
we will no longer use or disclose personal information about you
for the reasons covered by your written authorization. We will
be unable to take back any disclosures already made based upon
your original permission.
COMPLAINTS AND COMMENTS
If you have any complaints concerning our
Privacy Policy, you may contact the Secretary of the Department of
Health and Human Services, at 200 Independence Avenue, S.W., Room
509F, HHH Building, Washington, D.C. 20201 (e-mail: ocrmail@hhs.gov).
You also may contact the HIPAA Compliance Officer at Windsor Medical
Commons, Building A, Suite 101, 300 Princeton-Hightstown Road, East
Windsor, NJ 08520.
To obtain more information concerning this Notice of Privacy Practices,
you may contact our Privacy Officer at Windsor Medical Commons, Building
A, Suite 101, 300 Princeton-Hightstown Road, East Windsor, NJ 08520.
This Privacy Policy is effective May 1,2005.
This information is being provided in accordance
with the Heath Insurance Portability and Accountability Act of 1996
(HIPAA)
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