Privacy Notice
This notice describes how medical information about you may be used and disclosed, please review it carefully.
If you have any questions about this Notice, please contact our Privacy Officer.
This Notice of Privacy Practices describes how we may use and disclose your protested health information to carry out treatment, payment or health care operations and for other purposes permitted or required by law. It also describes your rights to access and control your protected information. “Protected health information” is information about you, including demographics, 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 by terms of this Notice of Privacy Practices. We may change our notice, at any time. The new notice will be effective for all protected health information maintained at that time. Upon your request, we will provide you with any revised Notice of Privacy by calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your appointment.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
Treatment - Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions and providing treatment. For example, results of laboratory test and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment – Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided and the medical condition being treated.
Health Care Operations – Your health information may be used as necessary to support the day-to-day activities and management of Diagnostic Clinic of Longview, P.A. For example, information on the services you received may be used to support budgeting and financial reporting and activities to evaluate and promote quality.
Law Enforcement – Your health information may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections, to facilitate law enforcement investigations and to comply with government mandated reporting.
Public Health Reporting – Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
Appointment Reminders – Your health information will be used by our staff to send you appointment reminders.
Information about treatments – Your health information may be used to send you information on the treatment and management of your medical condition that you may find to be of interest. We may also send you information describing other health related goods and service that we believe may interest you.
Photographs – Photographs may be taken in some instances and placed in your chart for referral. Also, photographs received from you may be placed on the wall for display. Examples are pictorial Christmas cards, Senior Pictures, etc.)
Business Associates – Diagnostic Clinic of Longview does business with many different business associates. These associates have access to our records, but they are also bound to the terms of the Privacy Notice.
Other uses and disclosures require your authorization – Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision.
Individual Rights
You have certain rights under the federal privacy standards. These include:
- The right to request restriction on the use and disclosure of your protected health information.
- The right to receive confidential communications concerning your medical condition and treatment.
- The right to inspect and copy your protected health information.
- The right to amend or submit corrections to your protected health information.
- The right to receive an accounting of how and to whom your protected health information has been disclosed.
- The right to receive a printed copy of this notice.
Diagnostic Clinic of Longview, PA Duties
We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.
We also are required to abide by the privacy policies and practices that are outlined in this notice.
Right to Revise Privacy Practices
As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visit. The revised policies and practices will be applied to all protected health information that we maintain.
Requests to Inspect Protected Health Information
As permitted by federal regulation, we require that request to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the front desk receptionist or the medical director.
Complaints
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:
Medical Director
Diagnostic Clinic of Longview, PA
707 Hollybrook
Longview, TX 75605
Effective Date
This notice is effective on or after April 14, 2003.
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