NOTICE OF PRIVACY PRACTICES
Notice of Privacy Practices
Effective Date: October 2008
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
1. Purpose: The American Medical Diagnostiscs, Ltd (AMDX) and NeuroDiagnositc Laboratories, LLC (NDL) and its employees and its clinics follow the privacy practices described in this Notice. AMDX/NDL maintains your health information in records that are kept in a confidential manner, as required by law. AMDX/NDL must use and disclose or share your health information as necessary for treatment, payment, and health care operations to provide you with quality health care.
2. What Are Treatment, Payment, and Health Care Operations? Treatment includes sharing information among health care providers involved in your care. For example, your health care provider may share information about your condition with the pharmacist to discuss medications, or with radiologists or other consultants to make a diagnosis. AMDX/NDL may use your health information as required by your insurer or HMO to obtain payment for your treatment. AMDX/NDL may use and disclose your health information to improve the quality of care and for education and training purposes of AMDX/NDL employees.
3. How Will AMDX and NDL Use and Disclose My Health Information? Your health information may be used for the following purposes unless you ask for restrictions on a specific use or disclosure:
Note: You will have the opportunity to refuse some of these communications about your health information, indicated by (*).
· Family members or close friends involved in your care or payment for treatment. *
· Disaster relief agency if you are involved in a disaster relief effort. *
· To inform you of treatment alternatives or benefits or services related to your health. *
· Appointment reminders.
· Public health activities, including disease prevention, injury or disability; reporting births and deaths; reporting reactions to medications or product problems; notification of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect, or domestic violence.
· Health oversight activities, such as audits, inspections, investigations, and licensure.
· Law enforcement.
· Coroners, medical examiners, and funeral directors.
· Organ and tissue donation.
· Certain research projects.
· To prevent a serious threat to health or safety.
· To military command authorities if you are a member of the armed forces or a member of a foreign military authority.
· National security and intelligence activities to authorized persons to conduct special investigations.
· Workers’ Compensation. Your medical information regarding benefits for work-related injuries and illnesses may be released as appropriate.
· Alcohol and drug abuse information has special privacy protections. AMDX/NDL will not disclose any information identifying an individual as being a patient or provide any health information relating to the patient’s substance abuse treatment unless the patient consents in writing; to carry out treatment, payment, and operations; or as required by law.
· To carry out health care treatment, payment, and operations functions through business associates, such as to install a new computer system.
4. Your Authorization Is Required for Other Disclosures. Except as described above, we will not use or disclose your medical information, unless you allow AMDX/NDL in writing to do so. You may withdraw or revoke your permission in writing, which will be effective only after the date of your request.
5. You Have Rights Regarding Your Health Information. You have the following rights regarding your medical information, if requested on the form(s) provided by AMDX/NDL:
· Right to request restriction. You may request limitations on your health information that we use or disclose for health care treatment, payment, or operations, although we are not required to comply with your request.
· Right to confidential communications. You may request communications of your health information in a certain way or at a certain location, but you must tell us in writing how and/or where you wish to be contacted.
· Right to inspect and copy. You have the right to review and obtain a copy of your medical or health record. We may charge a fee for copying, mailing, and supplies. Under limited circumstances, your request may be denied; you may request review of the denial by another licensed health care professional chosen by AMDX/NDL. AMDX/NDL will comply with the outcome of the review.
· Right to request amendment. If you believe that the health information we have about you is incorrect or incomplete, you may request an amendment on the form provided by AMDX/NDL. AMDX/NDL is not required to accept the amendment.
· Right to accounting of disclosures. You may request a list of the disclosures of your health information that have been made to persons or entities for disclosures unrelated to health care treatment, payment, or operations within the past six (6) years, but not prior to April 14, 2003. After the first request, there may be a charge.
· Right to a copy of this Notice. You may request a paper copy of this Notice at any time, even if you have been provided with an electronic copy. You may obtain an electronic copy of this Notice at our web site: www.ndxlabs.com
6. Requirements Regarding This Notice. AMDX/NDL is required by law to provide you with this Notice. We will comply with this Notice for as long as it is in effect. AMDX/NDL reserves the right to change the terms of this Notice, and these changes will be effective for health information we have about you on file, as well as any information we receive in the future. If we revise the terms of this Notice, we will post a revised notice at www.ndxlabs.com and will make paper copies of the revised Notice of Privacy Practices available upon request. Each time you register at AMDX/NDL for health services, you may receive a copy of the Notice in effect at the time.
7. Complaints. If you believe your privacy rights have been violated, you may file a complaint with the AMDX/NDL Privacy Officer or with the Secretary of the United States Department of Health and Human Services. All complaints must be made in writing and must describe the situation giving rise to the complaint. We will not penalize or retaliate against you in any way for making a complaint to AMDX/NDL or to the Department of Health and Human Services.
Contact the AMDX/NDL Privacy Officer at
ATTN: Privacy Officer
6036 N 19th Avenue, #405
Phoenix, AZ 85015
· You have any questions about this Notice;
· You wish to request restrictions on uses and disclosures for health care treatment, payment, or operations; or
· You wish to obtain a form to exercise your individual rights described in paragraph 5.