| INTRODUCTION
At Charleston Radiologists, PA, we are
committed to treating and using protected health information about you
responsibly. This Notice of Health Information Practices describes the
personal information we collect, and how and when we use or disclose that
information.
It also describes your rights as they
relate to your protected health information. This Notice is effective
April 1, 2003 and applies to all protected health information as defined
by federal regulations.
Understanding your health
record/information
Each time you visit Charleston
Radiologists, PA, a record of your visit is made. This record will
typically contain your symptoms, examination, test results, diagnoses and
treatment plans. This information, referred to as your health or medical
record serves as a:
- Basis for planning your care and
treatment
- A means of communication among the many
health professionals who contribute to your care
- Legal document describing the care you
received
- A means by which you or a third-party
payer can verify that services billed were actually provided
- A tool for educating professionals
- A source of information for public
health officials charged with improving the health of this state and the
nation
- A source of data for our planning and
marketing
- A tool with which we can assess and
continually work to improve the care we give and the outcome of that
care.
Understanding what is in your health record
and how it is used helps you to ensure it’s accuracy, better understand
who, what, when, where and why others may access your health information.
Your Health Information Rights
Although your health record is the physical
property of Charleston Radiologists, PA, the
information belongs to you. You have the right to:
- Obtain a paper copy of this notice of
information practices upon request
- Inspect and copy your health record as
provided for in 45CFR 164.524
- Amend your health record as provided in
45 CFR 164.528
- Obtain an accounting of disclosures of
your health information as provided in 45 CFR 164.528
- Request communications of your health
information by alternative means or at alternative locations
- Request a restriction on certain uses
and disclosures of your information as provided by 45 CFR 1643.522
- Revoke your authorization to use or
disclose health information except to the extent that action has already
been taken
Our Responsibilities
Charleston Radiologists, PA is required to:
- Maintain the privacy of your health
information
- Provide you with this notice as to our
legal duties and privacy practices with respect to information we
collect and maintain about you
- Abide by the terms of this notice
- Notify you if we are unable to agree to
a requested restriction
- Accommodate reasonable requests you may
have to communicate health information by alternative means or at
alternative locations.
We reserve the right to change our
practices and to make the new provisions effective for all protected
health information we maintain. Should our information practices change,
we will mail a revised notice to the address you’ve supplied us, or if you
agree, we will email the revised notice to you.
We will not use or disclose your health
information without your authorization, except as described in this
notice. We will also discontinue to use or disclose your health
information after we have received a written revocation of the
authorization.
Get More Information, Report a Problem
If you have questions and would like
additional information, you may contact Charleston Radiologists’ Privacy
Officer, at (843) 824-0606. You can file a complaint with our Privacy
Officer or with the Office for Civil Rights, US Department of Health and
Human Services with no retaliation.
Office for Civil Rights
US Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, DC 20201
Examples of Disclosure:
We will use your health information for
treatment:
Information obtained by our staff will be recorded in your record and used
to determine the best course of treatment for you and to determine how you
are responding to that treatment. We will provide other healthcare
providers with copies of reports that should assist in treating you when
you are no longer under our care.
We will use your health information for
payment:
A bill may be sent to you or a third party payer. This information may
include identification, diagnosis, procedures and supplies used.
We will use your health information for
regular health operations: Referrals to other health organizations
(labs, emergency rooms, x-rays, specialists); Notification and
communication with family members, close personal friend, or another
person responsible for your care information about your appointments,
condition, or payment related to your care unless you notify us that you
object.
We will use your health information to
respond to requests by Worker’s Compensation, public health
organizations, and law enforcement agencies as required by law.
Please download and fill out our
Authorization of Use and Disclosure
of
Protected Health Information Form |
