Uses and Disclosures
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 tests 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
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, 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 Buffalo
Ultrasound, Inc. 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. We may release medical information if asked
to do so by a law enforcement officer
·
In
response to a court order, judicial subpoena, warrant, summons or similar
process;
·
To
identify or locate a suspect, fugitive, material witness, or missing person;
·
About
the victim of a crime if, under certain limited circumstances, we are unable to
obtain the person’s agreement;
·
About
a death we believe may be the result of criminal conduct;
·
About
criminal conduct at the clinic; and
·
In
emergency circumstances to report a crime; the location of the crime or
victims; or the identity, description or location of the person who committed
the crime.
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.
Health-Related
Benefits and Services. We
may use and disclose medical information to tell you about health-related
benefits or services that may be of interest to you.
Individuals Involved
in Your care or Payment for Your Care.
We may release medical information about you to a friend or family
member who is involved in your medical care.
We may also give information to someone who helps pay for your
care. We may also tell your family or
friends your condition. In addition, we
may disclose medical information about you to an entity assisting in a disaster
relief effort so that your family can be notified about your condition, status
and location.
Research. Under certain circumstances, we may use and
disclose medical information about you for research purposes. For example, a research project may involve comparing
the health and
recovery of all patients who received one medication to those who
received another, for the same condition.
All research projects, however, are subject to a special approval
process. This process evaluates a
proposed research project and its use of medical information, trying to balance
the research needs with patients’ need for privacy of their medical information. Before we use or disclose medical information
for research, the project will have been approved through this research
approval process, but we may, however, disclose medical information about you
to people preparing to conduct a research project, for example, to help them
look for patients with specific medical needs.
To Avert a Serious
Threat to Health or Safety. We
may use and disclose medical information about you when necessary to prevent a
serious threat to your health and safety or the health and safety of the public
or another person. Any disclosure,
however, would only be to someone able to help prevent the threat.
Special Situations
Organ and Tissue
Donation. If you are an organ donor, we may release
medical information to organizations that handle organ procurement or organ,
eye or tissue transplantation or to an organ donation bank, as necessary to
facilitate organ or tissue donation and transplantation.
Military and
Veterans. If you are a member of the armed forces, we
may release medical information about you as required by military command
authorities. We may also release medical
information about foreign military personnel to the appropriate foreign
military authority.
Worker’s Compensation. We may release medical information about you
for workers’ compensation or similar programs.
These programs provide benefits for work-related injuries or illness.
Public Health Risks. We may disclose medical information about you
for public health activities. These
activities generally include the following:
·
To
prevent or control disease, injury or disability;
·
To
report births and deaths;
·
To
report child abuse or neglect;
·
To
report reactions to medications or problems with products;
·
To
notify people of recalls of products they may be using;
·
To
notify a person who may have been exposed to a disease or may be at risk for
contracting or spreading a disease or condition;
·
To
notify the appropriate government authority if we believe a patient has been
the victim of abuse, neglect or domestic violence. We will only make this disclosure if you
agree or when required or authorized by law.
Health Oversight
Activities. We may disclose medical information to a
health oversight agency for activities authorized by law. These oversight activities include, for
example, audits, investigations, inspections, and licensure. These activities are necessary for the
government to monitor the health care system, government programs, and
compliance with civil rights laws.
Lawsuits and
Disputes. If you are involved in a lawsuit or a
dispute, we may disclose medical information about you in response to a court
or administrative order. We may also
disclose medical information about you in response to a judicial subpoena,
discovery request, or other lawful process by someone else involved in the
dispute.
Coroners, Medical
Examiners. We may release medical information to a
coroner or medical examiner.
National Security and
Intelligence Activities. We
may release medical information about you to authorized federal officials for
intelligence, counterintelligence, and other national security activities
authorized by law.
Protective Services
for the President and Others. We
may disclose medical information about you to authorized federal officials so
they may provide protection to the President of the
Inmates. If you are an inmate of a correctional
institution or under the custody of a law enforcement official, we may release
medical information about you to the correctional institution or law enforcement
official. This release would be
necessary (1) for the institution to provide you with health care; (2) to
protect your health and safety or the health and safety of others; or (3) for
the safety and security of the correctional institution.
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.
Additional Uses of Information
Appointment
reminders. Your health information will be used by our
staff to send you appointment reminders (via mail or telephone call or to
change the appointment).
Individual Rights. You have certain rights under the federal
privacy standards. These include:
·
The
right to request restrictions 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
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 the 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 requests 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 Contact Person listed at the end of this notice.
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:
Michael C. Straeck, President
Buffalo Ultrasound,
Inc.
If you believe that your privacy rights
have been violated, you should call the matter to our attention by sending a
letter describing the cause of your concern to the same address.
You will not be penalized or otherwise
retaliated against for filing complaint.
Contact
Person. The name and address of the person you
contact for further information concerning our privacy policy is:
Michael C. Straeck,
President
Buffalo Ultrasound, Inc.
Notice
of Privacy Practices
Effective
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
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. This notice applies to BUFFALO ULTRASOUND,
INC. This notice applies to all
healthcare professionals and staff personnel within our offices.