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.
Federal Law (the Health Insurance Portability and Accountability Act - HIPAA) requires that health care providers inform patients of their rights regarding how the provider may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. This Privacy Notice describes our privacy practices that relate to your protected health information. It also describes your rights to access and control your protected health information in some cases. Your "protected health information" means any written and oral health information about you, including demographic data that can be used to identify you. This is health information that is created or received by your health care provider, and that relates to your past, present or future physical or mental health or condition.
Kern Radiology Medical Group’s contact person
for all issues regarding patient privacy and your rights under the federal
privacy standards is the Privacy Officer. Information regarding matters
covered by this Notice can be requested by contacting the Privacy Officer.
If you feel that your privacy rights have been violated by this facility
you may submit a complaint to our Privacy Officer by sending it to:
The Privacy Officer can be contacted by telephone at 661-326-9600.
Each time you receive medical care from a physician, imaging center, or other healthcare provider, a record of your visit is created. This record typically includes, but is not limited to, information such as your name, age, address, a history of your illness, injury or symptoms, any test results, x-rays and laboratory work, the treatment provided to you and treatment plans devised for your care, and notes on follow-up care to be performed. How your health care information may be used and what controls you may exercise over the use of your healthcare information is described in this Privacy Notice.
Kern Radiology Medical Group, Inc. may use your protected health information (PHI) for purposes of providing treatment, obtaining payment for treatment, and conducting health care operations. Your protected health information (PHI) may be used or disclosed only for these purposes unless Kern Radiology Medical Group, Inc.has obtained your authorization or the HIPAA privacy regulations or state law otherwise permits the use or disclosure. Disclosures of your protected health information (PHI) for the purposes described in this Privacy Notice may be made in writing, orally, electronically or by facsimile.
Treatment. We may use and disclose your protected health information (PHI) to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with nurses, technologists, radiology personnel, other facility staff involved in your care or a third party for treatment purposes. For example, we may disclose your protected health information (PHI) to a laboratory to order pre-procedural tests or to a pharmacy to fill a prescription. We may also disclose protected health information (PHI) to physicians who may be treating you or consulting with Kern Radiology Medical Group, Inc. with respect to your care. In some cases, we may also disclose your protected health information (PHI) to people outside Kern Radiology Medical Group, Inc. who may be involved in your medical care while you are at Kern Radiology Medical Group, Inc. or after you leave Kern Radiology Medical Group, Inc., such as other physicians or health care workers we use to provide services that are part of your care.
Payment. Your protected health information (PHI) will be used, as needed, to obtain payment for the services that we provide. This may include certain communications to your health insurance company to get approval for the procedure that we have scheduled. For example, we may need to disclose information to your health insurance company to get prior approval for particular procedures. We may also disclose protected health information (PHI) to your health insurance company to determine whether you are eligible for benefits or whether a particular service is covered under your health plan. In order to get payment for the services we provide to you, we may also need to disclose your protected health information (PHI) to your health insurance company to demonstrate the medical necessity of the services or, as required by your insurance company, for utilization review. We may also disclose patient information to another provider involved in your care for the other provider’s payment activities.
Operations. We may use or disclose your protected health information (PHI), as necessary, for our own health care operations to facilitate the function of Kern Radiology Medical Group, Inc. and to provide quality care to all patients. Health care operations include such activities as: quality assessment and quality control, employee review activities, accreditation, certification, licensing or credentialing activities, review and auditing, including compliance reviews, medical reviews, legal services and maintaining compliance programs, and business management and general administrative activities. In certain situations, we may also disclose patient information to another provider or health plan for their health care operations.
Other uses and disclosures for health care operations
Appointment Reminders We may use or disclose your protected health information (PHI) to contact you or a family member involved in your health care or as authorized by you as a reminder that you have an appointment for treatment or medical care at our facility. We may also leave a message on your answering machine / voicemail system unless you tell us not to.
Treatment Alternatives We may use or disclose your protected health information (PHI) to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health Related Benefits and Services We may use or disclose your protected health information to tell you about health related benefits or services that may be of interest to you.
Individuals Involved in Your Care or Payment of Your Care We may use or disclose your protected health information (PHI) to a family member who is involved in your medical care. We may also give information to someone assisting you in the payment for your care. We may also tell your family that you are at Kern Radiology Medical Group, Inc. at the time of your care, or that information may be communicated to an entity assisting in a disaster relief effort in order to communicate your condition status and location to your family. If you want any of this information restricted you must communicate that to us using the appropriate procedure.
As Required By Law We will disclose health information about you when required to do so by federal, state, or local law. This may include reporting of communicable diseases, wounds, abuse, disease/trauma registries, health oversight matters and other public policy requirements. We may be required to report this information without your permission.
To Avert a Serious Threat to Health or Safety We may
use and disclose health information for the following public activities
To Conduct Health Oversight Activities. We may disclose your protected health information (PHI) to a health oversight agency for activities including audits; civil, administrative, or criminal investigations, proceedings, or actions; inspections; licensure or disciplinary actions; or other activities necessary for appropriate oversight as authorized by law. We will not disclose your protected health information (PHI) under this authority if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.
In Connection With Judicial And Administrative Proceedings. We may disclose your protected health information (PHI) in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order. In certain circumstances, we may disclose your protected health information (PHI) in response to a subpoena to the extent authorized by state law if we receive satisfactory assurances that you have been notified of the request or that an effort was made to secure a protective order.
For Law Enforcement Purposes. We may disclose your
protected health information to a law enforcement official for law enforcement
purposes as follows:
Inmates If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health 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.
For Specified Government Functions In certain circumstances, federal regulations authorize the facility to use or disclose your protected health information to facilitate specified government functions relating to military and veterans activities, national security and intelligence activities, protective services for the President and others, medical suitability determinations, correctional institutions, and law enforcement custodial situations.
For Worker's Compensation The facility may release your health information to comply with worker's compensation laws or similar programs.
You may object to these disclosures. If you do not object to these disclosures or we can infer from the circumstances that you do not object or we determine, in the exercise of our professional judgment, that it is in your best interests for us to make disclosure of information that is directly relevant to the person’s involvement with your care, we may disclose your protected health information as described.
Uses and Disclosures which you Authorize Other than as stated above, we will not disclose your health information other than with your written authorization. You may revoke your authorization in writing at any time except to the extent that we have taken action in reliance upon the authorization.
Although your health record is the physical property of the healthcare practitioner or Kern Radiology Medical Group, Inc.that compiled it, the information belongs to you. You have the following rights regarding your health information:
Right to Inspect and copy your protected health information
You may inspect and obtain a copy of your protected health information
(PHI) that is contained in a designated record set for as long as we
maintain the protected health information (PHI). A “designated
record set” contains medical and billing records and any other
records that your physician and Kern Radiology Medical Group, Inc.uses
for making decisions about you.
We may deny your request to inspect or copy your protected health information (PHI) if, in our professional judgment, we determine that the access requested is likely to endanger your life or safety or that of another person, or that it is likely to cause substantial harm to another person referenced within the information. You have the right to request a review of this decision.
To inspect and copy your medical information, you must submit a written request to the Privacy Officer whose contact information is listed on the first page of this Privacy Notice. If you request a copy of your information, we may charge you a fee for the costs of copying, mailing or other costs incurred by us in complying with your request.
Please contact our Privacy Officer if you have questions about access to your medical record.
Right to Request amendments to your protected health information. If you feel the health information we have in your record is incorrect or incomplete, you may request an amendment of the information for as long as we maintain this information. Kern Radiology Medical Group, Inc. has sixty days to comply with this request. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. In addition, we may deny your request if you ask us to amend information that:
— Was not created by Kern Radiology Medical
Group, Inc., unless the person or entity that created the information
is no longer available to make the amendment;
Requests for amendment must be in writing and must be directed to our Privacy Officer. In this written request, you must also provide a reason to support the requested amendments.
Right to Request a restriction on uses and disclosures of your protected health information. You may ask us not to use or disclose certain parts of your protected health information (PHI) for the purposes of treatment, payment or health care operations. You may also request that we not disclose your health information to family members or friends who may be involved in your care or for notification purposes as described in this Privacy Notice. Your request must state the specific restriction requested and to whom you want the restriction to apply. For example, you could ask that (1) we not use or disclose information about a surgery you had or (2) that certain people not be told of certain information.
Kern Radiology Medical Group, Inc. is not required to agree to a restriction that you may request. We will notify you if we deny your request to a restriction. If Kern Radiology Medical Group, Inc. does agree to the requested restriction, we may not use or disclose your protected health information (PHI) in violation of that restriction unless it is needed to provide emergency treatment. Under certain circumstances, we may terminate our agreement to a restriction. You may request a restriction by contacting the Privacy Officer.
Right to Request to receive confidential communications from us by alternative means or at an alternative location. You have the right to request that we communicate with you in certain ways. We will accommodate reasonable requests. We may condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not require you to provide an explanation for your request. Requests must be made in writing to our Privacy Officer.
Right to Receive an accounting. You have the right to request an accounting of certain disclosures of your protected health information (PHI) made by Kern Radiology Medical Group, Inc. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Privacy Notice. We are also not required to account for disclosures that you requested, disclosures that you agreed to by signing an authorization form, or certain other disclosures we are permitted to make without your authorization. The request for an accounting must be made in writing to our Privacy Officer. The request should specify the time period sought for the accounting. We are not required to provide an accounting for disclosures that take place prior to April 14, 2003. Accounting requests may not be made for periods of time in excess of six years. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
Right to obtain a paper copy of this notice. Upon request, we will provide a separate paper copy of this notice even if you have already received a copy of the notice or have agreed to accept this notice electronically.
Kern Radiology Medical Group, Inc. is required by law to maintain the privacy of your health information and to provide you with this Privacy Notice of our duties and privacy practices. We are required to:
— Keep your health information private and only
disclose it when required to do so by law;
We are required to abide by terms of this Notice as may be amended from time to time. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all future protected health information that we maintain. If Kern Radiology Medical Group, Inc.changes its Notice, we will provide a copy of the revised Notice by posting it on our web site or through in-person contact.
You have the right to express complaints to Kern Radiology Medical Group, Inc. and to the Secretary of Health and Human Services if you believe that your privacy rights have been violated. You may complain to Kern Radiology Medical Group, Inc. by contacting the Privacy Officer at Kern Radiology Medical Group, Inc. verbally or in writing, using the contact information provided on the first page of this Privacy Notice. We encourage you to express any concerns you may have regarding the privacy of your information.
YOU WILL NOT BE PENALIZED FOR FILING A COMPLAINT
© 2012 Kern Radiology Medical Group | Privacy Statement