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Our
goal is to take appropriate steps to attempt to safeguard any medical
or other personal health information (PHI) that is provided to us.
We are required to: (i) maintain the privacy of medical information
provided to us; (ii) provide notice of our legal duties and privacy
practices; and (iii) abide by the terms of our Notice of Privacy
Practices currently in effect.
| WHO
WILL FOLLOW THIS NOTICE |
This notice describes the practices of
the employees and staff of Princeton Radiology Associates and
any of its affiliated employers. |
| INFORMATION
COLLECTED ABOUT YOU |
In the ordinary
course of receiving treatment and health care services from
us, you will be providing us with personal health information
(PHI) such as, but not limited to:
- Your name, address, phone number,
SS number
- Information relating to your medical
history
- Your insurance information and coverage
- Information concerning your doctor,
nurse or other medical providers
In addition, we will gather certain
medical information about you and will create a record of
the care provided to you. Some information also may be provided
to us by other individuals or organizations that are part
of your "circle of care"- such as the referring
physician, your other doctors, your health plan, and close
friends or family members. |
| HOW WE MAY USE AND DISCLOSE INFORMATION
ABOUT YOU |
We may use and
disclose personal and identifiable health information about
you in different ways. All of the ways in which we may use
and disclose information will fall within one of the following
categories, but not every use or disclosure in a category
will be listed. |
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For Treatment.
We will use health information
about you to furnish services and supplies to you, in accordance
with our policies and procedures. For example, we will use
your medical history, such as any presence or absence of heart
disease, to assess your health and perform requested imaging
or oncologic services. |
For
Payment.
We will use and disclose health information
about you to bill for our services and to collect payment
from you or your insurance company. For example, we may need
to give a payer information about your current medical condition
so that it will pay us for the imaging or oncologic examinations
or other services that we have furnished you. We may also
need to inform your payer of the tests that you are going
to receive in order to obtain prior approval or to determine
whether the service is covered. |
For
Health Care Operations.
We may use
and disclose information about you for the general operation
of our business. For example, we sometimes arrange for accreditation
organizations, auditors or other consultants to review our
practice, evaluate our operations, and tell us how to improve
our services. |
Public
Policy Uses and Disclosures.
There are a number of public policy
reasons why we may disclose information about you.
We may disclose health information
about you when we are required to do so by federal, state,
or local law.
We may disclose protected health information
about you in connection with certain public health reporting
activities. For instance, we may disclose such information
to a public health authority authorized to collect or receive
PHI for the purpose of preventing or controlling disease,
injury or disability, or at the direction of a public health
authority, to an official of a foreign government agency that
is acting in collaboration with a public health authority.
Public health authorities include state health departments,
the Center for Disease Control, the Food and Drug Administration,
the Occupational Safety and Health Administration and the
Environmental Protection Agency, to name a few.
We are also permitted to disclose protected
health information to a public health authority or other government
authority authorized by law to receive reports of child abuse
or neglect. Additionally we may disclose protected health
information to a person subject to the Food and Drug Administration's
power for the following activities: to report adverse events,
product defects or problems, or biological product deviations,
to track products, to enable product recalls, repairs or replacements,
or to conduct post marketing surveillance.
We may disclose your protected health
information in situations of domestic abuse or elder abuse.
We may disclose protected health information
in connection with certain health oversight activities of
licensing and other agencies. Health oversight activities
include audit, investigation, inspection, licensure or disciplinary
actions, and civil, criminal, or administrative proceedings
or actions or any other activity necessary for the oversight
of 1) the health care system, 2) governmental benefit programs
for which health information is relevant to determining beneficiary
eligibility, 3) entities subject to governmental regulatory
programs for which health information is necessary for determining
compliance with program standards, or 4) entities subject
to civil rights laws for which health information is necessary
for determining compliance.
We may release personal health information
to a coroner or medical examiner to identify a deceased person
or determine the cause of death. We also may release personal
health information to organ procurement organizations, transplant
centers, and eye or tissue banks. We may release your personal
health information to workers' compensation or similar programs.
Information about you also will be disclosed when necessary
to prevent a serious threat to your health and safety or the
health and safety of others.
We may use or disclose certain personal
health information about your condition and treatment for
research purposes where an Institutional Review Board or a
similar body referred to as a Privacy Board determines that
your privacy interests will be adequately protected in the
study. We may also use and disclose your protected health
information to prepare or analyze a research protocol and
for other research purposes.
If you are a member of the Armed Forces,
we may release personal health information about you as required
by military command authorities. We also may release personal
health information about foreign military personnel to the
appropriate foreign military authority.
We may disclose your protected health
information for legal or administrative proceedings that involve
you. We may release such information upon order of a court
or administrative tribunal. We may also release protected
health information in the absence of such an order and in
response to a discovery or other lawful request, if efforts
have been made to notify you or secure a protective order.If
you are an inmate, we may release protected health information
about you to a correctional institution where you are incarcerated
or to law
enforcement officials.
Finally, we may disclose protected
health information for national security and intelligence
activities and for the provision of protective services to
the President of the United States and other officials or
foreign heads of state.
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Our
Business Associates.
We sometimes work with outside individuals
and businesses who help us operate our business successfully.
We may disclose your health information to these business
associates so that they can perform the tasks that we hire
them to do. Our business associates must guarantee to us that
they will respect the confidentiality of your personal and
identifiable health information |
Individuals Involved
in Your Care or Payment for Your Care.
We may disclose information to individuals
involved in your care or in the payment for your care, but
we will obtain your agreement before doing so. This includes
people and organizations that are part of your "circle
of care" -- such as your spouse, your other doctors,
or an aide who may be providing services to you. Although
we must be able to speak with your other physicians or health
care providers, you can let us know if we should not speak
with other individuals, such as your spouse or family.
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Appointment Reminders.
We may use and disclose medical information
to contact you as a reminder that you have an appointment
or that you should schedule an appointment. |
Treatment
Alternatives.
We may use and disclose your personal
health information in order to tell you about or recommend
possible treatment options, alternatives or health-related
services that may be of interest to you. |
| OTHER USES AND DISCLOSURES OF
PERSONAL INFORMATION |
| We are required
to obtain written authorization from you for any uses and disclosures
of medical information other than those described above. If
you provide us with such permission, you may revoke that permission,
in writing, at any time. If you revoke your permission, we will
no longer use or disclose personal information about you for
the reasons covered by your written authorization. We will be
unable to take back any disclosures already made based upon
your original permission. |
| OTHER USES AND DISCLOSURES OF
PERSONAL INFORMATION |
You have the
right to ask for restrictions on the ways in which we use
and disclose your medical information beyond those imposed
by law. We will consider your request, but we are not required
to accept it.
You have the right to request that
you receive communications containing your protected health
information from us by alternative means or at alternative
locations. For example, you may ask that we only contact you
at home or by mail.
Except under certain circumstances,
you have the right to inspect and copy medical and billing
records about you. If you ask for copies of this information,
we may charge you a fee for copying and mailing.
If you believe that information in
your records is incorrect or incomplete, you have the right
to ask us to correct the existing information or correct the
missing information. Under certain circumstances, we may deny
your request.
You have a right to ask for a list
of instances when we have used or disclosed your medical
information for reasons other than your treatment, payment
for services furnished to you, our health care operations,
or disclosures you give us authorization to make. If you ask
for this
information from us more than once every twelve months, we
may charge you a fee.
You have the right to a copy of this
Notice in paper form. You may ask us for a copy at any time.
To exercise any of your rights, please write to the HIPAA
Compliance Officer at Princeton Radiology Associates, Department
A, 3674 Route 27, Kendall Park, NJ 08824. |
| CHANGES TO THIS NOTICE |
| We are required
to obtain written authorization from you for any uses and disclosures
of medical information other than those described above. If
you provide us with such permission, you may revoke that permission,
in writing, at any time. If you revoke your permission, we will
no longer use or disclose personal information about you for
the reasons covered by your written authorization. We will be
unable to take back any disclosures already made based upon
your original permission. |
| COMPLAINTS AND COMMENTS |
If
you have any complaints concerning our Privacy Policy, you
may contact the Secretary of the Department of Health and
Human Services, at 200 Independence Avenue, S.W., Room 509F,
HHH Building, Washington, D.C. 20201 (e-mail: ocrmail@hhs.gov).
You also may contact the HIPAA Compliance Officer at Princeton
Radiology Associates, Department A, 3674 Route 27, Kendall
Park, NJ 08824.
To obtain more information concerning
this Notice of Privacy Practices, you may contact our Privacy
Officer at Princeton Radiology Associates, Department A, 3674
Route 27, Kendall Park, NJ 08824.
This Privacy Policy is effective April
1, 2003.
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This information is being provided in accordance
with the Heath Insurance Portability and Accountability
Act of 1996 (HIPAA)
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