We will disclose your health information;
a. for purposes of treatment. Example; To your primary care physician.
b. for purposes of payment. Example; To your Health Plan.
c. for healthcare operations. Example; To the radiologists and technologists who
will be providing our services to you.
We are also permitted by law to use or disclose your health information;
a. as required by law
b. for public health activities
c. to the appropriate government authority if it is believed that abuse, neglect or domestic violence has occurred
d. to a health oversight agency
e. for a judicial or administrative proceeding
f. for law enforcement purposes
g. to coroners, medical examiners and funeral directors
h. to organ procurement organizations engaged in cadaveric organ transplantation
I. for research purposes
j. to avert a serious threat to health or safety
k. to specialized government functions such as the military
l. for workers' compensation and similar programs
Uses and disclosures other than those listed above require your written authorization, and the authorization can be revoked.
We may contact you to provide appointment reminders or information about health related benefits that may be of interest to you.
You have the right to;
a. request restrictions on certain uses and disclosures of protected health information, said restrictions to be approved by us
b. request confidential communications of protected health information
c. request inspection and copying of protected health information
d. request that protected health information be amended
e. to receive an accounting of disclosures of protected health information
f. to receive a copy of this notice
We have a duty to maintain the privacy of your protected health information, to furnish you a copy of this notice if you request it, and to abide by the terms of this notice.
We have the right to revise this notice when there are material changes to the uses or disclosures, your rights, our legal duties or other privacy practices stated in this notice. The revision will be effective for all protected health information we retain, and the revised notice will be posted in the waiting area and available at the front desk.
If you feel your privacy rights have been violated you may file a complaint with us via our complaint form found at the front desk, or with the Secretary of Health & Human Services.
If you have questions about this notice please contact the facility manager at 314 567-4343.
This notice is effective April 14, 2003.
MANAGEMENT OF CLINICAL P.E.T. OF WEST COUNTY
FORM NPP
