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NOTICE OF PRIVACY PRACTICES
Effective date: January 1, 2005
THIS NOTICE DESCRIBES:
I. HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
II. HOW YOU CAN GET ACCESS TO THIS INFORMATION
PLEASE REVIEW IT CAREFULLY
Caris MPI has specific duties regarding your medical information. We understand that medical information about you and your health is personal. We are committed to protecting medical information about you.
This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of your medical information.
We are required by law to:
- Take reasonable steps to protect medical information that identifies you from unauthorized disclosure
- Give you this notice of our legal duties and privacy practices with respect to medical information about you
- Follow the terms of our notice that is currently in effect
HOW CARIS MPI MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
For Treatment: Caris MPI may provide medical test information about you to your personal physician. We may disclose medical information about you to the appropriate doctors, nurses and health care personnel who you have authorized.
For Payment: Caris MPI may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may send a claim to an insurance company that identifies you and the procedures you received from us. Your diagnosis may also be disclosed.
For Health Care Operations: Caris MPI may use and disclose medical information about you for operational reasons. These uses and disclosures are necessary for us to make sure that all of our patients receive quality care. For example, we may use medical information to review the quality of our services and to evaluate the performance of our staff.
As Required By Law: Caris MPI will disclose medical information about you when required to do so by federal, state, or local law. Special situations that would fall under this category include but are not limited to:
- Public health risks
- Court orders, including lawsuits and disputes in which you are involved
- Law enforcement duties
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.
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.
Government Functions: Caris MPI may disclose your health information to protect public officials as directed by law or as required by military command authorities.
Workers' Compensation: Caris MPI may release medical information about you for workers' compensation or similar programs.
Decedents: Caris MPI may release medical information to a coroner, medical examiner, or funeral director as necessary to carry out their duties.
Health Oversight Activities: Caris MPI may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities may include audits, investigations, inspections, licensure and disciplinary actions.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding medical information we maintain about you:
Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health operations. We are not required to agree to your request. We are required to notify you if we fail to approve a restriction request.
Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care.
Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.
Right to Accounting of Disclosures: You have the right to request a list of the disclosures we have made of medical information about you.
Right to a Paper Copy of This Notice: We will provide a paper copy of this notice upon request.
WE RESERVE THE RIGHT TO CHANGE THIS NOTICE
We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current code on our website at www.carismpi.com.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with the Caris MPI or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.
CONTACT INFORMATION
If you have any questions or complaints, please contact:
Privacy Policy
445 North Fifth Street
Phoenix, AZ 85004
602-358-8900 or 800-591-2610
information@carismpi.com
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