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.
This
Notice of Privacy Practices describes how San Diego Imaging (“SDi”) 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. It also describes your rights to access and control your protected health
information. “Protected health information” is information about you, including
demographic information, that may identify you and that relates to your past,
present or future physical or mental health or condition and related health care
services.
Understanding Your Health Information
Each time you visit a healthcare provider (hospital, imaging center, physician,
etc.), a record of your visit is made. Typically, this record contains your
symptoms, examination and test results, diagnosis(es), treatment(s), and a plan
for future care or treatment. This information, often referred to as your
health or medical record, serves as:
- A basis for planning your care and
treatment.
- A means of communication among the
many health professionals who contribute to your care.
- A legal document describing the care
you received.
- A means by which you or a third-party
payer can verify that services billed were actually provided.
- A tool for educating health
professionals.
- A source of data for medical research.
- A source of information for public
health officials charged with improving the health of the nation.
- A source of data for planning and
marketing.
- A tool for assessing ways in which to
continually improve rendered care and outcomes.
Your
healthcare providers also maintain information concerning the charges to your
account for healthcare services rendered to you, any third parties (insurance
companies, health plans, etc.) who may have an obligation for payment of the
charges and the status of your account.
Understanding what is in your record and how your health information is used
helps you:
- Ensure its accuracy.
- Better understand who, what, when,
where, and why others may access your health information.
- Make more informed decisions when
authorizing use by or disclosure to others.
SDi is required by law to maintain the privacy of
your medical information and to provide you with notice of our legal duties and
privacy practices. SDi is required to abide by the
terms of this Notice of Privacy Practices. We may change the terms of our
notice, at any time. The new notice will be effective for all protected health
information that we maintain at that time. Upon your request, we will provide
you with any revised Notice of Privacy Practices. Please send your request to
SDi, P.O. Box 23540, San Diego, CA 92193, Attention: Privacy Coordinator.
You may also contact the Privacy Coordinator at (858) 565-0950 ext.235 with any
questions regarding our privacy practices, your privacy rights, or requests for
additional information regarding your privacy.
Permitted Uses
SDi may use and disclose your medical information for specific reasons:
- Treatment: SDi provides your doctor or other healthcare providers with the results of the
diagnostic imaging exams we perform. We may contact you before an exam to
remind you of your appointment or call to talk with you about preparing for an
exam.
EXAMPLE: Your primary physician orders a study of
your right shoulder. An SDi radiologist interprets the study and reports the
results to your primary physician. Your primary physician then refers you to an
orthopedic surgeon for evaluation and the orthopedic surgeon contacts the SDi
radiologist for consultation regarding the study.
- Payment: SDi bills your insurance company, you directly, or another person that may be
responsible for payment of your account. We may contact your health plan to see
if they provide coverage for the exam(s) your doctor ordered.
EXAMPLE: SDi receives a request from your insurance
carrier for a copy of the report from your recent imaging study for payment
processing. SDi provides a copy of the report to the carrier to facilitate
payment.
- Health Care Operations: SDi routinely reviews previously performed exams to maintain quality
assurance goals. That means we may select your images for review by other
radiologists. We may also select your billing information for review by our
internal compliance department or external auditors.
EXAMPLE: SDi may
periodically select random imaging study reports for review to monitor the
quality and completeness of the documentation.
Other
Permitted Uses and Required Disclosures
(
With Consent, Authorization, or Opportunity to Object)
SDi may use or disclose your protected health information in the following
instances. You have the opportunity to agree or object to the use or disclosure
of all or part of your protected health information. If you are not present or
able to agree or object to the use or disclosure of the protected health
information, then your physician may, using professional judgment, determine
whether the disclosure is in your best interest. In this case, only the
protected health information that is relevant to your health care will be
disclosed.
-
Others Involved in Your Healthcare: Unless you object, SDi may disclose to a member of your family, a relative, a
close friend, or any other person you identify, your protected health
information that directly relates to that person’s involvement in your health
care. If you are unable to agree or object to such a disclosure, we may
disclose such information as necessary if we determine that it is in your best
interest based on our professional judgment.
-
Emergencies: SDi may use or disclose your protected health information in an emergency
treatment situation. If this happens, your physician shall try to obtain your
consent as soon as reasonably practicable after the delivery of treatment. If
your physician or another physician in the practice is required by law to treat
you and the physician has attempted to obtain your consent but is unable to
obtain your consent, he or she may still use or disclose your protected health
information to treat you.
-
Communication Barriers: SDi
may use and disclose your protected health information if your physician or
another physician in the practice attempts to obtain consent from you but is
unable to do so due to substantial communication barriers and the physician
determines, using professional judgment, that you intend to consent to use or
disclosure under the circumstances.
Other Permitted Uses and Required Disclosures
(
Without Consent, Authorization, or Opportunity to Object)
SDi may use or disclose your protected health information in the following
situations without your consent or authorization. These situations include:
-
Required By Law: SDi may
use or disclose your protected health information to the extent that law
requires the use or disclosure.
-
Public Health: SDi may disclose your protected health information for public health activities
and purposes to a public health authority that is permitted by law to collect or
receive the information.
-
Communicable Diseases: SDi
may disclose your protected health information, if authorized by law, to a
person who may have been exposed to a communicable disease or may otherwise be
at risk of contracting or spreading the disease or condition.
-
Health Oversight: SDi
may disclose protected health information to a health oversight agency for
activities authorized by law, such as audits, investigations, and inspections.
-
Abuse or Neglect: SDi
may disclose your protected health information to a public health authority,
governmental entity, or agency that is authorized by law to receive reports of
abuse or neglect.
-
Food and Drug Administration: SDi may disclose your protected health information to a person or company
required by the Food and Drug Administration to report adverse events, product
defects or problems, biologic product deviations, track products; to enable
product recalls; to make repairs or replacements, or to conduct post marketing
surveillance, as required.
-
Legal Proceedings: SDi may disclose your medical information in response to an order of a court or
administrative tribunal, or in response to a subpoena, discovery request, or
other lawful process.
-
Law Enforcement: SDi may disclose protected health information, so long as applicable legal
requirements are met, for law enforcement purposes.
-
Military Personnel: SDi
may disclose protected health information of individuals who are Armed Forces
personnel for activities deemed necessary by appropriate military command
authorities.
-
Medical Examiner: SDi
may disclose protected health information to a coroner or medical examiner to
permit such person to fulfil their lawful duties.
-
Workers’ Compensation: SDi may disclose your protected health information as authorized to comply with
workers’ compensation laws and other similar legally established programs.
Your Rights
SDi supports patient rights, including your rights with respect to your medical
information. These rights include:
-
Requesting Restrictions: You may ask SDi to limit use or disclosure of your health information. We are
not required to agree to your request, but if we agree, we will abide by your
request except as required by law, in emergencies, or when the information is
necessary to treat you. Your request must: 1) be in writing, 2) describe the
information that you want restricted, 3) state if the restriction is to limit
our use or disclosure, and 4) state to whom the restriction applies.
-
Confidential Communications: You may ask SDi to communicate with you in a particular way or at a certain
location to maintain your confidentiality. Your request must be in writing and
must tell us how you intend to satisfy your financial responsibility and specify
an alternate way that we can contact you confidentially. You do not have to
give a reason for your request.
-
Inspect and Copy: You may
request access to inspect and copy your personal information maintained in SDi
records. Your request must be in writing. We will act on your request within 5
business days after we get it. If we must deny your request we will send you a
written denial. If this happens, you may request a review of the denial. We
may charge you a fee for this service.
-
Amendment: You may ask SDi to amend personal information in SDi’s possession if you believe
that it is incorrect or incomplete. Your request must be in writing and must
include a reason to support the amendment. Your request may be denied if we
believe that the information is complete and accurate, if the information is not
part of the information that you would be permitted to inspect or copy, or if we
did not create the information.
-
Accounting of Disclosures: You may request a list of disclosures of your personal information made by SDi
over a previous six (6) year period (not including service dates prior to April
14, 2003). Your first request within a 12-month period is free, but we may
charge for additional lists within the same 12-month period.
-
File a Complaint: If
you believe that SDi has violated your privacy rights, you may file a complaint
directly with us by contacting the Privacy Coordinator. You may also file a
complaint with the Secretary of the Department of Health and Human Services.
You will not be penalized for complaining.
-
Provide an Authorization for Other Uses and Disclosures: SDi will request your written authorization for uses and disclosures of your
health information that are not identified in this notice or permitted by law.
You may revoke your authorization at any time in writing.