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NOTICE OF PRIVACY PRACTICES
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.
StatClinix, PLC is required, by law, to maintain the privacy and confidentiality of your protected health information and to provide our patients with notice of our legal duties and privacy practices with respect to your protected health information.
Disclosure of Your Health Care Information
Treatment: Your health information may be used by staff members or disclosed to other healthcare professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedures will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment: Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. Information provided for payment includes medical information such as diagnosis, date of injury or condition, and codes which describe the health care services received.
Health Care Operations: Your health information may be used as necessary to support the day to day activities and management of StatClinix, PLC For example, Information on services provided may be used for quality assurance, budgetary and financial purposes.
Reminders/Notifications: Our staff will use your health information t send you follow up care, referral or appointment reminders. We may call your home to remind you of an appointment follow up on your condition or inquire about the care you received during your visit. If you are not at home, we leave a reminder message on your answering machine or with the person answering the phone. No personal health information will be disclosed during this recording or message other than the date and time of your scheduled appointment along with a request to call our office if you need to cancel or reschedule your appointment. We may also send you information about changes at StatClinix such as new locations, changes in business hours or the services we provide.
Treatment Information: Your health information may be used to send you information regarding the treatment and management of your medical conditions. We may also send you information describing other health related products and services that we believe may interest you.
Workers’ Compensation: We may disclose your health information as necessary to comply with State Workers’ Compensation Laws.
Emergencies: We may disclose your health information to notify or assist in notifying a family member, or another person responsible for your care about your medical condition or in the event of an emergency or of your death.
Public Health: As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
Judicial and Administrative Proceedings: We may disclose your health information in the course of any administrative or judicial proceeding.
Law Enforcement: We may disclose your health information to a law enforcement agencies or official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, to support government audits and inspections, and other law enforcement purposes.
Deceased Persons: We may disclose your health information to coroners or medical examiners.
Organ Donation.: We may disclose your health information to organizations involved in procuring, banking, or transplanting organs and tissues.
Research: .We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.
Public Safety: It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.
Specialized Government Agencies: We may disclose your health information for military, national security, prisoner and government benefits purposes.
Change of Ownership.
In the event that StatClinix, PLC is sold or merged with another organization, your health information/record will become the property of the new owner.
Your Health Information Rights
Right to Restriction: You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that StatClinix, PLC is not required to agree to the restriction that you requested.
Right to Request Confidential Communication: You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.
Right to Inspect and Copy: You generally have the right to inspect and copy your health information. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. Your request will be reviewed and generally be approved unless there are legal or medical reasons to deny the request.
Right to Amend your Records: You have a right to request that StatClinix, PLC amend your protected health information. Please be advised, however, that StatClinix, PLC is not required to agree to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s)and information about how you can disagree with the denial.
Right to an Accounting of Disclosures: :You have a right to receive an accounting of disclosures of your protected health information made by StatClinix, PLC.
Right to a Paper Copy of this Notice: You have a right to a paper copy of this Notice of Privacy Practices at any time upon request.
Changes to this Notice of Privacy Practices
StatClinix, PLC reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. Until such amendment is made, StatClinix, PLC is required by law to comply with this Notice.
Complaints
If you would like to submit a comment or complaint about your Privacy rights, or how StatClinix, PLC has handled your health information, you may contact our Privacy Officer at the following address:
StatClinix, PLC
Privacy Officer
9382 E Bahia Dr. B-202
Scottsdale, AZ 85260
If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to:
DHHS, Office of Civil Rights
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from StatClinix.
We cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Services.
This notice is effective as of 2/9/2009. Revised 1/19/2006 --2nd Revision 10/3/2008
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