Notice of Privacy Practices
Effective September 23, 2013
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. If you have any questions about this notice, please contact Denise Ragusa, Chief Technologist. This notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). You will be asked to provide a signed acknowledgement of the receipt of this notice. The delivery of your health care services will in no way be conditioned upon your signed acknowledgement.
“Protected health information” (PHI) is information about you including demographic information that may identify you and that relates to your past, present and future physical and mental health or condition and related health care services. This notice will describe to you how we use and disclose your PHI. We may change the terms of this notice at any time. You may receive a revised notice by visiting our web site (ryerad.com), calling our office and requesting one be sent to you in the mail or asking for one at the time of your next visit.
Uses and Disclosures of Protected Health Information:
Your Protected Health Information may be used and disclosed by our physicians, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you.
Your Protected Health Information will be provided to the physician to whom you have been referred by us to ensure that the physician has the necessary information to diagnose or treat you. In addition, we may disclose your information from time-to-time to another physician or health care provider who, at your request or the request of your physician, becomes involved in your care.
Your Protected Health Information will be used, as needed, to obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we perform. For example; obtaining approval for a procedure might require that your relevant protected health information be disclosed to obtain such approval.
We will share your Protected Health Information with a third party “business associates” that perform various activities for our practice (biopsy lab, Pathologist). Whenever an arrangement between our office and a business associate involves the use or disclosure of your health information, we will have a written contract that contains terms that will protect your information. For example; if you have a biopsy in our office, we will disclose your information to the biopsy lab.
With your written authorization, we may use and disclose your information for marketing activities. For example; your name and address may be used to send you a newsletter or mailing about our practice and the services we offer.
We may use or disclose your Protected Health Information to the extent that the use or disclosure is required by law. The use and disclosure will be made in compliance with the following:
Anything to do with Public Health Administration, communicable diseases, any audits, investigations or inspecting by any federal or local agency. Any agencies dealing with victims of abuse, neglect or domestic violence. The Food and Drug Administration and any legal proceedings in response to a court order or subpoena. Also includes are the Military and Workers’ Compensation.
Your Rights
You have the right to inspect and obtain a copy of your Protected Health Information as long as we maintain that information. Under Federal Law, however, you may not inspect or copy our physicians’ notes. Depending on the circumstances, Rye Radiology reserves the right to deny such access. If you believe that the information we have about you is incorrect or incomplete, you may request an amendment. While we will accept requests, we are not required to agree to the amendment. You have the right to request an electronic copy of your medical record if your Protected Health Information is maintained in an electronic format.
Your Protected Health Information will not be disclosed to any family members, friends or any other person claiming to be involved with your health care, without your consent.
You have the right to be notified upon a breach of any of your unsecured Protected Health Information.
You may request certain restrictions on the use and disclosure of your Protected Health Information. Your request must state the specific restriction requested and to whom you want the restriction to apply. Please put your request in writing and send it to Denise Ragusa, Chief Technologist. If we believe it is in your best interest to permit use of your information, we have the right to overturn your request.
You may complain to the Secretary of Health and Human Services or us if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying Denise Ragusa at (914) 253-9200 or filling out the form below.
