This notice is effective on or after April 14, 2003.
Uses and Disclosures
Treament: Your health information may be used by staff members or disclosed to other health professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. Results of radiology procedures will be available 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. Your health plan may request and receive information on dates of services, the services provided, and the medical condition being treated. Your health information may also be used to tell your health plan about a treatment you are going to receive, to obtain prior approval, or to determine whether your plan will cover the treatment.
Health Care Operations: Your health information may be used as necessary to support day-to-day activities and management. Information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
Your Rights and Choices
RIGHT TO REVISE PRIVACY PRACTICES: As permitted by law, we reserve the right to amend or modify our privacy policies and practices. Additionally, changes in our policies and practices may be required by changes and federal and state law or regulations. The revised policies and procedures will be applied to all Protected Health Information we maintain.
REQUEST TO INSPECT PROTECTED HEALTH INFORMATION: You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy Protected Health Information be submitted in writing. You may obtain a form to request access to your records by contacting one of our receptionists or Privacy Official. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.
- The right to request restrictions on th use and disclosure of your Protected Health Information.
- The right to receive confidential communications concerning your medical condition and treatment.
- The right to inspect and copy your Protected Health Information.
- The right to amend or submit corrections to your Protected Health Information.
- The right to receive an accounting of how and to whom your Protected Health Information has been disclosed.
- The right to receive a printed copy of this notice.
Other Uses and Disclosures of Health Information
Law Enforcement: Your health information may be disclosed to law-enforcement agencies, without your permission, to support government audits and inspections, to facilitate law-enforcement investigations, to comply with government mandated reporting.
Public Health Reporting: Your health information may be disclosed to public health agencies as required by law. We are required to report certain communicable diseases to the state's public health department.
Health and Treatment Related Information: Your healt information may be used to send you information informing you or ouf health-related products and services, recommend other treatments and other health care providers, and to ascertain the quality of our services.
Duties: We are required by law to maintain the privacy of your Protected Health Information and to provide you with this notice of privacy practices.
We will not use or disclose your health information for any purpose other than those identified within this document without your specific written Authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoe the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoe the authorization.
How To Reach Us
If you have quesstions or concerns about our privacy practices or feel that your privacy rights have been violated, pleasae call or write us at:
Site Privacy Official, Open Imaging Redwood
6423 South Redwood Road, Suite #130, Taylorsville, Utah, 84123
Site Privacy Official, Open Imaging Layton
2071 North Main Street, Suite #100, Layton, Utah, 84041