The Health Insurance Portability and Accountability Act of 1996 (HIPAA) has established requirements that health care providers, including Metro Imaging, must follow when using or disclosing your health information. This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Understanding Your Health Information Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, may serve as a: basis for planning your care and treatment means of communication among the many health professionals who contribute to your care legal document describing the care you received means by which you or a third-party payor can verify that services billed were actually provided a tool in educating heath 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 facility planning and marketing a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve Understanding what is in your record and how your health information is used helps you to: ensure its accuracy better understand who, what, when, where, and why others may access your health information make more informed decisions when authorizing disclosure to others Who Will Follow This Notice This notice describes Metro Imaging’s practices and that of all employees, staff and other Metro Imaging personnel. This notice covers both Metro Imaging LLC and Radiologic Imaging Consultants LLP. For More Information or to Report a Problem If have questions or would like additional information, you may contact the privacy officer at 314-993-9555. If you believe your privacy rights have been violated, you can file a complaint with the privacy officer or with the secretary of Health and Human Services. There will be no retaliation for filing a complaint. Your Health Information Rights Although your health record is the physical property of the health care practitioner or facility that compiled it, the information belongs to you. You have the right to: request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522 request a paper copy of the notice of privacy practices upon request. You may obtain a copy of this notice at our website at www.metroimaging.org or by requesting a paper copy from the receptionist at any of our facilities. request in writing to obtain a copy of your health record as provided for in 45 CFR 164.524 request in writing to amend your health record as provided in 45 CFR 164.528 request in writing to obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528 request in writing communications of your health information by alternative means or at alternative locations revoke your authorization to use or disclose health information except to the extent that action has already been taken Our Responsibilities We understand that medical information about you and your health is private. We are committed to protecting medical information about you. We create a record of the care and services you receive here. We need this record to provide you with quality care and comply with certain legal requirements. This notice applies to all of the records of your care generated by us. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic. 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 medical information. We are required to: maintain the privacy of your health information provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you abide by the terms of this notice notify you if we are unable to agree to a requested restriction accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations. We reserve the right to change our practices and 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 notice in each facility. In addition, each time you register at one of our facilities, we will make available to you a copy of the current notice in effect. Examples of How We May Use or Disclose Your Medical Information The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. We will use your health information for treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose information about you to doctors, nurses, technologists or other health care professionals involved in your care. For example, information obtained by a member of the health care team, including but not limited to the radiologist, technologist, etc. will be recorded in your record and used to determine the course of treatment that should work best for you. Our radiologist will document in your record his or her findings. We will also provide your physician and any subsequent health care provider with copies of various reports and films, upon request, that should assist him or her in treating you. We will use your health information for payment. We may use and disclose medical information about you so that the treatment and services you receive here may be billed and payment collected from you, an insurance company, or third party. For example, a bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. We will use your health information for regular health operations. We may use and disclose medical information about you for our operations. These uses and disclosures are necessary to run our organization and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services to evaluate the performance of our care, necessity of services, effectiveness and expansion of services offered. Appointment Reminders: We may use and disclose medical information to contact you as a reminder that you have an appointment at our facility. We may also contact you to provide you with instructions to prepare for your exam or to reschedule your exam. If you are unavailable, we may leave a message on your answering machine at the phone number provided to us. This message will be limited to a reminder of the date, time and facility location. Business associates: There are some services provided in our organization through contacts with business associates. Examples include an outside billing service and outside personnel who provide maintenance services on our medical equipment. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job necessary. To protect your health information, however, we require the business associate to appropriately safeguard your information. Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, of your location, and general condition. Communication with family: Health professionals, using their best judgment, may disclose to your family member or other relative, your close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information. Workers’ compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law. Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability. Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals. Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Military and veterans: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority. 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.