NOTICE
OF PRIVACY PRACTICES
Effective: April 12, 2004
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
Privacy Promise
HerediLab understands that your medical and health information is personal.
Protecting your health information is important. We follow strict federal
and state laws that require us to maintain the confidentiality of your
health information.
How We
Use Your Health Information
When you receive testing from HerediLab, we may use your health information
for treating you, billing for services, and conducting our normal business
known as health care operations.
| Examples of how
we use your information include: |
| Treatment - We
keep records of the testing results provided to your health care
provider. Health care providers use these records to deliver quality
care to meet your needs. For example, your doctor may share your
health information with a specialist who will assist in your treatment. |
| Payment - We
keep billing records that include payment information and documentation
of the services provided to you. Your information may be used to
obtain payment from you, your insurance company, or another third
party. We may also contact your insurance company to verify coverage
for your care or to notify them of upcoming services that may need
prior notice or approval. For example, we may disclose health information
about the services provided to you to claim and obtain payment from
your insurance company or Medicare. |
| Health Care Operations
- We use health information to improve the quality of care, train
staff and students, provide customer service, manage costs, conduct
required business duties, and make plans to better serve our communities.
For example, we may use your health information to evaluate the
quality of services provided by our laboratory staff. |
Sharing
Your Health Information
There are limited situations when we are permitted or required to disclose
health information without your signed authorization (permission). These
situations are:
For public health purposes such as reporting communicable diseases,
work-related illnesses, or other diseases and injuries permitted by
law; reporting births and deaths, and reporting reactions to drugs and
problems with medical devices
To
protect victims of abuse, neglect, or domestic violence
For health oversight activities such as investigations, audits, and
inspections
For lawsuits and similar proceedings
When required by law
When requested by law enforcement as required by law or court order
To coroners, medical examiners, and funeral directors
For organ and tissue donation
For research approved by our review process under strict federal guidelines
To reduce or prevent a serious threat to public health and safety
For workers' compensation or other similar programs if you are injured
at work
For specialized government functions such as intelligence and national
security
All other uses
and disclosures, not described in this notice, require your signed authorization.
You may revoke your authorization at any time with a written statement
submitted to Health Information.
Our Privacy
Responsibilities
Maintain the privacy of your health information
Provide this notice that describes the ways we may use and share your
health information
Follow the terms of the notice currently in effect
We reserve the
right to make changes to this notice at any time and apply the new privacy
practices to all information we maintain. Current notices will be posted
at HerediLab and on our website, http://www.alpha1center.com. You may
also request a copy of this notice by contacting the laboratory at (801)
328-4254.
Your Individual
Rights
Request special restrictions on how we use and share your health information.
We will consider all requests for special restrictions carefully, but
are not required to agree to any restriction. Your request must be in
writing.
Request that we use a specific telephone number or address to communicate
with you. Your request must be in writing.
Inspect and receive a copy of your health information, including medical
and billing records. Fees may apply. Under limited circumstances, we
may deny you access to a portion of your health information and you
may request a review of the denial. Your request must be in writing.
Request an amendment to your health information. Your request must be
in writing.
Request an accounting of certain disclosures we make of your health
information. The list does not include disclosures made for treatment,
payment, and health care operations and some disclosures required by
law. Your request must state the period of time requested for the accounting.
An accounting goes back only six years and does not cover disclosures
made prior to April 14, 2003. The first accounting is free but a fee
will apply if more than one request is made in a 12-month period. Your
request must be made in writing.
Request a paper copy of this notice even if you agree to receive it
electronically.
Other
Services We Provide
We may also use your health information to:
Recommend treatment alternatives
Tell you about health services and products that may benefit you
Share information with family or friends directly involved in your care
or in paying for your care
Share information with third parties who assist us with treatment, payment,
and health care operations. Our business associates must follow our
privacy practices
Contact
Us
If you are concerned that your privacy rights may have been violated,
or disagree with a decision that we made about access to your health
information, please contact:
The Privacy
Officer
HerediLab, Inc.
5505 East Pioneer Fork Road
Salt Lake City, UT 84108
(801) 583-4123
We will investigate
all complaints and will not retaliate against you for filing a complaint.
You may also file a written complaint with the Office of Civil Rights
of the U.S. Department of Health and Human Services.
