Medical Privacy
Southern Arizona Laborists
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” (“PHI”) is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. We are required to abide by the terms of this Notice of Privacy Practices.
Nothing contained herein shall constitute medical advice. We do not intend by publishing this Notice for any physician patient relationship to be created. This Notice is strictly for informational purposes only. If you have a medical condition and/or require immediate care, you should immediately call your healthcare provider and/or dial 911.
The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. We make no representation and assume no responsibility for the accuracy of information contained on or available through this web site, and such information is subject to change without notice. You are encouraged to confirm any information obtained from or through this web site with other sources, and review all information regarding any medical condition or treatment with your physician.
SOUTHERN ARIZONA LABORISTS, LLC NOTICE OF PRIVACY PRACTICES
NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE.
Uses and Disclosures of Protected Health Information
Your PHI may be used and disclosed by your physician, 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 PHI may also be used and disclosed to pay your health care bills and to support the operation of the physician’s practice.
Following are examples of the types of uses and disclosures of your PHI that the physician’s office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Treatment
We will use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your PHI protected. For example, we would disclose your PHI, as necessary, to a home health agency that provides care to you. We will also disclose PHI to other physicians who may be treating you when we have the necessary permission from you to disclose your PHI.
In addition, we may disclose your PHI from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.
Payment
Your PHI 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 recommend for you such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
Healthcare Operations
We may use or disclose, as needed, your PHI in order to support the business activities of your physician’s practice. These activities include, but are not limited to, appointment activities, quality assessment activities, employee review activities, training of medical students, licensing, marketing activities, and conducting or arranging for other business activities.
For example: we may disclose your PHI by using a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We will call you by name in the waiting room when your physician is ready to see you.
For example: we may use or disclose your PHI, as necessary, to contact you to remind you of your appointment, results of any laboratory analysis performed on your behalf, and to notify you of potential treatment options or alternatives.
For example: we may use or disclose your PHI, to inform you of health-related benefits or services that may be of interest to you.
For example: we will share your PHI with third party “business associates” that perform various activities (e.g., transcription services) for the practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your PHI, we will have a written contract or agreement that contains terms that will protect the privacy of your PHI.
Uses and Disclosures of Protected Health Information Based Upon Your Written Authorization
Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.
Other Permitted and Required Uses and Disclosures That May Be Made With Your Authorization or Opportunity to Object
We may use and disclose your PHI in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use or disclosure of the PHI, then your physician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is relevant to your health care will be disclosed.
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
Required By Law: We may use or disclose your PHI to the extent that the use or disclosure is required by law. You will be notified, as required by law, of any such uses or disclosures.
Public Health: We may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability.
Communicable Diseases: We may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Health Oversight: We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.
Abuse or Neglect: We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information.
Food and Drug Administration: We may disclose your PHI to a person or company required by the FDA to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls, to make repairs or replacements, or to conduct post marketing surveillance, as required.
Legal Proceedings: We may disclose PHI in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal, in certain conditions in response to a subpoena, discovery request or other lawful process. This includes disclosure of PHI for medical malpractice claims.
Law Enforcement: We may also disclose PHI, so long as applicable legal requirements are met, for law enforcement purposes.
Coroners, Funeral Directors, and Organ Donation: We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties.
Research: We may disclose your PHI to researchers to determine if you meet the criteria to participate in a clinical research study and may contact you about participation.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your PHI, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.
Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel. We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
Workers’ Compensations: Your PHI may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally established programs.
Inmates: We may use or disclose your PHI if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.
Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Health Insurance Portability and Accountability Act (HIPAA) of 1996.
Your Rights
Following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights.
You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of PHI about you that is contained in a designated record set for as long as we maintain the PHI. A “designated record set” contains medical and billing records and any other records that your physician and the practice uses for making decisions about you.
Under federal law, however, you may not inspect or copy the following records: psychotherapy notes, information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewed. In some circumstances, you may have a right to have this decision reviewed.
You have the right to request a restriction of your protected health information. This means you have the right to request a restriction in our use or disclosure of your PHI for treatment, payment or healthcare operations. We are not required to agree to your request and in some cases where the requested restrictions limit our ability to provide quality healthcare, will recommend that you seek medical treatment with another healthcare provider or facility. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. We are not required to agree to your request, however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your PHI, your request must state the specific restriction requested and to whom you want the restriction to apply. In order to request a restriction on our use or disclosure of your PHI, you must make your request in writing to: the Chief Executive Officer and Managing Member. Your request must describe in a clear and concise fashion:
- the information you wish restricted;
- whether you are requesting to limit our practice’s use, disclosure or both; and
- to whom you want the limitations to apply.
You have the right to request to receive confidential communications, from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to: the Chief Executive Officer and Managing Member.
You may have the right to have your physician amend your protected health information. This means you may request an amendment of PHI about you in a designated record set for as long as we maintain this information. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact the Chief Executive Officer and Managing Member to investigate your questions about amending your medical record.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes.
You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. You may request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations.
You have the right to obtain a paper copy of this notice from us, upon request.
Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe we have violated your privacy rights. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a complaint.
You may contact, in writing, our Chief Executive Officer and Managing Member for further information about the complaint process at:
Southern Arizona Laborists, LLC
Attn: Elizabeth F. Weisert, M.D., CEO and Managing Member
5151 East Broadway Boulevard, Suite 1600
Tucson, Arizona 85711
(520) 721-8605
Miscellaneous
The construction and enforcement of this Notice shall be governed by the laws of the State of Arizona. Any dispute regarding the interpretation or validity of this Notice shall be subject to the exclusive jurisdiction of the state and federal courts in and for Pima County, Arizona, and you agree to submit to the personal and exclusive jurisdiction and venue of such courts.
You hereby voluntarily, knowingly, irrevocably and unconditionally waive any right to have a jury participate in resolving any dispute (whether based upon contract, tort or otherwise) between or among the parties arising out of or in any way related to this Notice or any relationship between the parties.
Should either party file an action to enforce any right or rights arising under this Notice, then the party prevailing in such action shall be entitled to recover reasonable attorney’s fees, together with taxable court costs and non-taxable costs and expenses incurred incidental to the prosecution of any such action, to be included in any final judgment or decree rendered on such action, together with provision for the anticipated costs, expenses and attorney’s fees in liquidating and collecting any such judgment or decree rendered in favor of the prevailing party.
It is the intent of this Notice to comply in all respects with all federal, state, and local laws, regulations, rules, and interpretative case decisions governing the relationship between the parties, including, but not limited to, those involving relationships between tax-exempt entities and providers, the Medicare laws, the AHCCCS laws, and other similar laws, rules, regulations, and decisions (“Health Care Laws”), and the parties have structured their relationship with that specific intent. However, each of the parties also understands that Health Care Laws and the development of interpretative regulations, rulings and case decisions are both complicated and in a state of flux. Therefore, in the event that any provision of this Notice is rendered invalid or unenforceable; or Health Care Laws are altered by Congress, the State of Arizona, or by any regulation duly promulgated by any agency or department of the United States or of the State of Arizona acting in accordance with law; or this Notice or any provision hereof is declared null, void, unenforceable, or in violation of any such Health Care Laws, then and in any of the foregoing events, the remainder of the provisions of this Notice shall remain in full force and effect and the parties shall attempt to restructure the offending provision(s).
We have not and shall not take any action directly or indirectly in violation of any applicable fraud and abuse laws including, without limitation, 18 U.S.C. § 201 (bribery of public officials); 18 U.S.C. § 286 (conspiracy to defraud government with respect to claims); 18 U.S.C. § 287 (false, fictitious or fraudulent claims); 18 U.S.C. § 371 (conspiracy to commit offense or to defraud the government); 18 U.S.C. § 666 (theft or bribery concerning programs receiving federal funds); 42 U.S.C. § 1320a-5 (disclosure of ownership and related information); 42 U.S.C. § 1320a-7a (civil monetary penalties); 42 U.S.C. § 1320a-7b (criminal penalties); 42 U.S.C. § 1395u(b)(6) (prohibition against factoring of Medicare payments); 42 U.S.C. § 1395nn(a) (making false statements or representations in application for Medicare payment; 42 U.S.C. § 1395nn(b) (illegal remunerations); 42 U.S.C. § 1395nn(d) (violation of assignment of terms); 42 U.S.C. § 1396(a)(32) (prohibition against factoring of Medicaid payments); 42 U.S.C. § 1396h(a) (making false statements or representations in application for medical payments); and 42 U.S.C. § 1396h(d) (illegal patient admittance and retention practices).