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THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVEW IT CAREFULLY.
Dart Medical Laboratory. (“Dart”) wants you to be assured that keeping your
information secure and confidential is our primary concern and obligation. At
Dart, we are committed to keeping your laboratory test results confidential.
Not only that, we make sure that other protected health information that we
collect from you or create for you as part of our diagnostic testing
activities is kept highly confidential and secure; unavailable to any third
party without your express permission.
As required by law, this Notice has been published to explain the information
that we collect and how we retain, use and disclose it to be utilized in
provision of diagnostic services and we will abide by the statements made
herein. Except as permitted by law and as explained in this Notice, we do not
disclose any information about our past, present or future patients to
anyone. The usage of the term “Protected Health Information” or “PHI” by us
refers to individually identifiable information concerning the provision of,
or payment for, health care to you.
What information do we collect?
In providing diagnostic testing services, we may collect Protected Health
Information from the following sources (including but not limited to):
- Information from healthcare
providers who are currently treating you or have treated you at any time
in the past. This information may include your health status and/or the
tests to be performed.
- Information from insurance
companies that are currently insuring you or have insured you at any
time in the past. This information may include your claims history.
- Information we may obtain while
providing diagnostic services to you. This information may be obtained
from our affiliates or others, such as other laboratories.
How do we protect Protected Health Information?
Our employees are required to maintain your Protected Health Information in
the strictest confidence, and they understand the confidentiality
requirements. Any employee negligent in this regard is bound to face disciplinary
action. We also maintain physical, electronic, and procedural safeguards to
guard your Protected Health Information. Finally, in those situations where
we rely on a third party to perform business, professional or insurance
services or functions for us, that third party must agree to protect the
privacy of your Protected Health Information and use it only as required to
perform those functions it performs for us and as otherwise permitted by law.
In these ways, Dart confirms the confidentiality promised to you.
When we must seek your authorization before disclosing Protected Health
Information
There may be circumstances where Dart will seek your authorization before we
make a disclosure of your Protected Health Information – to make sure we have
your express permission to make that disclosure. For example, in case you ask
someone who is not your personal representative to contact us on your behalf
to discuss your test results or your payment history, we will seek
authorization from you before divulging any of your Personal Health
Information, unless otherwise permitted or described below.
If you authorize us to
disclose your Protected Health Insurance, you are permitted to revoke that
authorization at any time in writing. We will honor your revocation of
authorization once processed, except to the extent that we may have taken
action in reliance upon your original authorization.
Uses and Disclosures
of Protected Health Information that do not require authorization
We are generally
permitted to make disclosures of your Protected Health Information without
your authorization for purposes of treatment, payment and health care
operations. Below we provide examples of those purposes although not
every use or disclosure falling in these categories is listed.
Please note that we may limit certain information we disclose in accordance
with laws regarding the special nature of the information (e.g. HIV/AIDS,
substance abuse, or genetic information). Also, as New York State
permits minors of a certain age to seek particular treatment services without
parental consent, information that would normally be provided to our
customers may be impacted as Dart protects the privacy of that minors’
information in accordance with those state laws.
- Treatment activities. As a health care provider
that provides laboratory testing for ordering physicians, Dart uses your
PHI as part of our testing process and discloses your PHI to physicians
and other authorized health care providers, such as a nursing home or
hospital, who need access to your laboratory results to treat you. In
addition to your treating physician, we may provide a specialist
consulting physician, with information about your results to further
validate the results before release to your physician. Occasionally, we
may contact you to arrange for a redraw of your specimens.
- Payment activities. We will use your PHI in our
billing department and disclose your PHI to insurance companies,
hospitals, physicians, and health plans for payment purposes, or to
third parties to assist us in creating bills, claim forms, or getting
paid for our services. For example, we may send your name, date of
service, test performed, diagnosis code, and other information to a
health plan so that the plan will pay us for the services we provided.
In some cases, we may have to contact you to obtain billing information
or for other billing purposes. When required, we may use an outside
collection agency to obtain payment.
- Health Care Operations
activities.
We may use or disclose your PHI in the course of activities necessary to
support our health care operations, such as performing quality checks on
our testing, for teaching purposes, or for developing normal reference
ranges for tests that we perform.
- Treatment, Payment and
Health Care Operations of Other Covered Entities. We may disclose your PHI
for another covered entity’s treatment and payment purposes. For
example, we may disclose your PHI to your health care provider for their
ongoing treatment of you or we may disclose your PHI when it would
facilitate payment for services between multiple health plans with
respect to coordination of benefits. In addition, we are permitted to
disclose PHI to other covered entities so that they can conduct certain
of their health care operations or for purposes, such as fraud and abuse
detection or compliance. We will only disclose PHI to other covered
entities for these health care operations purposes if that covered
entity has or has had a relationship with you.
- Additional reasons for
disclosure.
We may also use or disclose Protected Health Information to:
- A governmental agency or
its agents as required by state or federal law;
- military authorities if you
are or were previously a member of the armed forces;
- further public safety or,
when requested by federal officials, for national security or
intelligence activities or for the protection of public officials;
- Appropriate bodies for
public health activities, including the reporting of child abuse or
neglect, reporting adverse events, product defects, or for Food and
Drug Administration reporting;
- A health oversight agency
for activities such as audits, investigations, licensure or for
disciplinary actions or civil, administrative or criminal proceedings.
These disclosures are necessary for the government to oversee the
health care system, government benefits programs for compliance with standards,
and compliance with civil rights laws;
- Appropriate bodies in
response to a subpoena or court order; or in response to litigation
that directly involves us;
- the correctional
institution or the law enforcement agency if you are an inmate or are
in the custody of law enforcement; and
- Prevent a serious threat to
your health and safety or the health and safety of the public or
another person. Any disclosure, however, would only be to someone able
to help prevent the threat.
- Organizations that handle organ
procurement or organ, eye or tissue transplantation or to an organ
donation bank, as necessary to facilitate organ or tissue donation and
transplantation.
- Comply with laws relating
to workers' compensation or similar programs. These programs provide benefits
for work-related injuries or illness.
- A court or administrative
tribunal in response to a court or administrative order. We may also
disclose health information about you in response to a subpoena,
discovery request, or other lawful process by someone else involved in
the dispute, but only if efforts have been made to tell you about the
request or to obtain an order protecting the information requested.
- A coroner or medical
examiner. This may be necessary, for example, to identify a deceased
person or determine the cause of death. The Plan may also release
health information to funeral directors as necessary to carry out their
duties.
You should understand
that, except in the circumstances described above, we will not disclose your
Protected Health Information without a written authorization from you. Except
for disclosures of Protected Health Information made directly to you, for
your treatment, or pursuant to your authorization, the federal rules that
govern the privacy of PHI generally require us to use and disclose only the
minimum PHI necessary to accomplish the purpose of the disclosure.
Legal Rights Related
to Protected Health Information
- The federal privacy rule,
entitles you to request restrictions on our uses and disclosures of
Protected Health Information for treatment, payment or health care
operations purposes described above. We will consider each request but
are not required to agree to any restrictions.
- The federal privacy rule
entitles you to request to receive confidential communications of
Protected Health Information if disclosing this information by the usual
means could endanger you. Dart will accommodate all reasonable requests,
subject to the restrictions and capabilities of our information
processing systems.
- The federal privacy rule
entitles you to request to receive an accounting of certain disclosures
of your PHI made by Dart, such as disclosure to health oversight
agencies. These do not include disclosures made for purposes of
treatment, payment or health care operations.
- You have a right to request,
in writing, to inspect and obtain a copy of Protected Health Information
that we maintain about you that is included in what is called a
“designated record set.” Additionally, when requesting information, you
must reasonably describe the information you seek in your written
request; and the information must be reasonably locatable and
retrievable by us. We may charge you a fee to cover the cost of
providing copies of this requested Protected Health Information. Please
note, however, both federal and state law in most circumstances
prohibits our laboratory from disclosing laboratory test results
directly to you subject to limited exception. If your request for PHI is
for a laboratory test result and does not fit within such exceptions, we
will refer you to the provider that requested that we perform the test
in order to obtain a copy of your test results.
- You have the right to amend
your Protected Health Information included in the designated record set.
We may deny your request pursuant to those rules if we determine that
our records are accurate and complete, if we determine that the
information was not created by us, the information is not contained in
our designated record set, or if access is otherwise restricted by law.
If you wish to exercise
any of the legal rights described above, you must do so in writing. To obtain
further information about these rights, or if you would like to make such a
request, contact the Privacy Officer at 718-934-1918.
Keeping up-to-date
with our Privacy Policy
We will provide you with notice of our privacy policy annually for as long as
you maintain an ongoing customer relationship with us. Our policies may
change as we periodically review and revise them, and as we complete our
implementation of the federal rules on privacy of health information. For
these enrollees, we will provide a new Notice if the changes are significant.
It may be necessary to
use or disclose your Protected Health Information for the purposes described
above even after our relationship with you has terminated. Thus, we do not
necessarily destroy your Protected Health Information upon the termination of
our relationship.
Complaints
You may file a complaint with Dart if you feel that your privacy rights have
been violated. All complaints must be submitted in writing. To file a
complaint, contact Dart’s Privacy Officer at 718-934-1918. You may also complain to the U.S. Secretary of Health
and Human Services, who is responsible for overseeing compliance with federal
privacy law. You will not be retaliated against for filing a complaint. If
you would like to file a complain with the U.S. Department of Health and
Human Services your complaint should be directed to: Michael Carter, Regional
Manager, Office for Civil Rights, DHHS Region II, U.S. Department of Health
and Human Services, Jacob Javits Federal Building, 26 Federal Plaza – Suite
3312, New York, NY 10278
If you have any
questions or comments about this Notice, or to request a paper copy of it,
you can call the Privacy Officer at 718-934-1918.
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