Notice of Privacy Practices
The privacy and confidentiality of your personal health information is very important to us at Rhode Island Medical Imaging (RIMI). This notice describes how we use and disclose your protected health information. Protected Health Information (PHI) is information, including demographic information, that may identify you and that relates to health care services provided to you, the payment of health care services provided to you, or your physical or mental health or condition, in the past, present or future. Rhode Island Medical Imaging is required by state and federal law to maintain the privacy of your PHI and give you this notice which describes our legal duties and practices with respect to the privacy of your protected health information. This notice applies to the information and records we have about your health, health status, and the health care and services you receive at this office.
We will abide by the privacy practices described in this notice but we reserve the right to change the privacy practices described in this notice in accordance with the law. Changes to our privacy practices would apply to all health information we maintain. If we change our privacy practices, you can receive a revised copy.
In general, when we release your health information, we must release only the information we need to achieve the purpose of the use or disclosure. Without your written authorization we can use your health information for the following purposes:
Treatment: refers to the provision and coordination of health care by a doctor, hospital or other health care provider including consultations between health care providers regarding your care and referrals for health care from one health care provider to another. For example, we may disclose your medical information to your doctor(s), at the doctor’s request, for your treatment by him/her. Or we may have an indirect treatment relationship with you, that is, we provide health care to you based on the orders of another health care provider. For example, if you come to us for a diagnostic procedure, we can disclose the results of that test to the physician who ordered the procedure.
Payment: refers to the activities we undertake to obtain reimbursement for the health care services provided to you, including determinations of eligibility and coverage and other utilization review activities.
Healthcare Operations: refers to the support functions of our practice related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient complaints, physician review, compliance programs, audits, business planning, development, management and administrative activities. For example we may review your medical information to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what additional services we should offer, or what services are not needed.
In addition we may want to use your health information for appointment reminders.
As required or permitted by law: Sometimes we must report some of your health information to legal authorities, such as law enforcement officials, court officials, or government agencies. For example, we may have to report abuse, neglect, domestic violence or certain physical injuries or accidents, or to respond to a court order.
Public Health Risks: We may disclose medical information about you for public health activities.
These activities generally include the following:
- to prevent or control disease, injury or disability;
- to report child abuse or neglect;
- to report reactions to medications or problems with products;
- to notify people of product, recalls, repairs, or replacements;
- to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
For activities related to death: We may disclose your health information to coroners, medical examiners, and funeral directors so they can carry out their duties related to your death, such as identifying the body, determining cause of death, or in the case of funeral directors, to carry out funeral preparation activities.
Organ and Tissue Donation: If you are an organ donor, we may release medical information to 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.
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.
Worker’s Compensation: We may release medical information about you for programs that provide benefits for work-related injuries or illness.
Health Oversight Activities: We may disclose medical information to federal or state agencies that oversee our activities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. We may disclose protected health information to persons under the Food and Drug Administration’s jurisdiction to track products or to conduct post-marketing surveillance.
Research: Under certain circumstances, and only after a special approval process, we may use and disclose your health information to help conduct research. Such research might try to find out whether a certain treatment is effective in curing an illness.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information if we believe that the use of 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 protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
Emergencies: We may use or disclose your protected health information in an emergency treatment situation. If this happens, your physician shall try to obtain your consent as soon as reasonably practicable after the delivery of treatment.
Communication Barriers: We may use and disclose your protected health information if your physician or another physician in the practice attempts to obtain consent from you but is unable to do so due to substantial communication barriers and the physician determines, using professional judgment that you intend to consent to use or disclosure under the circumstances.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical 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.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
To those involved with your care or payment of your care: If people such as family members, relatives, or close personal friends are helping care for you or helping you pay your medical bills, we may release important health information about you to those people. You have the right to object to such disclosure, unless you are unable to function or there is an emergency. In addition, we may release your health information to organizations authorized to handle disaster relief efforts so those who care for you can receive information about your location or health status. We may allow you to disagree to such release, unless there is an emergency. It is our duty to give you enough information so you can decide whether or not to object to release of your health information to others involved with your care.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITH YOUR WRITTEN AUTHORIZATION
Except for the situations listed above, we must obtain your specific written authorization for any other release of your health information. If you sign an authorization form, you may withdraw your authorization at any time, as long as your withdrawal is in writing. If you wish to withdraw your authorization, please submit your written withdrawal to the Privacy Officer, Rhode Island Medical Imaging, 125 Metro Center Boulevard, Suite 2000, Warwick, RI 02886.
YOUR RIGHTS
You have the right to receive treatment and information without discrimination based on age, color, culture, ethnicity, gender identity or expression, language, national origin, physical or mental disability, race, religion, sex, sexual orientation, socioeconomic status, or source of payment.
You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information 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. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Your referring physician is not required to agree to a restriction that you may request. If your physician believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. If your physician does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restrictions you wish to request with your physician. You may request a restriction in writing to the Privacy Officer, Rhode Island Medical Imaging, 125 Metro Center Boulevard, Suite 2000, Warwick, RI 02886.
You have the right to receive confidential communications from us by alternative means or at an alternate 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 Rhode Island Medical Imaging Administration.
You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you that is contained in a designated record set, and was created by us, for as long as we maintain the protected health information. We are not required to grant every request for access, as explained below. Under 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 protected health information. Please contact Rhode Island Medical Imaging Administration if you have questions about access to your medical record.
We may also deny a request for access to protected health information if:
- a licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger your life or physical safety or that of another person;
- the protected health information makes reference to another person (unless such other person is a health care provider) and a licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonable likely to cause substantial harm to such other person;
- the request for access is made by the individual’s personal representative and a licensed health care professional has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to you or another person.
If we deny a request for access for any of the three reasons described above, then you have the right to have our denial reviewed in accordance with the requirements of applicable law.
You have the right to amend protected health information. This means you may request an amendment of protected health information 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 our executive staff at 401-432-2520 if you have 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 the Notice of Privacy Practices. It excludes disclosures we may have made to you, for a facility directory, 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. 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, even if you have agreed to accept this notice electronically.
COMPLAINTS
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You must file the complaint in writing to the Privacy Officer, Rhode Island Medical Imaging, 125 Metro Center Boulevard, Suite 2000, Warwick, RI 02886. We will not retaliate against you for filing a complaint.
PRIVACY CONTACT
If you believe that your privacy rights have been violated, you should contact Rhode Island Medical Imaging Administration at 401-432-2520 for further information about the complaint process.
This notice was published and becomes effective on April 14, 2003.
1If you cannot afford to pay for copies, you will not be denied access.
CONSULTANT DISCLOSURE
Dr. Peter T. Evangelista, MD is a consultant for Wright Medical Technology, Inc. In his role as diagnostic radiologist, he does not prescribe or promote any of their products. This relationship does not interfere with your care and is being disclosed in order to foster transparency with regard to potential conflicts of interest.