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Patient Information

Medical Facility Information


Notice of Privacy Practices

This Notice presents how information of medical nature about you may be utilized and disclosed and how you can access it.

Please review this notice thoroughly.

This Notice offers you the knowledge to safeguard the privacy of your confidential health care information, henceforth indicated as protected health information (PHI). Also, the Notice presents your privacy rights and how you can exercise them.

The HIPAA (Health Insurance Portability and Accounting Act) Privacy Rule regulates the way PHI is utilized and disclosed. Application and compliance with this rule are not optional. It is mandatory that we offer the attached information. Please review it and familiarize yourself with it. For your records, you can print out a copy. Please express your receipt of the Notice below. This will be a constant part of your medical record. For some patients, we will need a consent form signed by a parent or legal guardian.

Utilization and Disclosures of your Health Care Information

Based on your agreement with this Notice of Privacy Practices and our Terms of Use, your PHI may be applied or disclosed for the following reasons.

To Provide Treatment: Your PHI may be utilized and disclosed to health care professionals to provide you with health care services. For this purpose, we may need to retrieve PHI from your former health care providers. For example, PHI obtained will be recorded and used to determine the best course of treatment.

For Health Care Operations:Your information may be utilized or disclosed for health care operations. Access to your PHI may be allowed to our staff members and independent contractors for some business operations and quality improvement objectives. These utilization and disclosures are needed to help ensure all Mesotheliomadr users receive quality care. For example, we may utilize PHI about your condition to review our services.

For Business Associates:Some of our services are offered through a contract with business associates. Your information may be utilized or disclosed to provide services and bill for them. Any business associates will sign an agreement that they have procedures in place that protect your PHI.

Your PHI may be utilized or disclosed for the specified purposes, depending on your opportunity to agree or disagree.

Maintaining Patient Directory:We will use your information to keep a listing of the name. Location, and general condition of our users. You may inform us if you object to this utilization or disclosure.

Communication With Family and Notification:Your information may be utilized or disclosed to announce or assist in announcing a family member, personal representative, or any other person responsible for the care of your general condition. The health information disclosed is that relevant to their involvement in your care or to payment.

Your PHI may be utilized and disclosed for the subsequent purposes without your authorization or opportunity to agree or disagree.

As Demanded by Law:Your information will be utilized or disclosed when we are legally demanded to do so. We will restrict the PHI utilized or disclosed to the minimum needed to observe the law.

Inmates: If you are an inmate, your health information may be utilized or disclosed to the correctional institutions or their agents when needed for their health or the health and safety of the rest.

In Case of Emergency:Your health information may be utilized or disclosed in an emergency situation, following that your acknowledgment be obtained as soon as practicable.

To Prevent a Serious Threat to Health or Security:We may utilize and disclose your personal health information when needed to avoid serious threats to the health and security of you or another person.

Organ Procurement Organizations (OPO):We may disclose PHI to OPOs, consistent with the applicable law, for the purpose of organ and tissue donation and transplant.

Military:As demanded by military command authorities, if you are or have been a member of the armed forces, we may release PHI about you.

Research:PHI about you may be disclosed for research when the research has been certified by an institutional review board and privacy codes have been established.

Public Health Authorities:We may disclose your PHI to public health authorities accountable for preventing or controlling disease, injury, or disability.

Health Oversight Agencies: Your PHI may be disclosed to health oversight agencies for actions authorized by law, as audits or inspections.

Litigation and Disputes:We may disclose PHI about you in response to a court or administrative order if you are involved in a litigation or dispute. Medical information about you may be disclosed in reply to a subpoena, discovery request, or another process by someone implicated in the dispute. In this case, efforts have to be made to inform you of the demand or retrieve an order protecting the requested information.

Law Enforcement Officials: Your PHI may be released

  • For law enforcement purposes as demanded by law
  • In response to a court order, warrant, subpoena, summons, another process
  • To identify or find a suspect, material witness, fugitive, or missing person
  • In connection with the victim of a crime if, under some limited circumstances, we cannot secure a person's agreement
  • In connection with a death we consider may be the result of criminal conduct
  • In connection with criminal conduct at or during services provided by Mesotheliomadr.com
  • In emergency situations to report a crime

Coroners, Medical examiners, Funeral Directors: Your PHI may be disclosed consistent with relevant law to permit the mentioned individuals to carry out their work.

National Security and Intelligence Activities:Your personal health information may be released to federal officials for intelligence and additional national security activities authorized by law.

Your personal health information may be utilized or disclosed for other reasons not mentioned above based on your signing a particular authorization form.

You can revoke the permission at any time by submitting the revocation in writing to Mesotheliomadr.com. Any utilization or disclosures made prior to the revocation can not be taken back.

Health Information Rights

The right to ask for a restriction of utilization and disclosure: You have the right to ask us to restrict the utilization and disclosure of your PHI. You must inform us about

  • What information you want to restrict
  • If you want to restrict the utilization, disclosure, or both
  • To whom you want the limitations to apply

You can contact us directly. By law, we are not demanded to grant your request. We will inform you in writing whether we grant or deny your request. The granted restriction does not apply if you need emergency treatment and the information is needed for that treatment. We may choose, at a later date, to decline maintaining the restriction and will notify you of our decision.

The right to ask for confidential exchange of information:You have the right to ask that we exchange information with you about your PHI in a particular way or at a particular location to safeguard the privacy of the information. To ask for private communications, you must make your demand in writing. We cannot demand the reason for such a demand. We will adapt to all reasonable request. Your demand must specify how and where you wish to be contacted.

The right to inspect and copy:You have the right to demand to inspect and attain a copy of your PHI. This right knows a few exceptions. For example, psychotherapy notes. You must submit to us your request in writing. Your request has to be approved or denied within in 30 days and provide an explanation in case of denial. We may charge an acceptable fee for copying, postage, or other costs. If the records are maintained off-site, we have 60 days to answer your request.

The right to amend:You have the right to demand that we correct your PHI, if you feel that your information is incorrect or incomplete. To ask for the amendment, you have to submit us the request in writing providing reasoning to back your request. We will answer your request in writing within 60 days of receipt of the demand. If the request is not in writing or motivated, it may be denied. We may deny your demand if the information you request we amend

  • Was not crated by us, unless the ones that crated it can no longer amend it.
  • Is not kept by us.
  • Is not part of the data you can inspect or copy.
  • Is correct and complete.

The right to get an accounting of disclosures:you may ask that we obtain for you an accounting of your PHI disclosures. This does not include standard disclosures, for example, disclosures to you. You must state a period for the accounting not greater than 6 years and in what form you want to receive the accounting. The first accounting is free. For following accountings in a 12 month period we may charge a moderate fee.

The right to get a paper copy of this Notice:you have the right to obtain a paper copy of this Notice of Privacy. The copy may be obtained at our website Mesotheliomadr.com or you may contact us to obtain a paper copy.

The right to make a complaint:If you believe we are not in compliance with our Notice of Privacy and HIPAA or if you believe your privacy rights have been violated you have the right to make a complaint. Your complaint can be signed or anonymous and can sent to us in writing. You have the right to raise an objection at the Secretary of the Department of Health and Human Services.

Disclosure Presentation

  • We aim to utilize and disclose PHI to contact you or leave messages regarding your test results, treatment information, or appointments.
  • The law demands that we have privacy protections for PHI and to offer you Notice of our legal responsibilities.
  • We must follow the terms and conditions in this notice of Privacy.
  • We maintain the right to make changes to this Notice of Privacy, retrocative or non-retroactive.
  • Anyone who would like a copy of our revised Notice of Privacy can submit us the request in writing.

Contact us for more information at (435) 200-5326 or at contact@mesotheliomadr.com

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