NOTICE OF PRIVACY PRACTICES
Histopathology Reference Laboratory is committed to protecting your medical information. We are required by law to:
We may use and disclose your medical information for treatment, payment and our healthcare operations. We may share your information with individuals/agencies that will be involved in your care during and post hospitalization. Unless you object, we may include your name, room location, religious affiliation, and general condition in the hospital directory so we can route visitors and phone calls to you. We may disclose your information as required by law, such as for public health activities to prevent or control disease, to report abuse situations, to notify people of recall of products, or in response to a court order. You have a right to inspect and receive copies of your medical information (i.e. medical and billing records). You may request to amend your records if you feel the information is incorrect or incomplete. To request an amendment, you must submit a written request and must provide a reason to support the request. You have a right to an accounting of certain disclosures of your information that we have made and a right to request restrictions of our use or disclosure of your medical information. For more information on these rights, see the full Notice of Privacy Practices. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. Complete contact information is provided in our full Notice of Privacy Practices.
- Make sure that medical information that identifies you is kept private, except as you authorize or as laws require or permit.
- Give you a Notice of Privacy Practice that describes our legal duties and privacy practices with respect to your medical information.
- Follow the terms of the Notice of Privacy Practice that is currently in effect.
If you have any questions about this Notice of Privacy Practices, please contact the Privacy Coordinator at 510.662.5245
WHO WILL FOLLOW THIS NOTICE OF PRIVACY PRACTICES
This Notice describes the Histopathology Reference Laboratory Privacy Practices and
OUR PLEDGE REGARDING MEDICAL INFORMATION
We are committed to protecting medical information about you. In order to provide you with quality care and to comply with certain legal requirements, we create a record of the care and services you receive. This Notice of Privacy Practices applies to all of the records of your care that are used to make medical decisions about you. This Notice of Privacy Practices tells you or your legal representative about the ways in which we may use and disclose your medical information. We also describe your rights and certain obligations
regarding the use and disclosure of medical information.
We are required by law to:
- Any health care professional authorized to access and/or enter information into the medical records that we maintain.
- All departments and units of Histopathology Reference Laboratory
- All employees, staff and other personnel of Histopathology Reference Laboratory.
HOW WE MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION
The following categories describe different ways that we may use and disclose your medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
- make sure that medical information that identifies you is kept private, except as you authorize or as laws require or permit;
- give you this Notice of Privacy Practices of our legal duties and privacy practices with respect to medical information about you; and
- follow the terms of the Notice of Privacy Practices that is currently in effect.
We may use your medical information to provide your physician with medical treatment or services. We may disclose your medical information to physicians, nurses, technicians, medical students, or other personnel who are involved in your care.
We may use and disclose your medical information so that the treatment and services you receive may be billed and payment may be collected from an insurance company, a third party, or from you.
For Health Care Operations
We may use and disclose your medical information for Health Care Operations. These uses and disclosures are necessary to operate the Health System and to ensure that all patients receive quality care.
Individuals Involved in Your Care or Payment for Your Care
We may release your medical information to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. Unless there is a specific written request from you to the contrary, we may also tell your family or friends your condition and your location. In addition, we may disclose your medical information to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
As Required By Law
We may disclose your medical information when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety
We may use and disclose your medical information when necessary to 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.
Military and Veterans
If you are a member of the armed forces, we may release your medical information as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
We may release your medical information for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks
We may disclose your medical information for public health activities. These activities generally include the following:
Health Oversight Activities
- To prevent or control disease, injury or disability;
- To report births and deaths;
- To report the abuse or neglect of children, elders and dependent adults;
- To report reactions to medications or problems with products;
- To notify people of recalls of products they may be using;
- 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;
- To notify the appropriate government authority or reporting agency if we believe a patient has been the victim of abuse, neglect or domestic violence; but only when required or authorized by law.
We may disclose your medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, governmental audits, investigations, inspections, and accrediting, and licensing. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil and patient rights laws.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose your medical information in response to a court or administrative order. We may also disclose your medical information in response to a subpoena, discovery request, or other lawful process. In accordance with California Law, efforts may be made to tell you about the request or
to obtain an order protecting the information requested.
We may release your medical information if asked to do so by law enforcement officials:
Coroners, Medical Examiners and Funeral Directors
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness, or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the victim's agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at the listed entities; and
- In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
We may release your medical information to a coroner, medical examiner or funeral director. This may be necessary to identify a deceased person or determine the cause of death, or to enable such persons to carry out their duties.
National Security and Intelligence Activities
We may release your medical information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President of the United States and Others
We may disclose your medical information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your medical information 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.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Receive a Copy
You have the right to inspect or obtain a copy of medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect or obtain a copy of your medical information, you must submit your request in writing to Histopathology Reference Laboratory. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and receive a copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed.
Right to Amend
If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must be made in writing to Histopathology Reference Laboratory directly. In addition, you must provide a reason to support the requested amendment. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
Even if we deny your request for amendment, you have the right to submit a written addendum with respect to any item or statement in your record you believe is incomplete or incorrect. If you clearly indicate in writing that you want the addendum to be made part of your medical record, we will attach it to your records and include it whenever we make a disclosure of the item or statement you believe to be incomplete or incorrect.
- Was not created by us;
- Is not part of the medical information kept by us;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request a list of persons or agencies to whom we may have given your medical information when authorized. This list will not include our own uses for Diagnosis, Payment and Health Care Operations, or for other reasons specified by laws.
To request this list of disclosures, you must submit your request in writing to Histopathology Reference Laboratory. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions
You have the right to request a restriction or limitation on how we use or disclose your medical information for your Diagnosis, Payment or our Health Care Operations. You also have the right to request a limit on the medical information we disclose about you to someone else, like a family member or friend, who may be involved in your care or the payment for your care. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. If we do not agree, we will tell you the reason we cannot comply with your request. To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you request to limit; (2) whether you request to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at an alternative address. For example, you might ask that we only contact you at work or by mail. To request confidential or alternative communications, you must make your request in writing at the time of your appointment where your services are or Secretary were provided. We will not ask you the reason for your request. We will try to accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice of Privacy Practices
You have the right to a paper copy of this Notice of Privacy Practices. You may also access this Notice of Privacy Practices at our website, www.HistoPath.com
CHANGES TO THIS NOTICE OF PRIVACY PRACTICES
We reserve the right to change this Notice of Privacy Practices. We reserve the right to make the revised or changed Notice of Privacy Practices effective for your medical information we already have about you as well as any information we receive in the future.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing to:
OTHER USES OF MEDICAL INFORMATION
- Histopathology Reference Laboratory, Privacy Coordinator
- Secretary of Department of Health and Human Services:
Director, Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW - Room 506-F
Washington, D.C. 20201
- Director, Office for Civil Rights
U.S. Department of Health and Human Services
50 United Nations Plaza - Room 322
San Francisco, CA 94103
Other uses and disclosures of medical information not covered by this Notice of Privacy Practices or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose your medical information, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except if we have already acted in reliance on your permissions. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.