Privacy Notice

Your Information. Your Rights. Our Responsibilities.

Effective 9/2013, Revised 6/2014 this notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

You have the right to:

  • Obtain a copy of your paper or electronic medical record
  • Request to  have your paper or electronic medical record corrected
  • Request confidential communication (restrict  how you to contact you)
  • Request a password on your account  (To limit or restrict the information we share to those involved in your care that may call on your behalf)
  • Request a limit or restriction on the information we share to a specific individual , organization, during disaster relief, or other specific request related to disclosures  for purposes treatment, healthcare operations, or payment.
  • Request to pay out of pocket for services and not send have your  claim sent  to your insurance
  • Request an accounting of disclosure of your information (includes only those disclosures not for treatment, healthcare operation, or  payment or those with your signed release)
  • Obtain a copy of the full privacy notice
  • Choose someone to act for you (legal guardian, medical POA)
  • File a complaint if you believe your privacy rights have been violated

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to share certain health information for treatment, payment, or our operations. You can ask us not to use or share certain health information to a specific organization or individual
  • You can ask us not to use or share certain health information during a disaster relief effort
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
  • We are not required to agree to your request, and we may say “no” if it would affect your care, we can not full fill the request, or a law requires us to share that information.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us using the information on page 1.  You can file a complaint with Central Missouri Cardiology directly by asking to speak to the office privacy official, Arla Qualls or Kara Flanagan at 573-636-0635
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
    We will not retaliate against you for filing a complaint.

We may use and share your information as we:

  • Treat you  (example: share information for the purposes of treatment with physicians, hospitals, pharmacies  and family/friends that in the best judgment of the clinical staff are involved in your care)
  • Run our organization (example:  quality assurance activities to improve your care)
  • Bill for your services (example:  file your claims to your insurance)
  • Respond to public health or government oversight agencies as required by law
  • Disclosure is allowed for research but we do not participate in research
  • Comply with the law  per a subpoena request to release information
  • Respond to organ and tissue donation requests for information
  • Respond to a medical examiner or funeral director requests for information
  • Respond to workers’ compensation or  law  enforcement requests for information
  • Respond to disaster relief requests for information
  • We will never sell or share your information for any purpose such as marketing
  • If we have psychotherapy notes on file, we will not share them for any purpose
  • We will not  contact you for any fundraising efforts, but  fundraising activities may occur in our office when you  be present.

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

  • We can use your health information and share it with other professionals who are treating you.
  • Example: A doctor treating you for an injury asks another doctor about your overall health condition or requests medical records.
  • We can share with your family/friends  who contact us on your behalf , if in the best judgment of the clinical staff,  we believe they are involved  in your care.  The minimum necessary rule would apply to only provide the information necessary.
  • Example: A family member helping you with your medication calls for clarification how often a medication is to be taken.  A family member helping you with your appointments calls to reschedule an appointment.

Run our organization

  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  • Example: We use health information about you to manage your treatment and services for quality assurance activities.

Bill for your services

  • We can use and share your health information to bill and get payment from health plans or other entities.
  • Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
  • Disaster relief efforts

Do research

We can use or share your information for health research. We do not participate in research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.  We can change the terms of this notice, and the changes will apply to all information we have about you.  The new notice will be available upon request.

  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.