NORTH-WEST CARDIO-VASCULAR CENTER
Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.

Our legal duty

We are required by law to maintain the privacy of your health information. We are also required to give you this notice. This notice takes effect on April 1, 2003, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by law. Before we make a significant change, we will change this notice and make the new notice available upon request.

Uses and disclosures of health information

We may use and disclose health information about you for treatment, payment, and healthcare operations. For example:

Treatment: We may use or disclose your health information to a healthcare provider providing treatment to you.

Payment: We may use or disclose your health information to obtain payment for services.

Healthcare operations: We may use or disclose your health information in connection with our healthcare operations. Examples may include quality assessment, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, and licensing activities.

Your Authorization: In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time.

To your family and friends: We must disclose your health information to you. We may disclose your information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only with your permission.

Persons involved in care: We may use or disclose your health information to notify, or assist in the notification of a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present and able, you may object to this release of information. If you are absent or unable, we will use our professional judgment and common practice to make reasonable inferences for your best interest in allowing release of your health information.

Marketing Health-related services: We will not use your health information for marketing communications without your written authorization.

Required by law: We may use or disclose your health information when required by law.

Abuse or neglect: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence or other crimes.

National security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institutions or law enforcement officials who have lawful custody of protected health information of inmates or patients under certain circumstances.

Appointment reminders: We may use or disclose your health information to provide you with appointment reminders, such as voice-mail messages, postcards, or letters.

Patient Rights

Access: You have the right to review or receive copies of your health information with limited exceptions. You must make a request in writing to obtain access to your health information. You may obtain a form to request access by contacting the person listed at the end of this notice. If you request copies, we will charge you a reasonable cost-based fee for expenses such as copies, staff time and postage. If you request a format other than copies, cost-based fee for the alternative format will be charged.

Disclosure accounting: You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes other than treatment , payment, healthcare operations and certain other activities for the last 6 years, but not before April 14, 2003. If you request this information more than once during any 6 month period you will be charged a cost-based fee.

Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions but if we do , we will abide by our agreement (except in an emergency).

Alternative communication: You have the right to request communication about your health information by alternative means or to alternative locations. You must make this request in writing. Your request must specify the alternative means or location, and provide satisfactory explanation in regards to payments handled under the alternative means or location you request.

Amendment: You have the right to request that we amend your health information. Your request must be in writing and explain why the information should be amended. We may deny your request under certain circumstances.

Electronic notices: If you receive this notice by electronic means, you are entitled to receive this notice in written form.

Questions and Complaints

If you would like more information about our privacy practices or have questions or concerns, please contact us, or go to the web site http://www.hhs.gov/ocr/hippa, or by calling (866)627-7748.

If you have any concerns regarding any of the information stated previously, you may contact us by the information listed at the end of this notice. You also may submit a written complaint to the US Department of Health and Human Services. We will provide you with the address to file your complaint with the US Department of Health and Human Services upon request. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the US Department of Health and Human Services.