Vero Radiology Associates, Inc.
and Radiology Physicians Of Indian River County, LC
This notice describes how medical information
about you may be used and disclosed and how you can
get access to this information. Please read it carefully.
Our goal is to take appropriate steps to attempt to safeguard
any medical or other personal information that is provided
to us. We are required to: (i) maintain the privacy of
medical information provided to us; (ii) provide notice
of our legal duties and privacy practices; and (iii) abide
by the terms of our Notice of Privacy Practices currently
WHO WILL FOLLOW THIS NOTICE
This notice describes the practices of our employees and staff.
INFORMATION COLLECTED ABOUT YOU
In the ordinary course of receiving treatment and health
care services from us, you will be providing us with personal
information such as:
- Your name, address, and phone number.
- Information relating to your medical history.
- Your insurance information and coverage.
- Information concerning your doctor, nurse or other medical
In addition, we will gather certain medical information
about you and will create a record of the care provided to
you. Some information also may be provided to us by other
individuals or organizations that are part of your “circle
of care”- such as the referring physician, your other
doctors, your health plan, and close friends or family members.
HOW WE MAY USE AND DISCLOSE INFORMATION ABOUT YOU
We may use and disclose personal and identifiable health
information about you in different ways. All of the ways
in which we may use and disclose information will fall
within one of the following categories, but not every use
or disclosure in a category will be listed.
For Treatment: We will use health information
about you to furnish services and supplies to you, in accordance
with our policies and procedures. For example, we will
use your medical history, such as any presence or absence
of heart disease , to assess your health and perform requested
ultrasound or other diagnostic services.
For Payment: We will use and disclose
health information about you to bill for our services and
to collect payment from you or your insurance company.
For example, we may need to give a payer information about
your current medical condition so that it will pay us for
the ultrasound examinations or other services that we have
furnished you. We may also need to inform your payer of
the tests that you are going to receive in order to obtain
prior approval or to determine whether the service is covered.
For Health Care Operations: We may use
and disclose information about you for the general operation
of our business. For example, we sometimes arrange for
accreditation organizations, auditors or other consultants
to review our practice, evaluate our operations, and tell
us how to improve our services.
Public Policy Uses and Disclosures: There
are a number of public policy reasons why we may disclose
information about you.
We may disclose health information about you when we are
required to do so by federal, state, or local law.
We may disclose protected health information about you
in connection with certain public health reporting activities.
For instance, we may disclose such information to a public
health authority authorized to collect or receive PHI for
the purpose of preventing or controlling disease, injury
or disability, or at the direction of a public health authority,
to an official of a foreign government agency that is acting
in collaboration with a public health authority. Public
health authorities include state health departments, the
Center for Disease Control, the Food and Drug Administration,
the Occupational Safety and Health Administration and the
Environmental Protection Agency, to name a few.
We are also permitted to disclose protected health information
to a public health authority or other government authority
authorized by law to receive reports of child abuse or
neglect. Additionally we may disclose protected health
information to a person subject to the Food and Drug Administration’s
power for the following activities: to report adverse events,
product defects or problems, or biological product deviations,
to track products, to enable product recalls, repairs or
replacements, or to conduct post marketing surveillance.
We may disclose your protected health information in situations
of domestic abuse or elder abuse.
We may disclose protected health information in connection
with certain health oversight activities of licensing and
other agencies. Health oversight activities include audit,
investigation, inspection, licensure or disciplinary actions,
and civil, criminal, or administrative proceedings or actions
or any other activity necessary for the oversight of 1)
the health care system, 2) governmental benefit programs
for which health information is relevant to determining
beneficiary eligibility, 3) entities subject to governmental
regulatory programs for which health information is necessary
for determining compliance with program standards, or 4)
entities subject to civil rights laws for which health
information is necessary for determining compliance.
We may disclose information in response to a warrant,
subpoena, or other order of a court, or administrative
hearing body, and in connection with certain government
investigations and law enforcement activities.
We may release personal health information to a coroner
or medical examiner to identify a deceased person or determine
the cause of death. We also may release personal health
information to organ procurement organizations, transplant
centers, and eye or tissue banks.
We may release your personal health information to workers’
compensation or similar programs.
Information about you also will be disclosed when necessary
to prevent a serious threat to your health and safety or
the health and safety of others.
We may use or disclose certain personal health information
about your condition and treatment for research purposes
where an Institutional Review Board or a similar body referred
to as a Privacy Board determines that your privacy interests
will be adequately protected in the study. We may also
use and disclose your protected health information to prepare
or analyze a research protocol and for other research purposes.
If you are a member of the Armed Forces, we may release
personal health information about you as required by military
command authorities. We also may release personal health
information about foreign military personnel to the appropriate
foreign military authority.
We may disclose your protected health information for
legal or administrative proceedings that involve you. We
may release such information upon order of a court, or
subpoena, or administrative tribunal. We may also release
protected health information in the absence of such an
order and in response to a discovery or other lawful request.
If you are an inmate, we may release protected health
information about you to a correctional institution where
you are incarcerated or to law enforcement officials.
Finally, we may disclose protected health information
for national security and intelligence activities and for
the provision of protective services to the President of
the United States and other officials or foreign heads
Our Business Associates: We sometimes
work with outside individuals and businesses that help
us operate our business successfully. We may disclose your
health information to these business associates so that
they can perform the tasks that we hire them to do. Our
business associates must guarantee to us that they will
respect the confidentiality of your personal and identifiable
Individuals Involved in Your Care or Payment for
Your Care: We may disclose information to individuals
involved in your care or in the payment for your care.
This includes people and organizations that are part
of your "circle of care" -- such as your spouse,
your other doctors, or an aide who may be providing services
to you. Although we must be able to speak with your other
physicians or health care providers, you can let us know
in writing if we should not speak with other individuals,
such as your spouse or family.
Appointment Reminders: We may use and
disclose medical information to contact you as a reminder
that you have an appointment or that you should schedule
Treatment Alternatives: We may use and
disclose your personal health information in order to tell
you about or recommend possible treatment options, alternatives
or health-related services that may be of interest to you.
Other Uses and Disclosures of Personal Information:
We are required to obtain written authorization from you
for any other uses and disclosures of medical information
other than those described above. If you provide us with
such permission, you may revoke that permission, in writing,
at any time. If you revoke your permission, we will no
longer use or disclose personal information about you for
the reasons covered by your written authorization. We will
be unable to take back any disclosures already made based
upon your original permission.
You have the right to ask in writing for restrictions on
the ways in which we use and disclose your medical information
beyond those imposed by law. We will consider your request,
but we are not required, to accept it.
You have the right to request that you receive communications
containing your protected health information from us by alternative
means or at alternative locations. For example, you may ask
us in writing that we only contact you at home or by mail.
You have the right to request a restriction on certain disclosures
to their health plan if the disclosure is purely for carrying out
payment or health care operations if the patient pays for services
included in the requested restriction out of pocket in full at the
time services are rendered.
Except under certain circumstances, you have the right to
inspect and have copies of medical and billing records about
you. You must make this request in writing. If you ask for
copies of this information, we may charge you a fee for copying
If you believe that information in your records is incorrect
or incomplete, you have the right to ask us in writing to
correct the existing information or correct the missing information.
Under certain circumstances, we may deny your request.
You have a right to ask in writing for a list of instances
when we have used or disclosed your medical information for
reasons other than your treatment, payment for services furnished
to you, our health care operations, or disclosures you give
us authorization to make. If you ask for this information
from us more than once every twelve months, we may charge
you a fee.
You have the right to a copy of this Notice in paper form.
You may ask us for a copy at any time. Copies are available
from the reception staff.
You may also obtain a copy of this form at our web site:
The Practice is required to notify affected individuals of breaches
of their unsecure protected health information.
To exercise any of your rights, please contact us in writing:
Attn: Privacy Officer; 3725 11th Circle, Vero Beach, Florida 32960
CHANGES TO THIS NOTICE
We reserve the right to make changes to this notice at any
time. We reserve the right to make the revised notice effective
for personal health information we have about you as well
as any information we receive in the future. In the event
there is a material change to this Notice, the revised Notice
will be posted. In addition, you may request a copy of the
revised Notice at any time.
you may contact the Secretary of the Department of Health
and Human Services, at 200 Independence Avenue, S.W., Room
509F, HHH Building, Washington, D.C. 20201 (e-mail: firstname.lastname@example.org).
You also may contact us at:
Attn: Privacy Officer; 3725 11th Circle, Vero Beach, Florida
To obtain more information concerning this Notice of Privacy
Practices, you may contact our Privacy Officer at the above
September 23, 2013 due to recent changes in federal law.