Privacy Practices
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.
Click here for a printable PDF version of our privacy practices
At Midwest Center for Advanced Imaging (MCAI) we respect your health information with the utmost care. MCAI management and staff pledge to uphold our privacy health information practice policy.
We are required by law and committed as a professional healthcare institution to maintain the privacy of protected health information (PHI) and to post & distribute our facility’s privacy practices.
The following is a summary of the circumstances under which your health information may be used & disclosed to others who provide care for you.
To Provide Treatment
MCAI may use your PHI to provide care to you and disclose your health information to others who provide care to you. For example, MCAI may mail, courier, or electronically transmit your radiology images and/or report to your specialist. MCAI may also electronically submit your images to another radiologist for a second opinion or to the home offices of our own staff radiologists.
To Obtain Payment
MCAI may submit your PHI to collect payment from third party payors for the care you receive from MCAI. For example, MCAI may be required by your health insurer to provide information including, but not limited to, medical reports so the insurer releases payment to our facility. We also reserve the right to send uncollected balances to a collection agency of our choice.
To Conduct Healthcare Operations
MCAI may use & disclose PHI for its own operations in order to facilitate the function of MCAI & as necessary to provide quality care to all MCAI patients.
For example, MCAI may use your PHI:
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To evaluate its staff performances
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For network system & database resource maintenance
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To contact you for an appointment reminder
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As part of community information mailings or for business management & administrative activities, such as cost management.
For Facility Directory
MCAI may disclose certain limited information about you while you are a patient here. This information may include your name, location within the facility, & your general condition. The information about you that is disclosed may be released to people who ask for you by name. This sharing of information is so people who care about you can assist with your transportation and/or find out about your condition.
For Appointment Reminders
MCAI may use & disclose your PHI to contact you as a reminder that you have an appointment for treatment or medical care with our facility. This may include voice mail messages or mailings.
For Treatment Alternatives
MCAI may use & disclose your PHI to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
The following is a summary of the circumstances under which your PHI may be used & disclosed without your written consent or authorization.
As Required by Law
MCAI will disclose your PHI when it is required to do so by any Federal, State or local law.
When There Are Risks to Public Health MCAI may disclose your PHI for the following public activities/purposes:
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To prevent/control disease, injury, or disability.
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To report vital statistics.
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To report child abuse or domestic violence.
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To notify persons of product recalls.
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To notify persons who are exposed to a communicable disease or at risk to spread it.
Health Oversight Activities
We may use & disclose PHI about you to health oversight agencies for certain activities authorized by law for the appropriate oversight of the healthcare system, governmental benefit programs and regulatory compliance.
For Research Purposes
MCAI may, under very select purposes, use your PHI for research. All research projects are first carefully reviewed, both with regard to the purpose & scope of the project itself and with regard to their use and disclosure of PHI. MCAI will make every attempt to balance the need for medical research with your need for privacy. If possible, all information that can be used to identify you will be removed from data used in research projects.
In the Event of a Serious Threat…
…to health or safety. MCAI may, consistent with applicable law & ethical standards of conduct, disclose your health information if MCAI, in good faith, believes that such disclosure is necessary to prevent or lessen a serious & imminent threat to your health or safety or the health & safety of the public.
For Workers’ Compensation
MCAI may release your PHI for workers’ compensation or similar programs.
Other than stated above, MCAI will not disclose your health information other than with your authorization. If you or your representative authorizes MCAI to use or disclose your health information, you may revoke that authorization in writing at any time.
Your rights with respect to your health information.
Right to Request Restrictions
You may request restrictions on certain uses & disclosures of your health information. You have the right to request a limit on MCAI’s disclosure of your health information to someone who is involved in your care. We are not required to agree to any request for a restriction of our uses & disclosures of PHI about you for such purposes. If you wish to make a request for restrictions,
please contact our Compliance Officer at:
MCAI
Attn: Compliance Officer
4355 Montgomery Road
Naperville, IL 60564
630-236-8300
info@mcairadiology.com
Right to Receive Confidential Information
You have the right to request that MCAI communicate with you in a certain way. For example, you may ask that MCAI only conduct communications pertaining to your health information with you privately, without family members present. If you wish to receive confidential communications, please contact our Compliance Officer.
Access to Your Health Information
You have the right to inspect and/or copy your health information, including billing records. MCAI will strongly encourage you to obtain & discuss the initial results of your exams from your referring physician first. MCAI may charge a reasonable fee for copying & assembling costs associated with your request. Any third parties requests for patient information must be submitted in writing and include signed patient authorization.
Right to Amend Your Health Information
You or your designated representative has the right to request that MCAI amend your records if you believe your health information is incomplete or inaccurate. That request may be made as long as the information is maintained by MCAI. The request must be in writing to the Compliance Officer.
We may deny your request for amendment if it is not made in writing or does not include a reason supporting it.
For example, if the health information:
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Was not created by MCAI or part of our records
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Is not part of the medical & billing information that we keep about you
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In the opinion of MCAI administration & medical director, the records containing your health information are accurate & complete already.
Right of Accounting Disclosures
You or your representative have the right to request an accounting of disclosures of your health information made by MCAI for any reason other than for treatment, payment or health operations. The request must be made in writing to our Compliance Officer. The request may not cover a period longer than six years & may not include dates prior to April 15, 2003. MCAI will provide the first accounting you request within a 12 month period free of charge to the patient & provide it in a timely fashion. Subsequent accounting requests may be subject to a reasonable cost-based fee.
Right to a Paper Copy of This Notice
You or your representative has the right to a separate paper copy of this Notice at any time even if you or your representative has received this Notice previously. To obtain a copy, please contact our Compliance Officer or visit our website at: www.mcairadiology.com.
Duties of Provider
MCAI is required by law to maintain the privacy of your health information & to provide to you & your representative the Notice of our duties & privacy practices. MCAI is required to abide by the terms of the Notice as may be amended from time to time. MCAI reserves the right to change the terms of this Notice & to make the new Notice provisions effective for all health information that we maintain. You have the right to express complaints to MCAI & to the Secretary of Health & Human Services if you believe that your privacy rights have been violated. Any complaints to MCAI should be made in writing to:
MCAI
Executive Director or Customer Service Manager
4355 Montgomery Road
Naperville, IL 60564
630-236-8300
info@mcairadiology.com
At MCAI, we consistently strive to improve our service & are eager to listen to feedback from our patients. Please be assured that you will not be penalized or retaliated against in any way for filing a complaint.
Contact Person
We would be happy to discuss our privacy practices further with you & ease any possible concerns that you might have. MCAI has designated a Compliance Officer as its contact person for all issues regarding patient privacy & your rights under the Federal privacy standards. You may contact this person at:
MCAI
HIPAA Compliance Department
4355 Montgomery Road
Naperville, IL 60564
630-236-8300
info@mcairadiology.com
Effective Date
This Notice is effective April 15, 2003.
This Notice subsequently reviewed and reprinted December 19, 2011.
Click here for a printable PDF version of our privacy practices