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.
1. Your Rights With Respect to Your Confidential Information:
- To review, copy (including paper copy) and receive information;
- To request the right to amend your information if incorrect (although we are not required to do so);
- To receive an accounting of non-routine or non-authorized disclosures of your information for six years;
- To request a restriction on certain uses and disclosures of your information (although we are not required to do so);
- To file a complaint if you believe your rights have been violated; and
- To receive confidential communications.
To request information about your rights to health information, complete and submit a written request to the Medical Care Services Manager at 3510 Biscayne Boulevard, Miami, FL 33137, or the Medical Care Services Manager at 871 West Oakland Park Boulevard, Fort Lauderdale, FL 33311.
2. The Following are Various Uses and Disclosures of Your Confidential Patient Information that May be Used by Our Providers (No Specific Medical Consent is Required):
- For your Medical care:
- For example, your healthcare team may share your medical information including their observations, in order to determine how you are responding to treatment, and to communicate with a specialist.
- For example, we may use your healthcare information to contact you regarding an appointment.
- To bill for your medical services:
- For example, a bill may be sent to your insurance company, which contains your diagnosis, procedure performed and supplies used.
- For our operational services:
- For example, your information may be used in connection with quality we provide.
- For example, our business associates may need to access your confidential information so they can perform the job we ask them to do. Business associates include accreditation agencies, laboratories, state hospital associations, our attorneys, and accountants.
3. Uses and Disclosures of Your Confidential Information We Make Unless You Object:
- To family and friends involved in your care;
- With respect to treatment alternatives or other health-related benefits which may be of interest to you;
- Fundraising activities; and
- Appointment reminders.
If you have objections to the uses and disclosures mentioned above, you must complete a written request to the Medical Care Services Manager at 3510 Biscayne Boulevards, Miami, FL 33137, or the Medical Care Services Manager at 871 West Oakland Park Boulevard, Fort Lauderdale, FL 33311.
4. Uses and Disclosures of Your Confidential Information We Must Make (Without Your Consent):
- When required by state or federal law;
- To state and federal public health authorities for disease prevention;
- To protective service agencies authorized to receive reports of abuse, neglect and domestic violence;
- To governmental oversight agencies;
- When required pursuant to a court order;
- Pursuant to established research protocols (IRB or Privacy Board approval);
- When required to avert a serious threat to health or safety;
- In connection with worker’s compensation programs;
- Lawsuits and similar proceedings; and
- National Security & Intelligence Agencies.
Any other uses other than what is described above are prohibited unless you give specific authorization. You have the right to revoke such authorization at any time in writing except to the extent we have already relied on it.
5. Our Duties:
- We are required to maintain the confidentiality of your medical information and to provide you with notice of our legal duties and privacy practices.
- We are required to abide by the terms of this notice
- We reserve the right to change the terms of this notice and post a new version without notice.
6. Right to Complain:
- All complaints must be submitted in writing. If you believe your rights identified in this notice have been violated, you may complain to the Director of Medical Care & Pharmacy Services or Medical Care Services Manager, if you are here to receive medical care. If you are here to receive Behavioral Health Services, you may make a complaint to the Director request a complaint form to file a complaint.
- If you are unhappy with how your complaint was handled, you may contact the Secretary of Health and Human Services.
- The law prohibits any retaliation for filing a complaint.
7. For Further Information:
You may contact the Privacy Officer at 3510 Biscayne Boulevard, Miami, FL 33137 or call 305-576-1234, for any further information with respect to this policy. In addition, you may refer to the Grievance Procedure posted online or in the Patient Handbook.
