Effective Date: October 18, 2019
Notice of Privacy Practices of Greater Cincinnati Pathologists, Inc.
(“GCP” or “we” or “our” or “us” (and similar terms)
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.
CONTACT PERSON: If you have any questions about this notice, please contact our Privacy Officer at (513) 585-1120 or via U.S. Mail at Greater Cincinnati Pathologists, Inc., 2139 Auburn Avenue, Cincinnati, Ohio, 45219, Attention: Privacy Officer.
WHO WILL FOLLOW THIS NOTICE
OUR PLEDGE REGARDING MEDICAL INFORMATION:
This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at GCP. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all the records of your care generated or maintained by us, whether made by our personnel or other health care providers.
We are required by law to: (1) make sure that medical information that identifies you is kept private; (2) give you this notice of our legal duties and privacy practices with respect to medical information about you; (3) notify you in the event of a breach of your unsecured medical information; and (4) follow the terms of the notice that are currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and will provide some examples. Not every use or disclosure in a category will be listed. However, all the ways we are permitted to use and disclose information will fall within one of the categories.
WAYS WE MAY USE OR DISCLOSE YOUR MEDICAL INFORMATION WITHOUT YOUR AUTHORIZATION:
WE MAY USE OR DISCLOSE YOUR MEDICAL INFORMATION IN THE FOLLOWING WAYS ONLY WITH YOUR WRITTEN AUTHORIZATION:
IF WE CONDUCT FUNDRAISING ACTIVITIES, YOU CAN "OPT OUT" OF RECEIVING MATERIALS:
If we conduct fundraising activities, we may use or disclose your medical information in order to contact you; however, you have the right to "opt out" of receiving fundraising materials. If you do not want to receive these types of materials, please submit a written request to our Privacy Officer.
OTHER USES OF MEDICAL INFORMATION:
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You acknowledge and understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you.
THESE ARE YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION MAINTAINED BY US:
To request an amendment, your request must be made in writing and submitted to the contact person listed on page one of this notice. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: (i) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (ii) is not part of the medical information kept by or for us; (iii) is not part of the information which you would be permitted to inspect and copy; or (iv) is accurate and complete.
To request this list or accounting of disclosures: You must submit your request in writing to the contact person listed on page one of this notice. Your request must state a time period that may not be longer than six years prior to your request. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
To request restrictions: You must make your request in writing to the person listed on page one of this notice. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
To request confidential communications: You must make your request in writing to the person listed on page one of this notice. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
CHANGES TO THIS NOTICE:
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for the medical information we already have about you, as well as any information we receive in the future. We will prominently post a copy of the current notice at our office(s). The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you sign-in for care at our office(s), we will offer you a copy of the current notice then in effect.
COMPLAINTS (You will not be penalized for filing a complaint.)
If you believe your privacy rights have been violated, you may file a complaint. To file a complaint with our practice, please contact the person listed on page one of this notice. Or, you can file a complaint with the Secretary of the Department of Health and Human Services at the Office of Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C., 20201. All complaints must be submitted in writing.