CAROLINA UROLOGY CENTER, PA
Notice of Patient Information Practices Privacy Policy
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.
The privacy of your personal information is important. We want you to understand our privacy practices and procedures.
Legal Duty
Carolina Urology Center, P.A. is required by law to protect the privacy of your personal health information, provide this notice about information practices and follow the information practices that are described herein.
Information We Collect
We collect information about you and your family as part of our registration process, during the course of your care and from other health care entities you utilize such as hospitals, laboratories, other physicians, imaging facilities and your insurance company. This personal information includes items such as your name, address, phone number, birth date, social security number, employer, health history and insurance policy and coverage information. During the course of treatment, we will collect health information regarding diagnosis, treatment plans, progress and any test results.
Uses and Disclosures of Health Information
Carolina Urology Center uses your personal health information primarily for treatment; obtaining payment for treatment; conducting internal administrative activities and evaluating the quality of care that we provide. For example, we will share our findings with your primary care or referring physician, send your diagnosis and treatment information to your insurance plan or review your record internally to review the care provided. Carolina Urology Center may also use your personal health information to contact you to provide appointment reminders and if you are not available we will leave a message on your voice mail or with another individual who answers the phone. We may also contact you with information about treatment alternatives or other health benefits that could be of interest to you.
Carolina Urology Center may also use or disclose your personal health information without prior authorization for public health purposes, for auditing purposes and for emergencies. We also provide information when required by law.
In any other situation, Carolina Urology Center policy is to obtain your written authorization before disclosing your personal health information. If you provide us with a written authorization to release your information for any reason, you may later revoke that authorization to stop future disclosures at any time.
Patient's Individual Rights
You have the right to review or obtain a copy of your personal health information at any time. You have the right to request that we correct any inaccurate or incomplete information in your records. You also have the right to request a list of instances where we have disclosed your personal health information for reasons other than treatment, payment, other related administrative purposes or as a result of an authorization signed by you. It also excludes disclosures we have made to you or to others who were involved in your care.
You may also request in writing that we not use or disclose your personal health information for treatment, payment and administrative purposes except when specifically authorized by you, when required by law or in emergency circumstances. Carolina Urology Center will consider all such requests on a case-by-case basis, but the practice is not legally required to accept them. You may also request to receive confidential communications by alternate means or at an alternate location. We will accommodate reasonable requests. You have the right to receive a copy of this privacy policy. Carolina Urology Center occasionally reviews its privacy policy and reserves the right to amend it. The amended Notice will apply to all information maintained at the time. When amended, the revised policy will be available in our office.
Concerns and Complaints
If you are concerned that Carolina Urology Center may have violated your privacy rights or if you disagree with any decisions we have made regarding access or disclosure of your personal health information, please contact our Privacy Officer at the address listed below. You may also send a written complaint to the US Department of Health and Human Services. We will not retaliate against you in any way for filing a complaint. This notice was published and became effective on April 1, 2003. It was revised on January 1, 2004.
Tracy Black, Office Manager
Privacy Officer
Carolina Urology Center, P.A.
1780 Medical Park Drive
Rock Hill, SC 29732? Phone: 803.327.1116 Fax: 803.327.6872
