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PRIVACY
NOTICE
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.
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OUR PLEDGE REGARDING
MEDICAL INFORMATION |
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We understand
that medical information about you and your
health is personal. We are committed to protecting
medical information about you. This Notice
applies to all records of your care generated
and maintained by MGM Medical Associates,
Ltd. S.C. Your hospital or other providers
may have different policies or notices about
the use and disclosure of information in their
possession.
We are required by law to: 1) make sure that
medical information that identifies you is
kept private; 2) make available to you this
Notice of our legal and privacy practices
with respect to medical information about
you; and 3) follow the terms of the Notice
that is currently in effect. |
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HOW WE MAY USE
AND DISCLOSE MEDICAL INFORMATION ABOUT YOU |
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We may disclose
medical information about you to doctors,
nurses, medical students, or other medical
personnel involved in taking care of you.
We may also disclose medical information to
people outside the medical group, such as
family members, specialists or others who
are involved in providing services that are
part of your care.
We may use or disclose medical information
about you so that the treatment and services
you receive at MGM Medical Associates may
be billed to and payment may be collected
from you, an insurance company or a third
party.
We may use or disclose medical information
about you for MGM Medical Associates’
operations. These may include use of information
to evaluate the performance of our staff,
effectiveness of programs, and ways to improve
care and services we offer. These uses and
disclosures are necessary to ensure that all
of our patients receive quality care.
We may use and disclose medical information
to contact you as a reminder that you have
an appointment for treatment or care at MGM
Medical Associates.
We may use or disclose medical information
to tell you about or recommend possible treatment
options or alternatives, and about health-related
benefits and services that may be of interest
to you.
We may disclose medical information about
you to other healthcare providers in the event
you need emergency care.
We will disclose medical information about
you as required by federal, state or local
law.
We may use or disclose medical information
to a public health organization or federal
organization when necessary to prevent a serious
threat to your health and safety or the health
and safety of the public or another person.
We may use or disclose medical information
about you in special situations such as for
workers' compensation programs, as required
by military command authorities or the Department
of Veterans Affairs, in response to a court
or administrative order, or for public health
activities.
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. You may later revoke this permission
in writing, at any time.
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YOUR RIGHTS REGARDING
MEDICAL INFORMATION ABOUT YOU |
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You have
the right to review and receive a copy of
medical information that may be used to make
decisions about your care. Usually this includes
medical and billing records, but does not
include psychotherapy notes. You must submit
a written request to review and copy your
medical information. We may charge a fee for
the costs of supplying a copy of the records.
You have the right to ask us to amend medical
information that you feel is incorrect or
incomplete. Your request for an amendment
must be submitted in writing and must provide
a reason that supports your request.
We may deny your request for 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 the information:
1) was not created by us; 2) is not part of
the medical information kept by or for MGM
Medical Associates; 3) is not part of the
information which you are permitted to inspect
and copy; or 4) is accurate and complete.
You have the right to request an "accounting
of disclosures." This is a list of disclosures
we have made of medical information about
you, with some exceptions. The exceptions
are governed by federal health privacy law,
and include: 1) routine disclosures for treatment,
payment and operations conducted pursuant
to your signed consent form; and 2) disclosures
to you. You must submit a written request.
The request must state a time period that
may not be longer than six years and may not
include dates before April 14, 2003, when
current federal health privacy laws become
effective for MGM Medical Associates.
You have the right to request restrictions
or limitations on the use or disclosure of
medical information about you. You must submit
a written request for restriction that specifies:
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. MGM Medical Associates reserves
the right to refuse your restriction if it
is in conflict of providing you quality healthcare
or in an emergency situation.
You have the right to request that we communicate
with you about medical matters in a certain
way or at a certain location, such as only
at work or by mail. You must submit a written
request for confidential communications restrictions,
specifying how or where you wish to be contacted.
We will accommodate reasonable requests.
You have the right to possess a copy of this
Privacy Notice upon request. You may receive
a paper copy of this notice, or you can also
obtain a copy of this Notice at our website,
www.mgmmedical.com.
You have the right to file a complaint with
MGM Medical Associates if you believe your
rights to privacy have been violated. All
complaints must be submitted in writing to
the Quality Management Department at the address
noted at the end of this Notice. All complaints
will be investigated. No personal issue will
be raised for filing a complaint.
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LINKS |
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This web
site contains links to other sites. Please
be aware that MGM Medical Associates, Ltd.
is not responsible for the privacy practices
of such other sites. We encourage our users
to be aware when they leave our site and to
read the privacy statements of each and every
web site that collects personally identifiable
information. This privacy statement applies
solely to information collected by this Web
site.
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CHANGES TO THIS
NOTICE |
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MGM Medical
Associates reserves the right to change this
Notice at any time. We will post a copy of
the current notice in our clinical sites and
on our website.
If you have any questions about this Privacy
Notice, please contact.
Attn:
Chief Privacy Officer MGM Medical
Associates, Ltd.
2425 W. 22nd Street, Suite: 210
Oak Brook, IL 60523
Tel:
(630) 368-3909
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Oak
Brook Medical and Surgical Centre
2425 w. 22nd St. Suite 210
Oak Brook, IL 60523
Tel: 630.368.3909 Fax: 630.368.3958
Email: |
| Copyright
© 2006 MGM Medical Associates Ltd.
All rights reserved. |
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