GEMINI IMAGING GROUP

NOTICE OF USE

PROTECTED HEALTH INFORMATION

THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED OR DISCLOSED AND ATTAINING ACCESS TO THIS INFORMATION, PLEASE REVIEW IT CAREFULLY.

IN accordance with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPPA), Gemini Imaging Group is required to inform you of our practices in relation to the protected health information that it retains about you.  HIPPA mandates minimum standards that a covered entity such as Imaging Group must maintain relations to your protected health information.  This Notice of Use is being used to help you understand how Gemini Imaging Group meets these minimum standards.  It is meant to inform you of the ways that Gemini Imaging Group meets these minimum standards.  It is meant to inform you of the ways that Gemini Imaging Group may use the personal information it collects about you and how it may disclose the information. 

TREATMENT, PAYMENT AND HEALTHCARE OPERATIONS:

As a covered entity, Gemini Imaging Group is required to inform you of the following ways it may use your protected health information.   In providing treatment to you,  Gemini Imaging Group will use your protected health information for the purposes of treatment, payment and healthcare operations.  For example:

·         Gemini Imaging Group may give your health information to healthcare professionals not on our staff, such as doctors and hospital staff who help to care for you.

·         Gemini Imaging Group may send a bill to your health Insurance plan or you.  If payment is not received in a timely manner,  Gemini Imaging Group may send you information to a dept collector for assistance in retrieving payment.

·         Gemini Imaging Group may use your medical records to review our performance and ensure you receive quality healthcare.

OTHER USE AND DISCLOSURES

There are a limited number of other uses and disclosures of protected health information that do not require specific authorization from you.  Gemini Imaging Group may in the following circumstances disclose your protected health information;

·         To government agencies that oversee practices such as our (license and certification inspectors)

·         To government agencies that have the right to receive and collect health information (those who control disease outbreaks);

·         To a court or judge that requests it;

·         To workers compensation programs when your health problem is from a work-related injury;

·         To law enforcement agencies that request information when such information is to prevent danger or injury;

·         For any purpose required or allowed by law

·         Except as stated above, Gemini Imaging Group will use or give out your health information only after getting written permission on an authorization from that my be revoked at any time by your written notification.

YOUR RIGHT AS A PATIENT OF GEMINI IMAGING GROUP

In accordance with HIPAA you have the following rights in relation to your protected health information;

·         You may request, in writing, additional restrictions to the use or disclosure of your protected health information; however, Gemini Imaging Group is not required to agree to the request.

·         You have the right to obtain a copy of this Notice of Uses

·         You have the right of access to inspect and obtain a copy of your medical record.

·         You have the right to obtain an accounting of disclosures of your medical record for purposes other than treatment, payment and health operations.

·         You have the right to revoke authorization to use or disclose your protected health information expect to the extent that action as already occurred.

RESPONSIBILITIES OF GEMINI IMAGING GROUP

In accordance with HIPAA, Gemini Imaging Group is required to:

·         Maintain the confidentiality of your protected health information.

·         Provide you with the notice of our legal obligations and privacy practices regarding information it may accumulate about you and is obligated to abide by the terms of this note.

·         Notify you if it is unable to agree to a requested restriction, and make every effort to accommodate reasonable request for communication of health information by alternative means. 

·         Post its Notice of Uses on its website @ geminiimaging.net/screening

Please be advised that in addition to these responsibilities, Gemini Imaging Group reserves the right to change the terms of its Notice of Uses and make those changes applicable to all protected health information maintained at the time.  If there is a change in its Notice of Uses, it will be posted on the Gemini Imaging Group website.

FOR MORE INFORMATION OR TO REPORT A PROBLEM

If you have questions, would like additional information or you suspect misuse of your protected health information and believe that your rights have been violated you may without fear of retaliation contact:

THE OFFICE OF CIVIL RIGHTS

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

200 Independence Ave. S.W.

Washington D.C., 20201

Ph.  1.877.696.6775

www.healthcare.gove