
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information to carry out treatment, payment or healthcare operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your Protected Health Information. "Protected Health Information" is information about you, including demographic information that may identify you and that relates to your past, present, or future physical or mental health or condition and related healthcare services.
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you and we are required to abide by the terms of this Notice of Privacy Practices.
TREATMENT: We may use Protected Health Information about you to provide you with medical treatment or services. When required, we will obtain your authorization before disclosing any of your information. Only the minimal amount of information will be revealed during any disclosures.
PAYMENT: Your Protected Health Information will be used, as needed, to obtain payment of your healthcare services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we recommend for you such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
HEALTHCARE OPERATIONS: We may use or disclose as needed, your Protected Health Information in order to support the business activities of your healthcare provider and Reliant. Whenever an arrangement between our facility and a business associated involves the use or disclosure of your Protected Health Information, we will have a written contract that contains terms that will protect the privacy of your Protected Health Information.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE WITH YOUR AUTHORIZATION, OR OPPORTUNITY TO OBJECT: You have the opportunity to agree or object to the use or disclosure of all or part of your Protected Health Information. If you are not present or able to agree or object to the use or disclosure of the Protected Health Information, then your healthcare provider may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the Protected Health Information that is relevant to your healthcare will be disclosed.
OTHERS INVOLVED IN YOUR HEALTHCARE: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your Protected Health Information that directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose your Protected Health Information to an authorized public or private entity to assist in disaster relief efforts.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE WITHOUT YOUR AUTHORIZATION OR OPPORTUNITY TO OBJECT: We may use or disclose your Protected Health Information without your authorization in the following situations:
YOUR RIGHTS
You have the right to inspect and copy your Protected Health Information. This means you may inspect and obtain a copy of Protected Health Information about you for as long as we maintain the Protected Health Information. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal or administrative action or proceeding; and protected health information that is subject to law that prohibits access to Protected Health Information.
You have the right to request a restriction of your Protected Health Information. This means you may ask us not to use or disclose any part of your Protected Health Information for the purposes of treatment, payment or healthcare operations. In addition, you may request that any part of your Protected Health Information not be disclosed to family members or friends who may be involved in your care, or for notification purposes as described in the Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
COMPLAINTS
You may file a complaint with us by notifying our Privacy Officer, with the Secretary of Health and Human Services, or with the Office of Civil Rights if you believe we have violated your privacy rights. No action will be taken against you for filing a complaint.
3351 Waterview Parkway
Richardson, Texas 75080
Phone: 972.398.5700
Fax: 972.398.5751
Contact us for more information

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