The only full-service urgent care with access to medical specialists in orthopedics, ophthalmology, otolaryngology and other specialties.
The only full-service urgent care with access to medical specialists in orthopedics, ophthalmology, otolaryngology and other specialties.
This privacy notice is being provided to you as a requirement of a federal law, the Health Insurance Portability and Accountability Act (HIPAA). This Privacy Notice describes how we may use and disclose your protected health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your right to access and control your protected health information. Your “protected health information” means any written or oral information about you, including demographic data that can be used to identify you, created or received by your health care provider, which relates to your past, present, or future physical or mental health or condition.
We may use your protected health information for the purpose of providing treatment, obtaining payment for treatment, and conduction of health care operations. Your protected health information may be used or disclosed only for these purposes unless we have obtained your authorization or the use or disclosure is permitted or required by HIPAA regulations or other law. Disclosures of your protected health information for the purposes described in this Privacy Notice may be made in writing, orally, or by electronic means.
We will use and disclose your protected healthcare information to provide, coordinate, or manage your health care and related services, including coordination and management with third parties for treatment purposes. Here are some examples of how we may use or disclose your protected health information for treatment:
We will use your protected health information to obtain payment for the services we provide to you. We may also disclose your protected health information to another provider involved in your care for their payment activities. Here are some examples of how we may use or disclose your protected health information for payment:
We may use and disclose your protected health information to facilitate our own health care operations and to provide quality care to all of our patients. Health care operations include such activities as: quality assessment and improvement; employee review activities; condition or arranging for medical review, legal services, and auditing functions, including fraud and abuse detection and compliance reviews; business planning and development; and business management and general administrative activities. In certain situations, we may also disclose your protected health information to another provider or health plan for their health care operations. here are some examples of how we may use or disclose your protected health information for health care operations:
The federal privacy rules allow us to use or disclose your protected health information without your authorization and without your having the opportunity to object to such use or disclosure in certain circumstances, including:
We will disclose your protected health information when we are required to do so by federal, state, or local law.
We may disclose your protected health information as permitted or required by law for the following public health reasons:
We may notify government authorities if we believe a patient is a victim of abuse, neglect or domestic violence. We will make this disclosure only when specifically authorized or required by law, or when the patient agrees to the disclosure.
We may disclose your protected health information to a health oversight agency for oversight activities authorized by law, including audits; civil, administrative, or criminal investigations; inspections; licensure or disciplinary actions; civil, administrative, or criminal proceedings or actions; or other activities necessary for appropriate oversight.
We may disclose your protected health information in course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order. We may disclose your protected health information in response to subpoena, discovery request, or other lawful process that is not accompanied by an order of a court or administrative tribunal if we have received satisfactory assurances that you have been notified of the request or that an effort has been made to secure a protective order.
We may disclose your protected health information to a law enforcement official for law enforcement purposes, including:
We may disclose protected health information to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or other duties as authorized by law. We may disclose protected health information to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the decedent. In some cases such disclosures may occur prior to, and in reasonable anticipation of the individual’s death.
We may use or disclose protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes, or tissues for the purpose of facilitating donation and transplant.
We may use or disclose your protected health information for research purposes when an institutional review board that has reviewed the research proposal and protocols to safeguard the privacy of your protected health information has approved such use or disclosure.
We may, consistent with applicable law and standards of ethical conduct, use or disclose your protected health information if we believe, in good faith, that such use or disclosure is necessary to prevent or lessen a serious and imminent threat to your health and safety or that of the public.
We may use or disclose your protected health information, as authorized or required by law, to facilitate specified government functions related to military and veterans activities; national security and intelligence activities; protective services for the president and others; medical suitability determinations; correctional institutions and other law enforcement custodial situations.
We may use and disclose your protected health information, as necessary, to comply with workers compensation laws or similar programs.
We may use your protected health information to maintain a directory of patients in our facility. The information included in the directory will be limited to your name, your location in our facility, and your condition described in general terms.
We may disclose your protected health information to a friend or a family member who is involved in your medical care or payment for care. In addition, if applicable, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
You may object to these disclosures. If you do not object to these disclosures, or we determine in the exercise of our professional judgment that it is in your best interest for us to disclose information that is directly relevant to the persons involved with your care, we may disclose your protected health information.
Other than the uses and disclosures described above, we require your written authorization in order to use or disclose your protected health information for:
Authorizations are for specific uses of protected health information, and once you give us authorization, any disclosures we make will be limited to those consistent with the terms of the authorization. You may revoke your authorization by submitting a revocation in writing at any time except to the extent that we have already taken action in reliance upon your authorization.
You have the following rights regarding your protected health information:
You have the right to request that we not use or disclose certain parts of your protected health information for the purpose of treatment, payment, or healthcare operations. You also have the right to request that we do not disclose your protected health information to friends or family members who may be involved in your care, or for notification purposes as described earlier in this notice. Your request must be made in writing and must state the specific restriction requested and the individuals to whom the restriction applies.
We must agree to your request to restrict disclosure of your protected health information to a health plan if:
Otherwise, we are not required to agree to a restriction you may request.
We will notify you if we do not agree to your restriction request. If we do agree to the restriction request, we will not use or disclose your protected health information in violation of the agreed upon restriction, unless necessary for the provision of emergency treatment.
We may terminate our agreement to a restriction if you agree to the termination in writing; if you agree to the termination orally and the oral agreement is documented, or if we notify you of termination of the agreement and the termination applies only to protected health information created or received by us after you receive the notice of termination of the restriction.
Request for restrictions must be made in writing to the Privacy Officer.
You have the right to request that you receive communications of protected health information from us by alternative means or at alternative locations. We must accommodate any responsible request of this nature. We may condition the provision or accommodation by requesting information from you describing how payment will be handled, or by requesting specification of an alternative address or alternative form of contact. Request for confidential communications must be made in writing to the Privacy Officer.
You have the right to inspect and obtain a copy of your protected health information that is maintained in a designated record set for as long as we maintain the protected health information. The designated record set is a collection of records maintained by us, which contains medical and billing information used in the course of your care, and any other information used to make decisions about you.
By law you do not have a right to access psychotherapy notes; information compiled in reasonable anticipation of or for use in a civil, criminal, or administrative proceeding; and protected health information which is subject to a law which prohibits access to protected health information. Depending on the circumstances of your request, you may have the right to have a decision to deny access reviewed.
We may deny your request to inspect or copy your protected health information in our professional judgement, we determine that the access requested is likely to endanger you or another person or is likely to cause substantial harm to another person referenced within the protected health information. You have a right to request a review of a denial of access.
If you request a copy of your information, we may charge you a fee for the costs of copying, mailing, or other costs incurred by us as a result of complying with your request.
Request for access to your protected health information must be made in writing to the Privacy Officer.
You have the right to request that we amend your protected health information in a designated record set for as long as we maintain that information. In certain cases we may deny your request. If we deny your request you will be notified in writing, and you will have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement of disagreement and if we do so we will provide a copy of our rebuttal to you.
Request for amendment of protected health information must be made in writing to the Privacy Officer, and must include a reason to support the request amendments.
You have the right to request an accounting of disclosures of your protected health information made by us. This right applies to disclosures made by us expect for disclosures: to carry out treatment, payment, or health care operations as described in this notice or incidental to such use; to you or your personal representatives; pursuant to your authorization; for our directory, or other notification purposes or to persons involved in your care; or for certain other disclosures we are permitted to make without your authorization.
Request for disclosure of accounting must specify a time period sought for the accounting, with the maximum time period being six years prior to the date of the request. We are not provided accounting for disclosures made before April 14, 2003. We will provide the first disclosure accounting you request during any 12-month period without charge. Subsequent disclosure accounting request will be subject to a reasonable cost-based fee.
Upon request, we will provide paper copy of this notice.
We are required by law to maintain the privacy of your health information and to provide you with this privacy notice of our legal duties and privacy practices with respect to protected health information. We are required by law to notify you if a breach of your unsecured protected health information occurs. We are required to abide by the terms of the notice currently in effect. We reserve the right to change the terms of this notice and to make any new provisions effective for all protected health information that we maintain. If we change the notice, we will provide a copy of the revised notice through in-person contact.
You have the right to express complaints to us and to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated.
If you wish to complain to us, please do so in writing and direct your complaint to the Privacy Officer.
You will not be penalized for filing a complaint.
For further information about this Notice, privacy issues, or if you believe that your privacy rights have been violated, please contact:
John Webster – The Privacy Officer by telephone at (520) 395-0471
Effective date: This notice is effective as of August 18, 2016, and has been revised from time to time for clerical updates.
Any information provided on this website should not be considered medical advice or a substitute for a consultation with a physician. If you have a medical problem, contact your local physician for diagnosis and treatment.
Tucson: (520) 395-0471
2120 W. Ina Road,
Suite 100
Tucson, AZ 85741
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2120 W. Ina Road,
Suite 100
Tucson, AZ 85741
Phone
(520) 395-0471
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Address
2120 W. Ina Road,
Suite 100
Tucson, AZ 85741
Phone
(520) 395-0471
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This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
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