NOTICE OF PRIVACY PRACTICES 

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

When this Notice refers to “we” or “us”, it is referring to DSI Laboratories.

This Notice describes how we will use and disclose your health information. The policies outlined in this Notice apply to all of your health information generated by this Organization, whether recorded in your medical record, invoices, payment forms or other ways. Similarly, these policies apply to the health information gathered from other Organizations by any health care professional, employee or volunteer who participates in your care.

The Clinical Laboratory Improvement Act and Florida Statutes prohibit the release of results of diagnostic laboratory tests to any one other than the primary care provider who ordered such tests. DSI Laboratories will provide this information to you if requested to do so by your physician or primary care provider.

USES AND DISCLOSURES OF YOUR HEALTH INFORMATION

1.                    In some circumstances we are permitted or required to use or disclose your health information without obtaining your prior authorization and without offering you the opportunity to object. These circumstances include:

a.                    Uses or disclosures for purposes relating to treatment, payment and health care operations:

i.                      Treatment. We may use or disclose your health information for the purpose of providing, or allowing others to provide, treatment to you or any other individual. An example would be faxing or printing results of laboratory tests to your primary care physician. An example would be if your primary care physician discloses your health information to another doctor for the purposes of a consultation.  Also, we may contact you with appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

ii.                     Payment. We may use and/or disclose your health information for the purpose of allowing us, as well as other entities, to secure payment for the health care services provided to you. For example, we may inform your health insurance company of your diagnosis and treatment in order to assist the insurer in processing our claim for the health care services provided to you.

iii.                    Health Care Operations. We may use and/or disclose your information for the purposes of our day-to-day operations and functions. We may also disclose your information to another covered entity to allow it to perform its day-to-day functions, but only to the extent that we both have a relationship with you. For example, we may compile your health information, along with that of other patients in order to allow a team of our health care professionals to review that information and make suggestions concerning how to improve the quality of care provided at this facility. Also, we may contact you as part of our efforts to raise funds for the Organization. All fundraising communications will include information about how you may opt out of future fundraising communications.

b.                    To create material(s) that originally had any identifying information concerning you deleted from the final material(s);

c.                    When required by law;

d.                    For public health purposes;

e.                    To disclose information about victims of abuse, neglect, or domestic violence;

f.                     For health oversight activities, such as audits or civil, administrative or criminal investigations;

g.                    For judicial or administrative proceedings;

h.                    For law enforcement purposes;

i.                      To assist coroners, medical examiners or funeral directors with their official duties;

j.                      To facilitate organ, eye or tissue donation;

k.                    For certain research projects that have been evaluated and approved through a research approval process that takes into account patients’ need for privacy;

l.                      To avert a serious threat to health or safety;

m.                   For specialized governmental functions, such as military, national security, criminal corrections, or public benefit purposes; and

n.                    For workers’ compensation purposes, as permitted by law.

YOUR RIGHTS

1.                    To Request Restrictions. You have the right to request restrictions on the use and disclosure of your health information for treatment, payment or health care operations purposes or notification purposes. We are not required to agree to your request. If we do agree to a restriction, we will abide by that restriction unless you are in need of emergency treatment and the restricted information is needed to provide that emergency treatment. To request a restriction, submit a written request to the Contact listed on the final page of this Notice.

2.                    To Limit Communications. You have the right to receive confidential communications about your own health information by alternative means or at alternative locations. This means that you may, for example, designate that we contact you only via e-mail, or at work rather than home. To request communications via alternative means or at alternative locations, you must submit a written request to the Contact listed on the final page of this Notice. All reasonable requests will be granted.

3.                    To Access and Copy Health Information. You have a right to inspect and copy any health information about you when we receive a release from the primary care provider who has ordered the tests. To arrange for access to your records, or to receive a copy of your records, you should submit a written request with a release statement to the Contact listed on the last page of this Notice. If you request copies, you will be charged our regular fee for copying and mailing the requested information.

OUR DUTIES

1.                    We are required by law to maintain the privacy of your health information and to provide you with this Notice of our legal duties and privacy practices.

2.                    We are required to abide by the terms of this Notice. We reserve the right to change the terms of this Notice and to make those changes applicable to all health information that we maintain. Any changes to this Notice will be posted on our website (if applicable) and at our facility, and will be available from us upon request.

COMPLAINTS

You can complain to us and to the Secretary of the federal Department of Health and Human Services if you believe your privacy rights have been violated. To lodge a complaint with us, please file a written complaint with the Contact set forth below. This Contact will also provide you with further information about our privacy policies upon request. No action will be taken against you for filing a complaint.

DESIGNATED CONTACT:

Compliance/Privacy Officer

(239) 561-8200

12700 Westlinks Drive

Ft Myers, FL  33913