| Privacy Notice
The staff at the Ambulatory Surgery and Laser Center of Cape Cod
considers it a privilege to provide your care and wants you to
know that they are committed to keeping your medical information
confidential. This notice describes how that information will
be used by us during and after your stay.
Your medical information will be used chiefly to ensure that
the doctors and the nursing staff provide you with the safest
and most effective care during your procedure. In addition, the
surgery center may share or use your medical information for the
following purposes:
1. TREATMENT: To coordinate your health care and related
services with other providers. As an example, some of your medical
information may be sent to other doctors who will be looking after
you, and facilities, laboratories and pharmacies that will provide
services to you now and in the future.
2. PAYMENT: If needed to obtain payment for the services
provided to you at our facility.
3. TO IMPROVE OUR SERVICES: The most effective way to
improve our care is to do medical and quality assurance audits
of the services we provide to individuals like yourself.
Federal law states that our facility may be legally required
to disclose your protected health information for reasons such
as: to report suspected abuse, neglect or domestic violence; to
conduct health oversight activities by an appropriate agency;
in connection with judicial and administrative proceedings; for
law enforcement purposes; to medical examiners and related persons;
and in the event of serious threat to the health or safety to
you or the public.
YOUR RIGHTS TO ACCESS AND CONTROL YOUR MEDICAL INFORMATION
You have the right to inspect and copy your medical information
including medical and billing records, unless prohibited or protected
by law. Your request must be in writing. We may charge you for
the cost incurred by us in complying with the request. If you
think there are errors, you may make a request to our Privacy
Officer, Lisa Brun, that the records be amended.
You may submit a written request to the Privacy Officer for the
Surgery Center not to use or disclose certain parts of your medical
information for the treatment, payment and audit purposes described
above. The facility is not required to agree to a restriction
that you may request. We will notify you if we deny your request.
You have the right to instruct us if you do not wish us to disclose
your medical information to a family member or a close friend
if the need should arise. You also have the right to request that
we contact and communicate with you in a special way.
You have the right to request an accounting for certain disclosures
of your health records made by the Surgery Center. You also have
the right to another copy of this notice with detailed explanations.
You may submit a complaint to our Privacy
Officer or the US
Secretary of Health and Human Services if you believe we have
violated your privacy rights.
PRIVACY OFFICER:
Lisa Brun, Medical Records Coordinator
Ambulatory Surgery and Laser Center of Cape Cod
508-833-6050
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