LCM Pathologists: Medical Laboratory, Anatomic & Clinical Pathology

Privacy Policy

LCM Pathologists, P.C. (LCM)

NOTICE OF MEDICAL INFORMATION PRIVACY RIGHTS

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

When specimens from you are collected by your physician’s office and sent to us for examination, information about your medical history and your current health is also collected and sent to us with the specimen(s). This notice will explain how such information may be used by us and shared with others. It will also explain your privacy rights regarding this kind of information.

Your medical information will be used and disclosed for the following purposes:

• Diagnosis: We will use your information to help arrive at a diagnosis for your specimen. For example, an LCM physician may share your medical information with another physician for a consultation or referral.

• Payment: We will use your information to receive payment for the services we provide. For example, we will disclose information in order to submit bills or claims to insurance companies and / or Medicare or Medicaid.

• Health Care Operations: We will use your information for certain activities related to the functioning of LCM. For example, we may use or disclose information for quality assurance activities, legal services, underwriting, and other business management and administrative activities.

LCM may also use or disclose your information for the following purposes:

• To people who will be taking care of you or helping to pay your medical bills, such as family members or close friends. LCM will only disclose medical information that these people need to know. If you are able to make your own health care decisions, LCM will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, LCM will disclose relevant information to family members or other responsible people if we feel it is in your best interest to do so. For example, we may provide limited medical information to allow a family member to pick up slides or blocks for you.

• Under emergency conditions, to government or other groups that assist in emergencies or disasters.

• LCM also may disclose or use your information without your consent in the following cases: when required by law; for public health activities; relating to victims of abuse / neglect / domestic violence, if required / authorized by law and / or if you agree; for health oversight activities; for judicial and administrative proceedings to the extent permitted by law; for law enforcement purposes, as permitted or required by law; to coroners / medical examiners / funeral directors, as permitted by law; for organ donation purposes; for research purposes under certain circumstances; to avert a serious threat to health or safety; for certain specialized government functions, such as military discharge, and national security and intelligence; and for workers’ compensation purposes.

LCM will not use or disclose your medical information in any other way unless you allow us to do so in writing. If you do give us permission to use or disclose your medical information for another purpose, you have the right to change your mind and revoke the permission at any time.

Your Privacy Rights:

• You may request that LCM not use your medical information in certain ways or for certain purposes. You may also request that LCM not provide your medical information to certain people. However, LCM has the right to refuse your request, and LCM may use or disclose your medical information in situations requiring emergency treatment, in which case we will ask the person(s) who receive the information not to further use or disclose the information.

• You may request that LCM provide you with your medical information in a confidential manner. For example, you can request that we send your bills and other mailings to a different address or that we notify you of this kind of information in another way, such as by a phone call. You must make this request in writing and specify another address or means of communication. We may also ask you to give us information on how you will pay your bills.

• You may ask to see and copy your medical records, unless that information is protected by law. You must make these requests in writing. If your request to look at or copy your medical records is denied, you have the right to have the denial reviewed by a health care professional. We will act upon your request within 30 days, and we may charge you a legally accepted amount for copying costs.

• You may ask us to change information in your medical records. If your request is denied, you can write a statement of disagreement with the denial that we will keep with your medical records.

• You may ask us to provide you with information about certain disclosures of your medical information in the past. You may request an accounting of disclosures made in the past six years, but this accounting will only cover disclosures made after April 14, 2003.

• If you have received this notice of your medical information privacy rights electronically, you may ask us to provide you with a paper copy.

• If you feel your medical information privacy rights have been violated, you may file a complaint with the Secretary of Health and Human Services, and / or with the LCM contact person listed below. Filing a complaint will not affect the quality of the services you receive from LCM and you will not be retaliated against for filing a complaint.

• You can contact the designated privacy official at LCM:
Name: Thomas J Schnabel
Title: Business Manager
Telephone: (605) 333-1720

The effective date of this notice is April 14, 2003. LCM is required by law to maintain the privacy of protected health information and to provide individuals with this notice of its legal duties and privacy practices with respect to health information. LCM is required to abide by the terms of the notice currently in effect. LCM reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information maintained by LCM. If the terms of this notice are changed, LCM will provide individuals with a revised notice upon request and by posting the revised notice in designated locations at LCM. This notice of privacy rights will be available at all locations of LCM and on our website, (www.lcmpath.com)

April 14, 2003

If you have any questions about our privacy standards, please contact us at:

LCM Pathologists
1305 W. 18th Street
Sioux Falls, SD 57105

Phone: 800-424-0564