of Privacy Practice
Here at Centro de Mi Salud (CdMS), we understand
that medical information about you is personal.
We are committed to protecting medical information
about you. CdMS
employees are committed to protecting your personal health
information and privacy.
We will use your information to provide you care and
treatment, create a record of the care and services you
receive, bill your insurance in a timely fashion and operate
our facility in a diligent manner.
We will safeguard your information and share it only
with those who need or are entitled to know.
We will obtain your permission for other use or
may ask to see, change, restrict or obtain a copy of your
information and file a formal complaint if we fail to assure
your privacy or information confidentiality.
For more details, please read this Notice of Privacy
you have any question, please contact the US Department of
Health Services 1 (800) 368-1019.
provides health care to our patients in partnership with
psychiatrist and other professionals and organizations
involved in your care. Our
Privacy Practices guide:
Any health care professional who treats you at any of our locations.
All departments and units of our organization, including all
off-campus units or departments.
All staff or volunteers of our organization.
Any business associate or partner of CdMS with whom we need to share
your health information.
We are required by law to:
medical information about you private.
you this notice of our legal duties and privacy practices
with respect to medical information about you.
the most stringent state or federal law.
by our currently published Notice of Privacy Practices
may change our policies at any time.
Changes will apply to medical information we already
have. Before we
make significant change in our policies, we will change our
notice and post the new notice in waiting areas, exam rooms,
and our Web site at www.centromisalud.com.
You can receive a copy of the current notice at any
time. You will be
offered a copy of the current notice at the time you are
admitted to treatment. You
will also be asked to acknowledge in writing your receipt of
How we may use and disclose medical information about you.
may use and disclose medical information about you for
treatment, to obtain payment for treatment and to support
our health care operations (QM Department).
may use and disclose medical information about you without
your prior authorization for several other reasons.
Subject to certain requirements, we may give out
medical information about you without prior authorization
for public health purposes, abuse or neglect reporting;
heal oversight audits or inspections, funeral arrangement,
organ donations, worker’s compensation purposes, and
also disclose medical information when required by law,
such as in response to a valid judicial or administrative
may also contact you for appointment reminders, to tell
you about or recommend possible treatment options,
alternatives, health-related benefits or services that may
be of interest to you.
admitted as a patient, unless you tell us otherwise, we
will list your name, location in the hospital, your
general condition (good, fair, etc) and your religious
affiliation in the patient directory.
Your religious affiliation may be disclosed to a
may disclose medical information about you to a friend or
family member who is involved in your medical care or to
disaster relief authorities so that your family can be
notified of your location and condition.
may cont you for our fundraising activities.
uses of medical information
any other situation not involving routine care, financial
and insurance matters or hospital operations, we will ask
for your written authorization before using or disclosing
medical information about you.
If you choose to authorize use or disclosure, you
can later revoke that authorization by notifying us in
writing of your decisions.
Your rights regarding medical information about you.
most cases, you have the right to look at or get a copy of
medical information that we use to make decisions about
your care, after you submit a written request.
If you request copies, we may charge a few for the
cost of copying, mailing or related supplies.
If we deny your request to review or obtain a copy,
you may submit a written request for a review of that
you believe that information in your record is incorrect
or if important information is missing, you have the right
to request that we correct the records, by submitting a
request in writing that provides your reason for
requesting the amendment.
We could deny your request to amend a record if the
information was not created by us; if it is not part of
or maintained by us; or we determine that record is
may appeal, in writing, a decision by us not to amend a
have a right to a list of those instances where we have
disclosed medical information about you, other than for
treatment, payment, healthcare operat5ions or where you
specifically authorized a disclosure, when you submit a
written request. The
request must state the time period desired for the
accounting, which must be less than a 6-year period and
starting after April 14, 2003.
You may receive the list in paper or electronic
first disclosure list requested in a 12-month period is
free; other request will be charged according to our cost
of producing the list.
We will inform you of the cost before you incur any
have the right to request that medical information about
you be communicated to you in a confidential manner, such
as sending mail to an address other than your home, by
notifying us in writing of a specific way or location for
us to use to communicate with you.
may request, in writing, that we not use or disclose
medical information about you for treatment, payment or
health care operations or to persons involved in your care
except when specifically authorized by you, when required
by law, or in an emergency.
We will consider your request but we are not
legally required to accept it.
We will inform you of our decision on your request.
All written requests or appeals should be submitted
to our Privacy Office listed at the bottom of this notice.
You may contact our Privacy Officer or the US Department of Health and
You will not be penalized or retaliated against for filing a