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.
If you have any questions about this notice, please contact Meridian Surgery Center Administration at 601.485.4443.
This notice describes our facility’s practices and that of:
• Any health care professional authorized to enter information into your medical record.
• All areas of the facility
• All employees and other facility personnel.
• Members of Meridian Surgery Center medical staff.
Our Pledge Regarding Medical Information
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at the facility. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care created by the facility, whether made by facility personnel, your doctor, or other practitioners involved in your care. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosures of your medical information created in the doctor’s office or clinic. This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
• Make sure that medical information that identifies you is kept private.
• Give you this notice of our legal duties and privacy practices with respect to medical information about you; and
• Follow the terms of the notice that is currently in effect.
How We May Use and Disclose Medical Information About You
The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
• For treatment
We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, health care students, or others who are involved in your care. We also may disclose medical information about you to people outside the facility who may be involved in your medical care after you leave the facility, such as long term care facilities or other agencies your physician uses to provide services that are part of your care.
• For payment
We may use and disclose medical information about you so that the treatment and services you receive at our facility may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about your procedure so your health plan will pay us or reimburse you for the services provided. We may also tell your health plan about procedures you are going to receive to obtain prior approval or to determine whether your plan will cover the procedure.
• For Health Care Operations.
We may use and disclose medical information about you for facility operations. These uses and disclosures are necessary to run the facility and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may send you a patient satisfaction survey. We may also combine the medical information we have with medical information from other facilities to compare how we are doing and see where we can make improvements in the care and services we offer. We remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.
• Appointment Reminders.
We may use and disclose medical information to contact you as a reminder that you have an appointment.
• Business Associates
There are some services provided in our organization through contracts with business associates. Examples include physician services in pathology, anesthesia, and certain laboratory testing. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we’ve asked them to do and bill you or third party payer for services rendered. So that your health information is protected, however, we require the business associate to appropriately safeguard your information.
Unless you object. We may disclose your medical information to notify a family member, a personal representative, or another person responsible for your care of your location, general condition, or death.
• Individuals Involved in Your Care or Payment for Your Care
We may release medical information about you to a care giver who may be a friend or family member after receiving a signed consent. We may also give information to someone who helps pay for your care.
We may submit data to state and national data registries for operational purposes.
• As Required by Law
We will disclose medical information about you when required to do so by the federal, state or local law.
• Organ and Tissue Donation
If you are an organ donor, we may disclose your medical information to an organ donation and procurement organization.
If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
• Workers’ Compensation.
We may disclose your medical information as authorized by laws relating to workers’ compensation or similar programs.
• Health oversight activities
We may use or disclose your medical information for public health activities, including the reporting of disease, injury, vital events, and the conduct of public health surveillance, investigation and/or intervention. We may disclose your medical information to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings. We may notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
• Abuse or Neglect
We may disclose your medical information when it concerns abuse, neglect, or violence to you in accordance with federal and state law.
• Public Safety
We may use or disclose your medical information to prevent or lessen a serious threat to the health or safety to another person or to the public.
• Food and Drug Administration (FDA)
We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects or post marketing surveillance information to enable product recalls, repairs, or replacement.
• Legal Proceedings
We may disclose your medical information in the course of certain judicial or administrative proceedings.
• Law enforcement
We may disclose your medical information for law enforcement purposes or other specialized governmental functions.
• Coroners, Medical Examiners, and Funeral Directors
We may release medical information to a coroner or medical examiner. We may also release medical information about patients of the facility to funeral directors as necessary to carry out their duties.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; (3) for the safety and security of the correctional facility.
We will not use or disclose your medical information for any other purpose without your written authorization except as otherwise permitted or required by law. Once given, you may revoke your authorization except as otherwise permitted or required by law. Once given, you may revoke your authorization in writing at any time except to the extent that Meridian Surgery Center has taken an action in reliance on the use or disclosure as indicated in the authorization. To submit a revocation of authorization request, you may contact:
Meridian Surgery Center
2100 13th Street
You have the following rights with respect to your medical information:
• You may ask us to restrict certain uses and disclosure of your medical information. We are not required to agree to your request, but if we do, we will honor it.
• You have the right to receive communications from us in a confidential manner.
• Generally, you may inspect and copy your medical information. This right is subject to certain specific exceptions, and you may be charged for reasonable fee for any copies of your medical information.
• You may ask us to amend your medical information. We may deny your request for certain specific reasons. If we deny your request, we will provide you with a written explanation for the denial and information regarding further rights you may have at that point.
• You have the right to receive an accounting of the disclosures of your medical information made by Meridian Surgery Center. Except for disclosures for treatment, payment or healthcare operations, disclosure types, The right to receive this information is subject certain exceptions, restrictions and limitations.
• You may request a paper copy of this Notice of Privacy Practices. You may ask us to give you a copy of this privacy notice at any time by requesting a copy from any member of our facility personnel.
You have the right to complain to us and/or to the United States Department of Health and Human Services if you believe that we have violated your privacy rights. If you choose to file a complaint, you will not be retaliated against in anyway.
To complain, please contact:
Meridian Surgery Center
2100 13th Street
Department of Health and Human Services Toll Free:
Revisions of Notice of Privacy Practices:
We reserve the right to change the terms of this Notice, making any revision applicable to all the protected health information we maintain. If we revise the terms of this Notice, we will post a revised notice at Meridian Surgery Center and will make paper copies of the revised Notice of Privacy Practices available upon request.
This notice is effective December 2011.