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This Notice Describes Our Practices and Those of:
Archangels Centers uses health information about you for treatment, to obtain payment for treatment for administrative purposes, and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of Archangelscenters. We understand that health information about you and your health is personal. We are committed to protecting health information about you. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of health information. archangelscenters is required by law to:
Archangelscenters may use your health information to provide you with medical treatment for services. For Example, information obtained by a health care provider, such as physician, nurse, or other person providing health care services to you, will need information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them during your treatment and note how you respond to the actions.
Archangelscenters may use and disclose your health information to others for purposes of receiving payments for treatment and services that you receive. For example, a bill may be sent to you or a third party, such as an insurance company, HMO, or health plan. The information of the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.
Archangelscenters may use and disclose health care information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk, or quality improvement personnel, and others to:
You voluntarily consent to the collection and testing of your specimen and certify that the specimen identified on this form is my own and has not been adulterated in any manner. I certify that the information provided on this form and on the specimen, is accurate. I further authorize Archangelscenters to release the results of this testing to the ordering facility and/or my insurance company. I authorize my insurance company to pay and mail directly to Archangelscenters and its affiliated laboratories all benefits for payment of services rendered. I also authorize Archangelscenters and its affiliated laboratories to endorse any checks received on my behalf for payment of services provided.
I hereby irrevocably assign to Archangelscenters and its affiliated laboratories all benefits under any policy of insurance indemnity agreement, or any collateral source as defined by statute for services provided. This assignment includes all rights to collect benefits directly from my insurance company and all rights to proceed against my insurance company in any action including legal suit, if for any reason my insurance company fails to make payment to benefits due. This assignment also includes all rights to recover attorney fees and costs for such action brought by the provider as my assignee.
Archangelscenters may use your information to contact you to provide appointment reminders. We may also contact you to tell you about treatment alternatives or other health-related benefits and services that may be of interest to you.
Archangelscenters may release relevant health information to a family member, friend, or anyone else you designate in order for that person to be involved in your case or payment related to your case. Archangelscenters may also disclose health information to those assisting in disaster relief efforts so that others can be notified a status, our condition, status and location.
Archangelscenters does not use information for fundraising unless authorized, in writing, by you.
Archangelscenters may use and disclose information about you as required by law. For example, we may disclose information for the following purposes:
Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities (State Health Department, Center for Disease Control, Etc.) to prevent or control disease, injury, or disability, or for other public health activities.
Archangelscenters may disclose your health information to a health oversight agency for activities authorized by law. Examples of these activities include audits, investigations, and inspections to monitor the health care system and compliance with laws and regulations.
Other uses and disclosures will be made only with your written authorization. You may revoke an authorization except to the extent Archangelscenters has taken action in reliance to it.
“SMS consent will not be shared with any third party, nor will the phone numbers for SMS purposes”
Your Health Information Rights Under HIPAA you have the right to:
Archangelscenters reserves the right to change the terms of this notice and make the new terms effective for all protected health information kept by Archangelscenters. Archangelscenters will post a copy of the current notice in the facility. You may also get a current copy by contacting our Executive Director at info@archangelscenters.com
Complaints:
If you believe your privacy rights have been violated, you may file a complaint with Archangelscenters.
To file a complaint with Archangelscenters, submit a written complaint to our Executive Director (at the address of this notice). You will not be penalized for filing a complaint.
Contact Information for Questions or to File a Complaint:
If you have questions about this notice, want to exercise one of your rights that are described in this notice, or want to file a complaint, please contact Archangelscenters at: (888)464-2144
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