The Health Insurance Portability Act of 1996 (HIPAA) protects the confidentiality of medical records and other personal health information. The rule limits the use and release of individually identifiable health information; gives patients the right to access their medical records; restricts most disclosure of health information to the minimum needed for the intended purpose; and establishes safeguards and restrictions regarding the disclosure of records for certain public responsibilities, such as public health, research and law enforcement. Improper uses or disclosures under the rule are subject to criminal and civil sanctions prescribed in HIPAA.
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.
Fountain Point Imaging Center, LLC collects health information from you, and stores it in a chart and on a computer. This is a medical record. The medical record is the property of the Fountain Point Imaging Center, LLC but the information in the medical record belongs to you. Fountain Point Imaging Center, LLC protects the privacy of your health information. The law permits Fountain Point Imaging Center, LLC to use or disclose your health information for the following authorized purposes:
We are required by law to provide medical information that is court ordered and or requested by law enforcement officials. We may disclose your protected health information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services. We will disclose only the minimum necessary amount of personal health information need to accomplish the contracted duties. All of our business associates are obligated under contract with us to protect the privacy of your information and are not allowed to use or disclose any information other than in a manner that would be permissible by Fountain Point Imaging Center, LLC to do so. No other uses or disclosures, except explicitly listed in the Notice of Privacy practices, may be made without an individual authorization. You have the right to revoke such an authorization in writing and we will honor your request, except under uncontrollable circumstances in which we acted upon your initial authorization.
You have the right to:
If you are concerned that we have violated your privacy rights, and or would like to express a concern regarding our privacy practices, you may report your complaint in writing to our Security Office at the address listed below. Please ask for the Security Officer for assistance in filing a complaint.
Fountain Point Imaging Center, LLC
3901 W. Norfolk Ave. Suite R
Norfolk, NE 68701
You may also send a written complaint to the U.S. Department of Health and Human Services at the following address:
The U.S. Department of Health and Human Services Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll Free 1-877-696-6775
We will not retaliate against you for filing a complaint.
We are required by law to protect the privacy of your information, provide this notice about our practices and to follow the guidelines described in this notice.
We reserve the right to change our policies at any time. If a significant change is made to our policy, it will be posted immediately in a conspicuous place in the imaging center.