Clinical Pathology Laboratories Southeast, Inc. (CPLSE)
Notice of Privacy Practices for Protected Health Information
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Under federal and state law, CPLSE is not required to provide you with any information regarding tests performed at the direction of your health care practitioner. However, CPLSE will provide you with a copy of the test result(s) only upon receipt of written consent from the practitioner who ordered the test(s) and confirmation of your identification through a current photo ID issued by a federal or state government agency. For additional information, ask your health care practitioner to contact CPLSE Customer Service at 321-445-6600 or 866-236-5757.
Your Health Information Rights:
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:
- request a restriction on certain uses and disclosures of your information; however, we are not required to agree to the requested restriction;
- request to receive confidential communications of protected health information by alternate means;
- inspect and obtain a copy of your health record, upon the conditions stated above;
- amend your health record;
- obtain a written accounting of disclosures of your health information; and
- obtain a paper copy of this Notice of Privacy Practices for Protected Health Information.
CPLSE is required to:
- maintain the privacy of your health information;
- provide you with a notice of our legal duties and privacy practices regarding the information we collect and maintain about you;
- abide by the terms of this notice; and
- should CPLSE’s Health Information Practices change, we will mail a revised notice to the address you supply us specifically for such purpose.
CPLSE Disclosures for Treatment, Payment and Health Care Operations:
- We will report your health information for treatment. For example: We will report the results of your laboratory test(s) to the health care practitioner who requested the test(s).
- We will use your health information for payment. For example: A bill may be sent to you or a third-party payer. The bill may include information that identifies you, your diagnosis and tests performed.
- We will use your health information for regular health care operations. For example: We may use information about you to assess the timely reporting of the results of your test(s). This information will then be used in an effort to continually improve the quality and effectiveness of the service we provide.
Other Disclosures by CPLSE which are legally permitted or required:
- Health and safety: As required or permitted by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability or to avert a serious threat to the health or safety of a person or the public.
- Workers compensation: We may disclose your health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
- Health oversight activities: We may disclose your health information for health oversight activities authorized by law.
- Judicial and Administrative proceedings: We may disclose your health information as legally required for judicial and administrative proceedings.
- Law enforcement: We may disclose your health information for law enforcement purposes as required by law or in response to a valid subpoena.
All Other Uses and Disclosures:
- Any other uses and disclosures not described in this notice will be made only with your written authorization. You may revoke the authorization at any time, except to the extent that action has already been taken.
Changes to Health Information Practices:
- CPLSE reserves the right to change our health information practices and to make the new provisions effective for all protected health information we maintain.
For More Information or to Report a Problem:
- If you have questions or would like additional information, you may contact the CPLSE Privacy Officer at (321) 445-6627.
- If you believe your privacy rights have been violated, you can file a written complaint to CPLSE by sending it to the CPLSE Privacy Officer at 6490 Hazeltine National Drive, #170, Orlando, FL 32822; or you may file a complaint with the Secretary of Health and Human Services. There will be no retaliation by CPLSE for your filing of a complaint.
Effective Date: March 30, 2010