THIS NOTICE DESCRIBES HOW PROTECTED MEDICAL INFORMATION ABOUT YOU MAY BE — USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The AZ Heart Rhythm Center physicians and staff may use and disclose medical information (protected health information or PHI) about an individual for:
- Medical Treatment – i.e.; providing medical care services, sending/coordinating medical care information with other health care providers caring for you, ordering and obtaining off site tests/results, writing prescriptions, etc.
- Payment – i.e.; submitting insurance claims on your behalf for treatment rendered.
- Health care operations – i.e.; internal business planning activities and quality of care evaluation.
The AZ Heart Rhythm Center is permitted or required, under specific circumstances,to use or disclose protected health information without the individual’s written authorization, including, but not limited to:
- Disclosures required by law
- Disclosures to avert serious threats to health or safety
- Disclosures with reference to workers” compensation or Food and Drug Administration
Other uses and disclosures will be made only with the individual’s written authorization, and the individual may revoke such authorization. (Please see below for identifying persons to whom you would allow disclosures of otherwise protected information.)
The AZ Heart Rhythm Center may contact the individual to provide appointment reminders or information about treatment or other health-related benefits and services that may be of interest to the individual or patient. The AZ Heart Rhythm Center will routinely contact patients via telephone at home and/or work and, unless otherwise requested, may leave messages on the appropriate voicemail or answering service regarding appointments, test results, etc. We may also send faxes or email if you have designated this option.
Our patients have the following rights regarding their protected health information:
- The right to request restrictions on certain uses and disclosures of protected health information. However, the AZ Heart Rhythm Center is not required to agree to a requested restriction.
- The right to receive confidential communications of protected health information, as applicable.
- The right to inspect and copy protected health information, as provided in the Privacy Regulation.
- The right to amend protected health information, as provided in the Privacy Regulation.
- The right to receive an accounting of disclosures of protected health information.
- The right to obtain a paper copy of the Notice from the covered entity upon request. This right extends to an individual who has agreed to receive the Notice electronically.
The AZ Heart Rhythm Center is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information. AZ Heart Rhythm Center is required to abide by the terms of the Notice currently in effect.
The AZ Heart Rhythm Center reserves the right to change the terms of this Notice. The new Notice provisions will be effective for all protected health information that it maintains. The AZ Heart Rhythm Center will provide individuals or patients with a revised Notice by posting new regulations in each office.
Individuals may complain to the AZ Heart Rhythm Center and to the Secretary of the Department of Health and Human Services, without fear of retaliation by the organization, if they believe their privacy rights have been violated. The AZ Heart Rhythm Center’s contact person for matters relating to complaints is:
1848 E. Thomas Road, Suite 100
Phoenix, AZ 85016
Phone: (602) 456-2342