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DISCLAIMER AND PRIVACY POLICY
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.

Uses And Disclosures of Health Information

With your consent, USARAD may use health information about you for:
• Treatment (such as sending your medical record information to a specialist physician as part of a referral).
• To obtain payment for services USARAD provides (such as sending billing information to a health insurance company), for administrative purposes.
• To evaluate the quality of care that you receive (such as comparing data to improve treatment and imaging methods and techniques).

USARAD may use or disclose health information about you and that identifies you without your authorization for several other reasons. Subject to certain requirements,USARAD may give out health information without your authorization for:
• Public health purposes (required reporting of certain diseases to the Center for Disease Control - the CDC).
• The reporting of abuse or neglect (reporting suspected abuse or neglect to local police).
• Auditing purposes (making records available to Medicare, Medicaid or other auditing agencies and authorities).
• Research studies (such as studies measuring how often a certain condition or type of service is provided).
• Funeral arrangements and organ donation (for cosmetic reconstruction and determining the condition of organs for transplant).
• Worker’s Compensation purposes (mandated by State Worker’s Compensation regulations)
• Emergencies (when consent is not possible or practical or taking the time to secure consent would not be in your best medical interests).

USARAD provides information when otherwise required by law, such as for law enforcement in specific circumstances.USARAD may also contact you to remind you of an appointment or to conduct a pre-screening process. This process may involve the use of:
• Appointment reminders sent by U.S. Mail (post cards).
• Voice messages left on an answering machine you have in use on the phone number you provide as your contact phone number.
• By fax in the event you provide us with a fax number.
• Telephone conversation where we will identify ourselves and ask for you if you do not personally answer the phone.

USARAD may also use or disclose health information about you to inform you of any changes regarding our participation in insurance plans or the development of new services and capabilities. If you have an objection to any of the appointment reminder methods listed above you must inform the receptionist and include the restrictions on the authorization form you will be asked to read and sign prior to services being rendered.

In any other situation, USARAD will ask for your written authorization before using or disclosing any identifiable health information about you. This may result in your having to come to USARAD to read and sign an authorization specifically for the “other” use and disclosure. If you chose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosers from the date and time USARAD receives your revocation. You can revoke any prior authorization by signing a new authorization that will indicate how you wish to limit or stop USARAD from further use or disclosure of your information. The most recent authorization will replace and take precedence over any prior authorization.

USARAD may change its policies at any time. Before we make a significant change in our policies, we will change our Notice of Privacy Practices and post the new notice in our waiting areas and reception desks. You can also request a copy of our notice at any time. For more information about our privacy practices, contact the person listed below.

Individual Rights

In most cases, you have the right to look at or get a copy of health information about you that we use to make decisions about you. If you request copies, we will charge you ($0.10) for each paper page and ($7.00) for each sheet of film for standard X-ray studies and $35.00 per set for MRI and CT studies. You also have the right to receive a list of instances where we have disclosed health information about you for reasons other than treatment, payment, or related administrative purposes. RSA does not keep records regarding its uses and disclosures of health information about you for treatment, payment, or related administrative purposes. If you believe information in your record is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information. Requests for such changes to your record must be in writing.

Federal and State law require that your request to look at, make changes to or add missing information to your health information and for USARAD to communicate it’s determination to either comply with or deny your request must be made within 60 days of the date of your request.

You have the right to request that your health information be communicated to you in a confidential manner such as sending mail to an address other than your home. If this notice was sent to you electronically, you may obtain a paper copy of the notice.You may request in writing that we not use or disclose your information for treatment, payment or administrative purposes or to persons involved in your care except when specifically authorized by you, when required law, or in emergency circumstances. We will certainly consider and attempt to honor your request to restrict or limit our use of health information about you, however, USARAD is not legally required to accept or agree to your request.

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