UPSI PRIVACY POLICY

NOTICE OF PRIVACY PRACTICES

Utah Pathology Services, Inc. (or UPSI) uses and discloses your protected health information only in ways permitted by a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In addition to imposing restrictions on how providers may use protected health information, HIPAA also gives patients certain specific rights. It is important for you to understand your rights.

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.

Federal law (HIPAA) permits us to use your information for many of our normal treatment and business purposes without obtaining an authorization from you. There are also a limited number of other reasons we might disclose your information without your authorization. And there are several uses that, although indirectly related to your care, require us to obtain your authorization.

A. For treatment, payment and health care operations:

We may disclose your information as needed to provide the best care for you. For example, we may share your records with a specialist who is called in to consult with your providers, or with a hospital if you need to be admitted for a medical emergency.

We may disclose your information as needed to obtain payment for services we provide. For example, we may need to share treatment notes with your insurance company to support our claim for payment.

We may disclose your health information for activities referred to as health care operations. These include, for example, patient safety studies, reviewing the performance of our providers, cooperating with government investigations or site visits, or activities related to our state license to operate.

B. Other uses and disclosures without your written authorization:

We may be required to respond to requests from law enforcement agencies, public health authorities and health oversight agencies. We are also required to report certain kinds of conduct such as abuse of a child or an elderly person. Judicial and administrative proceedings may result in subpoenas or court orders to produce protected health information. We may also release limited information to law enforcement where there is a crime on our premises.

C. Uses and disclosures that require a written authorization:

We must have your authorization for the release of your information for any marketing purposes. We will not sell your information under any circumstances.

Your rights.

A. You have the right to make requests for restrictions on how we use or disclose your health information. We are not required to honor your request, unless it pertains to the disclosure, for payment purposes, of services for which the entire amount has been paid in full. In other words, if you pay us in full for services we provide to your child, you may instruct us not to disclose that to your insurance company.

B. You have the right to request that we communicate with you in a confidential manner of your choosing. We will make reasonable efforts to comply with your request.

C. You have the right to inspect and to receive a copy of your protected health information.

D. You have the right to request an amendment of anything in your health information you believe is inaccurate. If we deny your request, you have the right to have the request reviewed by an independent objective third party.

E. You have the right to receive an accounting of our disclosures of your health information.

F. You have the right to receive a paper copy of this Notice upon request.

Our duties.

UPSI is required by HIPAA regulations to maintain the privacy of your protected health information, to provide you with this Notice of our legal duties and privacy practices, and to notify you if we experience a breach of unsecured protected health information.

We are required to abide by the terms of this Notice, but we reserve the right to make changes to our practices. Should we decide to make changes, we will notify you by the method you elect upon admission to your program. No changes to our practices will be effective until you have received notice unless the changes are mandated by state or Federal Law.

Complaints.

If you believe your rights have been violated, you may complain to us and, if you wish, to the United States Department of Health and Human Services. We can only help with problems we are aware of, so we encourage you to always let us know about any complaints you have about your health information privacy. You will never be retaliated against in any way for filing a complaint. For more information about our privacy practices, or for complaints you would like to share, please contact:

Privacy Officer

Utah Pathology Services, Inc.

5330 South 900 East #120

Salt Lake City, UT, 84117

801-266-0055

For filing complaints with the Department of Health and Human Services, please visit: