Privacy Statement

Tel: 305-471-4581     Fax: 305-471-4593  1-800-DORALMR
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.

Our Pledge Regaurding Health Information

Doral Medical Imaging uses and shares health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. We are committed to protecting health information about you. Your health information is contained in a medical record that is the physical property of Doral Medical Imaging.

Who Will Follow This Notice ?

This notice describes the practices of Doral Medical Imaging at all its locations and that of: o All employees, staff, volunteers and other members of the Doral Medical Imaging work force at all its locations.

How We May Use Your Health Information?

For Diagnostic Imaging. We may use your health information to provide, coordinate or manage your medical treatment or related services. Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your medical record and used to determine the course of treatment that will work best for you. For example, a doctor treating you for a broken hip may need to know if you have diabetes. The doctor may need to tell the dietician if you have diabetes so that we can arrange for appropriate meals. Different Doral Medical Imaging departments may also access your health information in order to coordinate services that you will need such as prescriptions, lab work and x-rays. For Payment. We may use and disclose your health information to bill and collect payment for treatment and services that you receive. For example, a bill may be sent to you or to your insurance company. The bill will contain information that identifies you, as well as your diagnosis, procedures and supplies used in the course of treatment. For Health Care Operations. We may use and disclose health information about you for hospital operations. For example, your health information may be disclosed to members of the medical staff, risk manager or quality improvement personnel, and others to:

Hospital Directory. We may include limited information about you in the hospital directory while you are a patient here. The directory information (name, location in the hospital and general condition as fair, stable, etc.) will only be released to people who ask for you by name. We will ask about your religious preference so that we understand if any of your beliefs affect the way care should be delivered while you are here. We will ask you if you would like to have clergy visits. If you agree, your religious affiliation will be included in the directory and will only be given to clergy of your own faith. Appointments/Follow-up Calls. We may use your information to contact you as a reminder that you have an appointment for treatment or to follow-up regarding medical care received at a Doral Medical Imaging facility. Individual Involved in Your Care. We may share information with an authorized representative, a family member or other person identified by you or who is involved in your care or payment related to your care. We may tell yourfamily or friends your condition. If you do not want information about you released to those involved in your care, see instructions for requesting a restriction under Your Health Information Rights.

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How We May Disclose Your Health Information Out Side Of Doral Medical Imaging Without Your Auothoriation?

Required by Law. We may disclose information about you when required to do so by federal, state or local laws. For example, we may disclose your health information to respond to a court order or to a court ordered subpoena. Public Health Risks. We may disclose information for the following public health activities:

Health Oversight Activities. We may disclose information to federal and state agencies for oversight activities authorized by law such as investigations, inspections, audits, surveys and licensing. Examples may include organizations that ensure the quality /safety of the care we provide and agencies that accredit our hospital. Health and Safety. We may disclose health information
about you to avert a serious threat to the health or safety of you, any other person or the public. For example, we may disclose health information to assist law enforcement officials in their duties to locate a suspect, fugitive or missing person. Deceased. Health information may be disclosed to funeral directors, medical examiners or coroners to enable them to carry out their lawful duties. Organ/Tissue Donation. If you are an organ donor, we may release health information to organizations that handle
organ procurement or organ, eye or tissue transplantation or to an organ donation bank. Research. We may disclose information for research purposes when the hospital's Institutional Review Board has reviewed and approved the research proposal. Medical record information that identifies you will only be used when you have given permission for us to do so. National Security. We may disclose your health information to federal officials for intelligence, counterintelligence, and national security activities authorized by law. Treatment Alternatives. We may use and disclose health information to tell you about or recommend possible treatment options or other health-related benefits and services that may be of interest to you. Inmates. We may disclose your health information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Workers' Compensation. Your health information may be used or disclosed in order to comply with laws and regulations related to Workers' Compensation or similar programs. These programs provide benefits for work-related injuries or illness.

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Your Health Information Rights

In accordance with federal regulations and Doral Medical Imaging policies and procedures, you have the right to:

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Doral Medical Imaging Obligations?

We are committed to:

Doral Medical Imaging reserves the right to change the terms of this notice and to make the new provisions effective for all protected health information it maintains. Revised notices will be made available to you by posting them in our facilities, posting them on our website at and upon your request, we will provide you with a copy of the most recent copy of our Notice of Privacy Practice. In the event that North Carolina law requires us to give more protection to your health information than required by Federal Law, we will give that additional protection to your health information.

Contact Information?

You may file a complaint to Doral Medical Imaging if you believe your privacy rights have been violated. You will not be penalized for filing a complaint. If you have any complaints or questions about information in this document, you may contact: Privacy Officer, Doral Medical Imaging at 8181 NW 36 St. Suite 3 Miami, Fl 33166call the Risk Management Department at 1-888-DoralMR.

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Informational Links

(Health Information Portability & Accountability Act)
(American Health Care Association)

(Centers For Medicare & Medicaid Services)

(American College Of Radiology)

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ã 2006 Doral Medical Imaging,
Doral Medical Imaging,Inc.
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