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.
Michigan Pediatric Surgery Associates, PC, (MPSA), understands that medical information about you and your health is personal and we are committed to protecting this information. We are required by law to maintain the privacy of your protected health information and to provide you with this Notice of Privacy Practices.
All personal and medical information collected by MPSA will be regarded as confidential and will not be used or released to any third party with the following exceptions:
MPSA will take reasonable precautions to ensure that confidential patient information is not accidentally or inadvertently disclosed, that medical records are maintained in a secure environment, that access to computerized information is restricted and electronic transmission of patient information is performed in a secure manner.
MPSA will not sell, trade or otherwise share listings of patient names, address or other confidential information, nor will it engage in any marketing, advertising or public relations activities which would involve the release of confidential medical or personal information, unless the patient has signed an authorization form specifically allowing us to do so.
MPSA physicians are engaged in the teaching of medical students, residents and fellows. These individuals are bound by the same privacy standards as the physicians and staff of Michigan Pediatric Surgery Associates.
MPSA may disclose your medical or demographic information to researchers when their research has been approved by an institutional review board and the board has determined that the research meets certain requirements for protection of this information.
MPSA also provides services to our patients through contracts with outside business associates, which would give them access to confidential patient information. Examples of such associates include answering services, computer vendors and transcription services. These associates are held to the same privacy standards as explained above.
You have the following rights regarding medical information we maintain about you:
Michigan Pediatric Surgery Associates reserves the right to revise this notice at any time. The new notice will apply to all confidential information we maintain at that time. The Notice of Privacy Practices in effect will be posted at the registration desk at each of our offices. You may request a copy at any time by asking the receptionist or contacting the Privacy Officer at 313-831-3220. If you believe your privacy rights have been violated, you may file a complaint with us by notifying the Privacy Officer. MPSA will not retaliate against you for filing a complaint.
All complaints must be submitted in writing:
Michigan Pediatric Surgery Associates, PC
You may also file a complaint with the Secretary of Health and Human Services.