MDL Medical Diagnostic Laboratory, Inc.



			NOTICE OF PRIVACY PRACTICES Medical Diagnostic Laboratory, Inc. Effective April 14, 2003 This notice describes how medical information about you that is maintained by Medical Diagnostic Laboratory, Inc. or any of its member facilities may be used and disclosed and how you can get access to this information. If you have any questions about this notice, please contact the Medical Diagnostic Laboratory, Inc. Privacy Officer at (618) 233-0522 WHO WILL FOLLOW THIS NOTICE: This notice describes Medical Diagnostic Laboratory, Inc. (MDL) offices, which create and maintain medical information, any health care professional authorized to enter information into your health record, all MDL sites and units of MDL, all employees, staff and other MDL personnel. In addition, these offices and locations, may share medical information with each other for treatment, payment or MDL operations purposes described in this notice. OUR PLEDGE REGARDING MEDICAL INFORMATION: We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the test results and services you receive at a Medical Diagnostic Laboratory office. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Medical Diagnostic Laboratory, Inc. whether made by Medical Diagnostic Laboratory, Inc. personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic. In all cases where we may share your medical information with others, it is only the minimum necessary amount of information required to satisfy the need or request. HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU: The following categories are examples of ways that we may use and disclose medical information. Not every potential use or disclosure will be listed. However, all of the ways that we are permitted to use and disclose information will fall within one of these categories: Treatment (e.g. lab test results to your ordering physician), Payment (e.g. third party payers and other organizations in order to satisfy payment for services), Health Care Operations of MDL (e.g. College of American Pathologists, and other organizations in order to operate the laboratory), Appointment Reminders, Treatment Alternatives, Health-Related Benefits and Services, Individuals Involved in Your Care or Payment for Your Care, Required By Law, To Avert a Serious Threat to Health or Safety. Special situations include Organ and Tissue Donation, Military and Veterans, Workers' Compensation, Public Health Risks (e.g. to prevent or control disease, to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition); Health Regulatory Oversight Activities, Lawsuits and Disputes, Law Enforcement (in response to a court order, subpoena, etc.), Coroners, Medical Examiners and Funeral Directors, National Security and Intelligence Activities, Protective Services for the President and Others. YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU: You have rights regarding medical information we maintain about you, such as the Right to Inspect and Copy, Right to Amend or Add, Right to an Accounting of Disclosures, Right to Request Restrictions, Right to Request Confidential Communications, Right to a Paper Copy of This Notice. We are not required to agree to your request(s). We reserve the right to charge a reasonable fee for copies and for such accountings (the first request for accounting within a 12 month period is free). CHANGES TO THIS NOTICE: We reserve the right to change this notice and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice at each Medical Diagnostic Laboratory, Inc. facility. The notice will contain the effective date on the first page in the top right hand corner. COMPLAINTS: If you believe your privacy rights have been violated, you may file a complaint with the Medical Diagnostic Laboratory, Inc. Privacy Officer at 45 Sheffield Drive, Belleville, IL 62223, (618) 233-0522 or with the Secretary of the Department of Health and Human Services, Office of Civil Rights. OTHER USES OF MEDICAL INFORMATION: Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

MDL Diagnostic Laboratory, Inc.

45 Sheffield Drive Belleville, Illinois 62223	p. 618.233.0522 f. 618.233.8335	contact@mdl-lab.com	site map privacy policy launch power web
toll free restricted. 1.800.593.0522 (St. Louis Metro & Southern Illinois)