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.

 

River City Medical Group – Notice of Privacy Practices
This Notice of Privacy Practices applies to the River City Medical Group, Inc. (“RCMG”), which is a health care provider, as that phrase is defined by the Health Insurance Portability and Accountability Act of 1996. RCMG is a California professional medical corporation that reimburses medical groups, clinics, pharmacies and other health care providers for health care services provided under the terms of RCMG’s contracts with health care plans and other payers. RCMG performs certain services in connection with these health care services, including performing utilization review and quality assurance activities and oversight, eligibility verification, provider credentialing and other management services. This Notice applies to information and records regarding your health care maintained by RCMG.

Our pledge regarding your medical information
River City Medical Group is committed to protecting medical information about you. We create and receive a record of the care and services you receive through the RCMG provider network for use in your care and treatment and our management activities relating to such services. This Notice tells you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of your medical information.

We are required by law to:

  • Make sure that your medical information is protected;
  • Give you this Notice describing our legal duties and privacy practices with respect to medical information about you
  • Follow the terms of the Notice that is currently in effect.

How we may use and disclose medical information about you
The following sections describe different ways that we may use and disclose your medical information. For each category of uses or disclosures we will describe them and give some examples. Some information, such as certain drug and alcohol information, HIV information and mental health information, is entitled to special restrictions related to its use and disclosure.

RCMG abides by all applicable state and federal laws related to the protection of this information. Not every use or disclosure will be listed. All of the ways we are permitted to use and disclose information, however, will fall within one of the following categories.

For treatment
We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, students or other health system personnel who are involved in taking care of you in the health system. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. We may also share medical information about you with other RCMG personnel or non-RCMG providers, agencies or facilities in order to provide or coordinate the different things you need, such as prescriptions, lab work and x-rays.

Uses and Disclosures for Payment
We will make uses and disclosures of your personal health information as necessary for the payment purposes of those health professionals and facilities that have treated you or provided services to you. For instance, we may forward information regarding your medical procedures and treatment to your insurance company to arrange payment for the services you receive. We may also use your information to prepare a bill to send to you or to the person responsible for your payment. In addition, we may provide access to your personal health information to your personal physician and physicians in the Emergency, Pathology, Radiology and Anesthesiology Departments to facilitate their billing for any services they provide to you at the Hospital. If you designate a guarantor of payment, that individual may request billing information which may contain personal health information.

For health-care operations
We may use and disclose medical information about you for RCMG operations. We will use and disclose your personal health information as necessary, and as permitted by law, for our health care operations. These operations include clinical improvement, professional peer review, business management, accreditation and licensing, etc. For instance, we may use and disclose your personal health information to accreditation survey team members who are involved with us through a Business Associate agreement. We may also disclose your personal health information to another health care facility, health care professional, or health plan for such things as quality assurance and case management, but only if that facility, professional, or plan also has or had a patient relationship with you.

Appointment reminders
We may contact you to remind you that you have an appointment with an RCMG provider.

Treatment alternatives
We may tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-related benefits and services
We may contact you about benefits or services that we provide.

Fund-raising activities
We may contact you to provide information about RCMG-sponsored activities, including fund-raising programs and events. We would only use contact information, such as your name, address, phone number and the dates you received treatment or services at RCMG.

News-gathering activities
We or a member of your health-care team may contact you or one of your family members to discuss whether or not you want to participate in a media or news story. News reporters often seek interviews with patients injured in accidents or experiencing particular medical conditions or procedures. For example, a reporter working on a story about changes in the health care system may ask whether any of the patients might be willing to be interviewed.

Individuals involved in your care or payment for your care
We may release medical information to anyone involved in your medical care, e.g., a friend, family member, personal representative or any individual you identify. We may also give information to someone who helps pay for your care. We may also tell your family or friends about your general condition and that you are in the hospital.

Disaster-relief efforts
We may disclose medical information about you to an entity assisting in a disaster-relief effort so that your family can be notified about your condition, status and location.

Research
Your medical information may be important to further research efforts and the development of new knowledge. We may use and disclose medical information about our patients for research purposes, subject to the confidentiality provisions of federal and state law.

On occasion, researchers contact patients regarding their interest in participating in certain research studies. Enrollment in those studies can only occur after you have been informed about the study, had an opportunity to ask questions and indicated your willingness to participate by signing a consent form. When approved through a special review process, other studies may be performed using your medical information without requiring your consent. For example, a research study may involve a chart review to compare the outcomes of patients who received different types of treatment.. These studies will not affect your treatment or welfare, and your medical information will continue to be protected.

As required by law
We will disclose medical information about you when required to do so by federal or state law.

To avert a serious threat to health or safety
We may use and disclose medical information about you when necessary to prevent or lessen a serious and imminent threat to your health and safety or the health and safety of the public or another person. Any disclosure would be to someone able to help stop or reduce the threat.

Organ and tissue donation
If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ-donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Military and veterans
If you are or were a member of the armed forces, we may release medical information about you to military command authorities as authorized or required by law. We may also release medical information about foreign military personnel to the appropriate military authority as authorized or required by law.

Workers’ compensation
We may use or disclose medical information about you for workers’ compensation or similar programs as authorized or required by law. These programs provide benefits for work-related injuries or illness.

Public-health disclosures
We may disclose medical information about you for public-health purposes. These purposes generally include the following:

  • Preventing or controlling disease (such as cancer and tuberculosis), injury or disability
  • Reporting vital events such as births and deaths
  • Reporting child abuse or neglect
  • Reporting adverse events or surveillance related to food, medications or defects or problems with products
  • Notifying persons of recalls, repairs or replacements of products they may be using
  • Notifying a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease or condition
  • Reporting to the employer findings concerning a work-related illness or injury or workplace-related medical surveillance
  • Notifying the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence and make this disclosure as authorized or required by law.

Health-oversight activities
We may disclose medical information to governmental, licensing, auditing and accrediting agencies as authorized or required by law.

Legal proceedings
We may disclose medical information to courts, attorneys and court employees in the course of conservatorship and certain other judicial or administrative proceedings.

Lawsuits and other legal actions
In connection with lawsuits or other legal proceedings, we may disclose medical information about you in response to a court or administrative order, or in response to a subpoena, discovery request, warrant, summons or other lawful process.

Law enforcement
If asked to do so by law enforcement, and as authorized or required by law, we may release medical information:

  • To identify or locate a suspect, fugitive, material witness or missing person
  • About a suspected victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement
  • About a death suspected to be the result of criminal conduct
  • About criminal conduct at River City Medical Group or one of its affiliates
  • In case of a medical emergency, to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

Coroners, medical examiners and funeral directors
In most circumstances, we may disclose medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine cause of death. We may also disclose medical information about patients of RCMG providers to funeral directors as necessary to carry out their duties.

National-security and intelligence activities
As authorized or required by law, we may disclose medical information about you to authorized federal officials for intelligence, counterintelligence and other national-security activities.

Protective services for the president and others
As authorized or required by law, we may disclose medical information about you to authorized federal officials so they may conduct special investigations or provide protection to the president, other authorized persons or foreign heads of state.

Inmates
If you are an inmate of a correctional institution or under the custody of law enforcement officials, we may release medical information about you to the correctional institution as authorized or required by law.

Your rights regarding medical information about you
Your medical information is the property of RCMG. You have the following rights, however, regarding medical information we maintain about you:

Right to inspect and copy
With certain exceptions, you have the right to inspect and/or receive a copy of your medical information. To inspect and/or to receive a copy of your medical information, you must submit your request in writing to:

River City Medical Group
Attn: Privacy Officer
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

If you request a copy of the information, there is a fee for these services. We may deny your request to inspect and/or to receive a copy in certain limited circumstances. If you are denied access to medical information, in most cases, you may have the denial reviewed. Another licensed health-care professional chosen by RCMG will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to request an amendment or addendum
If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information or add an addendum (addition to the record). You have the right to request an amendment or addendum for as long as the information is kept by or for River City Medical Group.

Amendment
To request an amendment, your request must be made in writing and submitted to:

River City Medical Group
Attn: Privacy Officer
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

  • Was not created by River City Medical Group
  • Is not part of the medical information kept by or for RCMG
  • Is not part of the information which you would be permitted to inspect and copy
  • Is accurate and complete in the record.

Addendum
To submit an addendum, the addendum must be made in writing and submitted to:

River City Medical Group
Attn: COO
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

An addendum must not be longer than 250 words per alleged incomplete or incorrect item in your record.

Right to an accounting of disclosures
You have the right to receive a list of the disclosures we have made of your medical information. To request this accounting of disclosures, you must submit your request in writing to:

River City Medical Group
Attn: Privacy Officer
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

Your request must state a time period that may not be longer than the six previous years. You are entitled to one accounting within any 12-month period at no cost. If you request a second accounting within that 12-month period, there will be a charge for the cost of compiling the accounting. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to request restrictions
You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information to a family member about a surgery you had. To request a restriction, you must make your request in writing to:

River City Medical Group
Attn: Privacy Officer
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, only to you and your spouse. We are not required to agree to your request. If we do agree, our agreement must be in writing, and we will comply with your request unless the information is needed to provide you emergency treatment.

Right to request confidential communications.
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you only at home or only by mail. To request confidential communications, you must make your request in writing to:

River City Medical Group
Attn: Privacy Officer
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a paper copy of this Notice.
You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice. Copies of this Notice shall be available at RCMG’s Offices, through our Web site, or by calling our Customer Service department at (916) 228-4300.

Changes to River City Medical Group’s Privacy Practices and This Notice
We reserve the right to change River City Medical Group’s privacy practices and this Notice. We reserve the right 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. At any time you may request a copy of the current Notice in effect.

Other uses of medical information
Other uses and disclosures of medical information not covered by this Notice 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. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written permission. We are unable to take back any disclosures we have already made with your permission, and we will retain our records of the care provided to you as required by law.

Questions or complaints
If you have any questions about this Notice, please contact:

River City Medical Group
Attn: Privacy Officer
7311 Greenhaven Drive, Suite 145
Sacramento, CA 95831

Telephone number (916) 228-4300.

If you believe your privacy rights have been violated, you may file a complaint with RCMG or with the Secretary of the Department of Health and Human Services. To file a written complaint with RCMG, contact Privacy Officer, River City Medical Group, 7311 Greenhaven Drive Suite 145, Sacramento, CA 95831, telephone number (916) 228-4300. You will not be penalized for filing a complaint.

Member and Patient Rights
RCMG will not require any member or patient to waive rights to which they are entitled under any applicable Privacy Laws as a condition of receiving medical treatment or payment.

No Intimidation of Retaliation
River City Medical Group will not intimidate, threaten, coerce, discriminate, retaliate, or withhold treatment any individual or entity from exercising any rights under this Privacy Policy or any associated Privacy Laws, including submitting complaints, filing reports, etc. Any retaliation or suspected retaliation against any person or entity, observed misconduct, non-compliance, or ethical concern can be reported to compliance@rcmg.com or by calling (916) 228-4318.