Privacy Policy

Notice of Privacy for Protected Health Information

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!

The office is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination, test results, diagnosis, treatment, and applying for future care or treatment. It also includes billing documents for those services.
A comprehensive copy of this information is available upon request.

Your Health Information Rights

The health and billing records we maintain are the physical property of the office. The information in it, however, belongs to you. You have a right to:
1. Request a restriction on certain uses and disclosures of your health information by delivering the request to our office.
2. Obtain a paper copy of the current Notice of Privacy Practices for Protected Health Information (“Notice”) by making a request at our office.
3. Request that you be allowed to inspect and copy your health record and billing record
4. Appeal a denial of access to your protected health information, except in certain circumstances.
5. Request that your health care record be amended to correct incomplete or incorrect information by making are quest at our office.
6. Request that communication of your health information be made by alternative means or at an alternative location by making the written request at our office.
7. Obtain an accounting of disclosures at your health information as required to be maintained by law by making a request at our office.
8. Revoke authorizations that you made previously to use or disclose information.

If your request is denied, you will be informed of the reason for the denial and will have an opportunity to submit a statement of disagreement to be maintained with our records.

Your Rights Regarding Electronic Health Information Technology

Central Care Cancer Center participates in electronic health information technology or HIT. This technology allows a provider or a health plan to make a single request through a health information organization or HIO to obtain electronic records for a specific patient from other HIT participants for purposes of treatment, payment, or health care operations. HIOs are required to use appropriate safeguards to prevent unauthorized uses and disclosures.
ve two options with respect to HIT. First, you may permit authorized individuals to access your electronic health information through an HIO. If you choose this option, you do not have to do anything.

Second, you may restrict access to all of your information through an HIO (except as required by law). If you wishto restrict access, you must submit the required information either online at or by completing and mailing a form. This form is available
at You cannot restrict access to certain information only; your choice is to permit or restrict access to all of your information.

If you have questions regarding HIT or HIOs, please visit for additional information.

If you receive health care services in a state other than Kansas, different rules may apply regarding restrictions on assess to your electronic health information. Please communicate directly with your out-of-state health care provider regarding those rules.

To Request Information of File a Complaint

If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact our administration office at 800-592-5110.

Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to the office assistant.  That employee will then forward your written complaint to the HIPAA compliance officer. You may also file a complaint by mailing or emailing it to the Secretary of Health and Human Services (HHS).

Please Note:
1. We cannot, and will not require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment.
2. We cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Services (HHS).

The office is required to:
1. Maintain the privacy of your health information as required by law.
2. Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain about you.
3. Abide by the terms of this notice.
4. Notify you if we cannot accommodate a requested restriction or request.
5. Accommodate your reasonable requests regarding methods to communicate health information with you.

We reserve the right to amend, change or eliminate provisions in our privacy practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend this notice. You are entitled to receive a revised copy of the notice by calling and requesting a copy of our “Notice” or by visiting our office and picking up a copy.

Other Disclosures and Uses

• Notification
• Communication with Family*
• Research*
• Disaster Relief*
• Organ Procurement Organizations*
• Food and Drug Administration (FDA)
• Public Health*
• Abuse and Neglect*
• Employers*
• Correctional Institutions*
• Law Enforcement*
• Health Oversight*
• Judicial/Administrative Proceedings*
• Serious Threat
• For Specialized Governmental Functions
• Coroners, Medical Examiners, and Funeral Directors

Note: (*) If an item has an asterisk, we will consult state law to avoid conflicts

Effective Date: 2/2018

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