Patient Privacy
Midwest Therapeutic Endoscopy Consultants
Notice of Privacy Practices
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.

Who we are:
This notice describes the privacy practices of Midwest Therapeutic Endoscopy Consultants and our employees. This notice applies to all of the medical records generated by any Midwest Therapeutic Endoscopy Consultants (MTEC) locations.

Our Privacy Obligation
We are required by law to maintain the privacy of your health information and provide you with a description of our privacy practices. When we use or disclose health information we are required to abide by the terms of this Notice or other Notice in effect at the time of the use or disclosure. Individuals will be notified of reportable breaches of privacy and security.

Electronic Health Records
Midwest Therapeutic Endoscopy Consultants uses an electronic health record (EHR) to store and retrieve much of your health information. One of the advantages of Midwest Therapeutic Endoscopy Consultants’ EHR is the ability to share and exchange health information among personnel and other community health care providers who are involved in your care. When MTEC enters your information into the HER, it may share that information by using shared clinical databases of health information exchanges. MTEC may also receive information about you from other health care providers in the community who are involved with your care by using shared databases or health information exchanges. If you have any questions or concerns about the sharing or exchange of your information, please discuss them with your provider.

Uses and Disclosures with your Consent or Authorization
Use and Disclosure with your consent: Before we provide medical care, except in an emergency or other special circumstance, we will ask you to read and sign a written consent authorizing us to use and disclose your health information for the following purposes:
To provide treatment
To obtain payment for services
To support health care operations such as quality improvement and customer service as described below:

Treatment. We may use your medical information to provide treatment or other services. We may disclose your medical information to health care professionals who are involved in your care in order to coordinate prescriptions, lab work, and radiology.
Payment. We may use and disclose medical information about you for billing purposes. For example, we may need to give your insurance company information about your procedure. We may also tell your health plan about the treatment you are going to receive to determine whether your plan will cover it or if precertification is needed.

Health Care Operations:
We may use and disclose your medical information for health care system operations. For example, members of the medical staff may use information in your heath record to assess the care and outcomes in your case and others like it. The results will then be used to support our ongoing efforts to continually improve our quality of care. We may also use medical information about patients to evaluate the need for new services. We may disclose information to doctors, nurses, and students for educational purposes. And we may combine patient medical information with that of other hospitals to see where we can make improvements. To protect your privacy, we may remove information that identifies you from this information. Use or Disclosure with your Authorization As described above, Your Consent only permits us to use your health information to treat you, receive payment for services, and for health care operations. We may use or disclose your health information for any reason other than these only when (1) you authorize us to use or disclose this information by signing an Authorization Form or (2) there is an exception described in the section below. Psychotherapy notes, PHI (Protected Health Information) for marketing purposes and PHI in instances constituting the sale of PHI require written authorization from the patient. Any uses and disclosures not addressed within the NPP require a written authorization from the patient. You may revoke any authorization granted for uses and disclosures upon written revocation. In the event of a breach of unsecured PHI the patient will receive notification of such breach of his or her unsecured PHI.

Uses and Disclosures Without your Consent or your Authorization
At MTEC we may use or disclose your health information without your consent or your authorization under the following circumstances: (1) when you require emergency treatment (2) when we are required by law to disclose your health information and (3) when we attempt to obtain Your Consent but are unable to do so because you are unconscious or otherwise incapacitated and we reasonable infer that you would have consented without these barriers to communication.

Disclosures to Individuals Involved in Your Care or Payment for Your Care
We may release relevant Health information about you to a friend or family member who is involved in your medical care or helps pay for your care.

Public Health Activities. We may disclose health information for the following public health activities and purposes: (1) to report health information to public health authorities for the purposes of preventing or controlling disease, injury, or disability, as required by law and public health concerns; (2) to report suspected abuse, neglect, or exploitation of children or vulnerable adults to public health authorities or other government authorities authorized by law to receive such reports (3) to report information about products under the jurisdiction of the U.S. Food and Drub Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk for contracting or spreading a disease or condition; and (5) to report information to your employer as required by law.

Health Oversight Activities. We may disclose your health information to a health oversight agency that ensures that MTEC is complying with the rules of government programs such as Medicare and Medicaid.

Judicial and Administrative Proceedings. We may disclose your health information in the course of a judicial or administrative proceeding if we receive a legal order or other lawful process requiring us to disclose your health information.

Law Enforcement Officials. We may disclose your health information to law enforcement officials as required by law or in compliance with a court order. We may also disclose limited health information to police or law enforcement officials for identification and location purposes and to assist in criminal investigations.

Health or Safety. We may disclose your health information if we reasonable believe that disclosure would prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety.

Medical Examiner. We may disclose your health information to a medical examiner as authorized by law.

Organ and Tissue Procurement. We may disclose your health information to organizations that facilitate organ, eye or tissue procurement, banking, or transplantation.

Research. We may use or disclose your health information without your consent or authorization to researchers when an institutional review board has approved a waiver of authorization for disclosure and the researcher has established protocols to ensure the privacy of your health information.

Workers Compensation. We may disclose your health information as necessary to comply with Missouri Workers Compensation Statue.

Organized Health Care Arrangement. MTEC and its medical staff members present this document to you as a joint notice. Physicians and other caregivers may have access to your health information in their facilities to assist in reviewing past treatments as it may affect present and future treatment plans.

Your Individual Rights.

For Further Information : Complaints. If you want further information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we have made about your health information, you may contact MTEC’s Privacy Officer by calling MTEC at 314-628-9000. Requests or complaints may also be submitted in writing to MTEC, 12855 N. Forty Drive, Suite 175, Saint Louis, MO 63141. We will not retaliate against you if you file a complaint with us.
Right to Request Additional Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you. 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 about your surgical procedure. If you with to request a restriction or limitation, you should discuss your request with the provider who is responsible for coordinating or managing your care. While we consider all requests for restrictions carefully, we are not required to agree to your request. If we do agree, we will comply with your request, unless the information is needed to provide you with emergency treatment. Individuals may request no information be shared with insurer if paid in full out of pocket.
Right to Receive 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 at work or by U.S. Mail. If you with to receive confidential communications you should discuss your request with MTEC registration staff. We will consider all requests for confidential communications carefully and will honor reasonable requests.
Right to Inspect and Copy Your Health Information. You have the right to obtain a copy of your medical information. Usually this includes medical and billing records, but does not include psychotherapy notes. Under very limited circumstances, we may deny you access to your medical record file. If you are denied access to your medical information, you may request that the denial be reviewed. A licensed health care professional chosen by MTEC will review your medical record file. This person will not be the person who denied your request. We will comply with the decision of the reviewer. If you request a copy or copies of your record, you will be charged a fee for each copy. You have a right to receive an electronic copy of PHI upon written request and agreement that patient understands that any records sent via email are sent using the public domain and are not encrypted by Midwest Therapeutic Endoscopy Consultants.
Right to Amend Your Records. If you feel that your medical information is incorrect or incomplete you may ask us to amend the information. While we will review each amendment request carefully, MTEC may deny your request if we believe that the information that you would like to amend is accurate and complete, or other circumstances apply. If your request for an amendment is denied, you will be notified of the reason for the denial.
Right to Receive a Paper Copy of This Notice. Upon request you may obtain a paper copy of this Notice even if you agreed to receive the Notice electronically.
Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures. This is a list of disclosures we make of your medical information for purposes other that treatment, payment, or health care operations.
Effective Date and Duration of this Notice. This Notice describes the privacy policy of MTEC that became effective on Sept 1, 2013.
Right to change terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new terms effective for any information created or received prior to issuing the new notice. We will post the new Notice in waiting areas or registration areas at all MTEC locations and on our Internet site at You may also obtain a new notice by contacting MTEC’s Office Manager.

Revision date: 09/20/2013