HIPAA Notice of Privacy Practices for Personal Health Information Effective Date: August 23, 2010 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS TO THIS INFORMATION.PLEASE REVIEW IT CAREFULLY.
Dear Customer of Lipid Labz Inc DBA Florida Laboratory Services We are required to provide you with this Notice of Privacy Practices and to explain our legal duties under the Federal Health Insurance Portability and Accountability Act (HIPAA). By law, we are required to:maintain the privacy of your Personal Health Information (PHI)provide you this notice of our legal duties and privacy practices with respect to your PHI; and follow the terms of this notice.How We Collect Information: We obtain most PHI directly from the Individual. The Information that an Individual gives us when registering for a services generally provides the Information we need. An individual’s clinical information is forwarded directly to the individual and some form of record is either retained in secure hard copy file or with a laboratory’s archival record for 3 years . If we need to verify information or need additional Information, we may obtain information from third parties such as adult family members or employers. Information collected may relate to an individual’s demographics, employment, health, avocations or other personal characteristics which may assist us in evaluating the individual’s healthcare. In most cases we do not retain the dates and locations where service was provided.We protect your PHI from inappropriate use or disclosure. Our employees, and those of companies that help us service your health screening, are required to comply with our requirements that protect the confidentiality of your PHI. They may look at your PHI only when there is appropriate reason to do so, such as to administer the process of returning your health test results back to you.We will not knowingly disclose or sell your PHI to any other individual or organization for their use in marketing products to your without your prior consent.We will not forward by mail, fax or electronically your PHI to any healthcare provider without your prior written consent.We will not make available your test results to your employer or 3rd party carrier without your prior written consent.We May Use and Disclose PHI about You without Your Authorization unless you Object as described below, together with some examples.Appointments and Other Health Information. We may send you reminders for medical care or checkups. We may send you information about future health services that may be of interest to you as a health conscious individual. For example, we will make frequent mailings to you as a prior customer Research: We may use PHI about you for studies and to develop reports. These reports do not identify specific people. For example, we may want to determine how many individuals of a sex in an age range from a defined population have a cholesterol value over 240 mg/dl . Future Business: PHI may be disclosed as part of a potential merger or acquisition involving our business in order to make an informed decision regarding any such prospective transaction. Should a merger or acquisition take place, our database of names and addresses may be part of the process.Where Required by Law or for Public Health Activities: We may disclose PHI when required by federal, state or local law. Examples of such mandatory disclosures include notifying state or local health authorities regarding particular communicable diseases, or providing PHI to a government agency or regulator with health care oversight responsibilities. We may also release PHI to a coroner or medical examiner to assist in identifying a diseased individual or to determine the cause of death.For Payment. We may use or disclose PHI about you to get payment or to pay for health care services you receive. For example, we may provide PHI to bill your health plan for health care provided to you.To Avert a Serious Threat to Health or Safety: We may disclose PHI about you to law enforcement in order to avoid a serious threat to the health and safety of a person or the public.For Law Enforcement or Specific Government Functions: We may disclose PHI in response to a request by law enforcement official made through a court order, subpoena, warrant, summons or similar process. We may disclose PHI about you to federal officials for intelligence, counterintelligence, and other national security activities authorized by law.When Requested as Part of a Regulatory or Legal Proceeding: If you or your estate is involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the PHI requested. We may also disclose PHI to any governmental agency or regulator with whom you have filed a complaint or as part of a regulatory agency examination.Other Uses of PHI: Other uses and disclosures of PHI not covered by this notice and permitted by the laws that apply to us will be made only with your written authorization or that of your legal representative. If we are authorized to use or disclose PHI about you, you or your legally authorized representative may revoke that authorization, in writing, at any time. We cannot take back any uses or disclosures already made with your authorization.Disclosure to Family, Friends, and Others. We may disclose PHI about you to your family or other persons who are involved in your medical care.Directory. We may use PHI about you to assist visitors at our facilities to locate you or to inform clergy about you.Your PHI Privacy RightsRight to See and Get Copies of Your PHI. In most cases, you have the right to look at or get copies of your PHI. You must make the request in writing and include dates and location(s) of service.. You may be charged a fee for the cost of copying and mailing the PHI to you.Right to Request to Correct or Update Your PHI. You may ask us to change or add missing PHI if you think there is a mistake. You must make the request in writing and provide a reason for your request. However, there are conditions under which we may deny this request.Right to Get a List of Disclosures. You have the right to ask us for a list of disclosures made after August 23, 2010 and up to six years prior to the date you made the request. You must make the request in writing.Right to Request Limits on Uses or Disclosures of Your PHI. You have the right to ask us to limit how PHI about you is used or disclosed. You must make the request in writing and tell us what PHI you want to limit and to whom you want the limits to apply. In your request, you must you must tell us (1) dates and location(s) of service (2) what information you want to limit; (3) whether you want to limit our use, disclosure , or both; and (4) to whom you want the limits to apply (for example , disclosure to your spouse or parent). To make a request, you must make your request in writing to Privacy Coordinator, Lipid Labz Inc DBA Florida Laboratory Services, 7550 Mission Hills DR Ste 316, Naples, FL 34119. We will not agree to restrictions on PHI uses or disclosures that are legally required, or which are necessary to administer our business. While we will consider your request, we are not required to agree to it. If we do agree to it, we will comply with your request.Right to Revoke Permission. If you are asked to sign an authorization to use or disclose PHI about you, you can cancel that authorization at any time. You must make the request in writing. This will not affect PHI that has already been shared.Right To Choose How We Communicate With You. You have the right to ask us to share your PHI with you in a certain way or in a certain place. For example, you may ask us to send PHI about you to your work address instead of your home address. You must make this request in writing. You do not have to explain the basis for your request.Right to File a Complaint. You have the right to file a complaint if you do not agree with how we have used or disclosed PHI about you. All complaints must be submitted in writing. Your services will not be affected by any complaints you make. We cannot retaliate against you for filing a complaint or refusing to agree to something that you believe to be unlawful.Right to Get a Paper Copy of this Notice. You have the right to ask for a paper copy of this notice at any time.ADDITIONAL INFORMATION We reserve the right to change the terms of this Notice of Privacy Practices at any time. Any changes will apply to information we already have and any information we receive in the future. A copy of the new notice will be posted at and provided to individuals upon request as required by law. You may request a copy of the current notice at anytime.
You agree to abide by the purchase and refund policies of Lipid Labz Inc DBA Florida Laboratory Services. Refunds are only permitted prior to entering one of our affiliate Patient Service Centers for testing and or submission of urine or blood specimens. No refund after 5 days from receipt of payment. Once your order has been processed you may cancel your order prior to your blood draw with a refund equal to the price of the test less a $25 cancellation/ processing fee if canceled within five (5) days from date of order. There is No refund after five (5) days from date of order.
Lipid Labz Inc DBA Florida Laboratory Services is an online lab test purchasing service. By using this service, you agree to be bound by the following terms & conditions. Lipid Labz Inc DBA Florida Laboratory Services reserves the right to make changes to the terms & conditions at any time. Changes will be effective immediately upon posting of the modified terms & conditions. Permission to use this site is at the discretion of Lipid labz Inc DBA Florida Laboratory Services and may be terminated at any time for any reason.
1. You agree that you and the patient are over the age of 18.
2. You agree that the information you submit during the course of purchasing a lab test from Lipid Labz Inc DBA Florida Laboratory Services is truthful and accurate.
3. You agree not to copy any images, text, or structure from this website. You also agree not to use the website for illegal purposes.
4. You agree to use the site according to the instructions and intended use and not to disclose your password to any other users.
5. You agree to abide by the purchase and refund policies of Lipid Labz inc DBA Florida Laboratory Services. Refunds are only permitted prior to entering one of our affiliate Patient Service Centers for testing and or submission of urine or blood specimens. No refund after 5 days from receipt of payment.
6. You agree that a lab test purchased through Lipid Labz Inc DBA Florida Laboratory Services does not constitute medical advice and will not diagnose, treat, or cure any disease or condition. You also agree that the lab test results can be inaccurate through no fault of Florida Laboratory Services. You understand the service provided by Lipid Labz Inc DBA Florida Laboratory Services is a service provided at your request and not suggested by our staff physician. As an online service we do not have a traditional doctor-patient relationship and do not provide CPT codes, diagnosis codes or provider information in order to file insurance claims.
7. The materials on the site are provided "as is" without any express or implied warranty of any kind including warranties of merchantability, no infringement of intellectual property or fitness for a particular purpose. Lipid Labz Inc DBA Florida Laboratory Services offers no assurance of uninterrupted or error free service. Lipid Labz Inc DBA Florida Laboratory Services does not warrant the accuracy or completeness of the information, text, graphics, links or other items contained on the site. Any of the information offered on the site may change at any time without notice.
8. Information on this website is for informational purposes only. Lpid Labz Inc DBA Florida Laboratory Services makes no express or implied warranties, representations or endorsements whatsoever with regard to the services provided. Lipid Labz Inc DBA Florida Laboratory Services shall not be liable for any cost or damage arising either directly or indirectly from any transactions conducted or information conveyed on the website. It is solely your responsibility to evaluate the accuracy, completeness and usefulness of all opinions, advice, services, merchandise and other information provided through the Service.
9. Indemnification. You agree to indemnify, defend and hold harmless Lipid Labz Inc DBA Florida Laboratory Services, its officers, directors, employees, agents, licensors, suppliers and any third party information providers to the Service from and against all losses, expenses, damages and costs, including reasonable attorneys' fees, resulting from any violation of this Agreement by you.
10. HIV Testing Consent (only applies when ordering an HIV test)
The purpose of this form is to document that I or my physician have requested that a blood test for the Human Immunodeficiency Virus (HIV) be performed. The blood test(s) are used to detect HIV antibody or DNA. HIV is the cause of Acquired Immune Deficiency Syndrome (AIDS). I understand that the test is performed by drawing blood from the arm and processing the resulting blood specimen by either ELISA, Western Blot or other laboratory technology.
I have been informed that the tests can produce false positive and false negative results. For HIV, antibody testing, the ELISA screening test produces three false "positive" (indicating the presence of anti-HIV when it is not present) test results in every 10,000 specimens processed, regardless of population tested. Also, I have been informed that, if positive, the ELISA test will be repeated, and if still positive, a secondary level test (Western Blot) will then be performed. The combination of these two tests reduces the possibility of a false positive HIV antibody result to a very small fraction per 10,000 tests processed.
I have been informed that the ELISA screening test fails to detect anti-HIV for a period of time immediately after infection with the virus. I have been offered re-testing if it is suspected that this has occurred. The ELISA screening test may fail to detect anti-HIV in rare cases.
My physician has explained the following to me in language that I understand: the nature of the blood test, it's expected benefits, it's risks, and alternative tests.
The results of the HIV test will become part of my medical record. The confidentiality of my medical record will be maintained. However, I understand that my physician or other health care provider may ask to see the results for medical reasons. I understand that positive test results must be reported to the appropriate State Health Division. Confirmed HIV antibody test results will be made available beyond that only in summary or statistical form in such a way as to preserve my confidentiality.
I have read the previous information and I understand it. By checking the box on the order form, I acknowledge that I have been given all of the information that I have requested concerning the blood test(s) and the release of results.
I acknowledge that I have given my consent for the performance of an HIV blood test, and the release of the results as described above.