Notice Of Privacy Practices Statement

This notice explains how Arkana Laboratories may use and disclose medical information about you, your rights in relation to that information, how you may access your PHI, and Arkana Laboratories’ obligation concerning the use and disclosure of PHI.

Arkana’s Privacy Commitment

Arkana Laboratories is dedicated to protecting the privacy of your protected health information (PHI) in the manner described in this statement. We are permitted by law to create and disclose information regarding you in the course of your treatment or our business activities. With few exceptions, we are required by law to maintain the confidentiality of information that may be used to identify you. The law also requires us to provide you with this notice of our legal duties and the privacy practices that we undertake at Arkana Laboratories to protect your PHI. By federal and state law, we are required to abide by the terms of the Notice of Privacy Practice’s in place at the time. From time to time this notice may be revised or amended. In the event of a revision or amendment, any change will take effect for all past and future records created or maintained by Arkana Laboratories. The most current version of this notice will be available on our website, or you may request a copy of the most current version at:

ARKANA LABORATORIES MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION (PHI) IN THE FOLLOWING WAYS:

For Treatment. Arkana Laboratories may use your PHI to diagnose and treat you. Many of the people who work for our practice may use or disclose your PHI in order to treat you or to assist others, including other health care providers, in your treatment. Finally, we may disclose your PHI to others identified by you who may assist in your care, such as your spouse, children or parents, unless such disclosure is prohibited by law.

For Payment. Arkana Laboratories may use and disclose your PHI in order to bill you or a third party to collect payment for your healthcare services. This may include providing information regarding your treatment to your insurer to verify if your treatment will be covered. We may use and disclose your PHI to obtain payment from third parties, including other healthcare providers or entities that may be responsible for such costs. Finally, we may disclose your PHI to other health care providers and entities involved in your care to assist in their billing and collection efforts.

For Health Care Operations. Arkana Laboratories may use and disclose your PHI to facilitate routine operate of our business. Routine operation includes, but is not limited to, internal training and education activities, administration, quality assurance activities, and strategic planning. We may disclose your PHI to outside entities that assist us in routine business functions such as accounting and legal services. Additionally, we may disclose information to other health care providers and entities involved in your care to assist in their health care operations.

When Required By Law. Arkana Laboratories will use and disclose your PHI when we are required to do so by federal, state or local law.

For Judicial Proceedings. Arkana Laboratories may use and disclose your PHI if ordered to do so by a court or administrative order.

For Research. Arkana Laboratories may use and disclose your PHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your PHI for research purposes except when an Internal Review Board or Privacy Board has approved a waiver of authorization for disclosure. Any research project issued a waiver must still take steps to protect the confidentiality of PHI.

To Law Enforcement. We may release PHI to law enforcement officials as required by law or to comply with the terms of a search warrant, subpoena, or court order. Additionally we may disclose PHI to assist law enforcement in identifying or locating an individual, to prosecute a violent crime, to report deaths that may have been the result of criminal activity, and to report criminal activity at Arkana Laboratories.

For Public Health Risks. Arkana Laboratories may disclose your PHI to public health authorities authorized by law to collect information to prevent or lessen a serious and/or imminent threat to an individual’s or the general public’s health or safety.

For Health Oversight Activities. Arkana Laboratories may disclose your PHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

To Medical Examiners, Coroners and Funeral Directors. Arkana Laboratories may release PHI to a medical examiner, coroner, or funeral director if necessary in order for them to perform their jobs.

For Organ and Tissue Donation. Arkana Laboratories may release your PHI to organizations that handle organ or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor.

Serious Threats to Health or Safety. Arkana Laboratories may use and disclose your PHI to appropriate authorities when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the general public.

For Military, National Security and Government Purposes. Arkana Laboratories may disclose your PHI if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military authorities. We may also disclose information to federal officials for national security, intelligence, or for Presidential Protective Services.

Inmates. Arkana Laboratories may disclose your PHI to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals.

Workers’ Compensation. Arkana Laboratories may release your PHI for workers’ compensation and similar programs.

YOUR RIGHTS REGARDING YOUR PHI

By law you have the following rights regarding PHI that we maintain about you:

Right to Inspect and Copy Records. You have the right to inspect and obtain a copy of the PHI maintained by our practice, including patient medical records and billing records. You must submit your request in writing in order to inspect and/or obtain a copy of your PHI. Arkana Laboratories may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. All inspection of PHI will be conducted during normal business hours. By law, Arkana Laboratories may deny your request to inspect and/or copy in certain limited circumstances.

Right to Provide an Authorization for Other Uses and Disclosures. Arkana Laboratories will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your PHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your PHI for the purposes described in the authorization.

Right to Confidential Communications. You have the right to request that Arkana Laboratories communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request specifying the requested method of contact, or the location where you wish to be contacted. Arkana Laboratories will honor all reasonable requests.

Right to Request Restrictions. You have the right to request a restriction in our use or disclosure of your PHI for treatment, payment or health care operations. In order to claim a restriction you must pay for all services, in full, at or before the time of service. We are not required to agree to your request; however, we will consider all requests. If we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. To request a restriction in our use or disclosure of your PHI, you must submit your request in writing. Your request must describe in detail:

what information you wish restricted; whether you are requesting to limit Arkana Laboratories use, disclosure or both; and to whom you want the limits to apply.

Right to Request Amendments. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for Arkana Laboratories. To request an amendment, your request must be made in writing and be accompanied with a reason that supports your request for amendment. Arkana Laboratories will review your request but is not obligated to comply if the records are felt to be accurate or if Arkana Laboratories was not the creator of the record.

Right to an Accounting of Disclosures. You have the right to request a list of disclosures made for purposes other than treatment, payment, or business operations. In order to obtain an accounting of disclosures, you must submit your request in writing. All requests must state a time period, which may not be longer than six (6) years prior to the date of request and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but you may be charged you for additional lists within the same 12-month period. Arkana Laboratories will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with Arkana Laboratories compliance officer or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact us.

Again, if you have any questions regarding this notice, privacy policies, or to make a request or complaint, please contact:

Arkana Laboratories Compliance Officer
10810 Executive Center Drive, Suite 100
Little Rock, AR 72211
501.604.2695