Memorial Abulatory Surgery Center, LLC

Tuesday - Friday: 6:00 AM - 5:00 PM

Privacy Practices

Memorial Ambulatory Surgery Center
Notice of Privacy Practices

Effective March 1, 2008 / Revised September 23, 2013

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.

At Memorial Ambulatory Surgery Center, LLC (MASC) we understand that medical information about you and your health is personal, and we are committed to protect that information.This Notice of Privacy Practices describes how we and the medical staff and personnel who provide you with care or services at this facility may use and disclose your Protected Health Information (“PHI”) to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law. It also describes your right to access and control your PHI, which is information about you, including demographic information that may identify you and that relates to your past, present or future physical or mental health or condition and related healthcare services. We are required by law to maintain the privacy of your PHI, to provide notice of our legal duties and privacy practices with respect to your PHI, to notify affected individuals following a breach of unsecured PHI, and to abide by the terms of this Notice of Privacy Practices.

We may change the terms of our notice at any time. The new notice will be effective for all PHI that we maintain at that time. Upon your request, you can receive any revised Notice of Privacy Practices by contacting the facility where you received services, or by contacting the Privacy Officer:

ddelacruz (at)

We may use or disclose your PHI as described in this section. The following are examples of the types of users and disclosures of your PHI that MASC is permitted to make without your specific authorization. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our facility. Where state or federal law restricts one of the described uses or disclosures, MASC will follow the requirements of such state or federal law. The following are general descriptions only They do not fall within one of the categories in this Notice of Privacy Practices.

We may use PHI about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students or other personnel who are involved in your care to, for example, plan a course of treatment for you. We also may disclose PHI about you to individuals outside of MASC who may be involved in your medical care, such as family members or others we use to provide services that are part of your care.

Your PHI will be used, as needed, to obtain payment for your healthcare services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we recommend for you, such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity and undertaking utilization review activities. For example, obtaining approval for a surgery may require that your relevant PHI be disclosed to your health plan.

Healthcare Operations:
We may use or disclose your PHI as needed to support our business activities. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, and conducting or arranging for other healthcare operations. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel and others to:

 Evaluate the performance of our staff.
  Assess the quality of care and outcomes in your care and similar cases.
  Learn how to improve our facilities and service. or
  Determine how to continually improve the quality and effectiveness of the healthcare we provide.

In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name. We may also call you by name in the waiting room when your healthcare provider is ready to see you. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment.

We will share your PHI with third party “business associates” that may perform various activities (e.g., billing or transcription services) for MASC. Whenever an arrangement between our facility and a business associate involves the use or disclosure of your PHI, we will require the business associate to appropriately safeguard it.