We are excited
to offer this service to SMA patients. The Portable Medical
Record (PMR) will be provided to patients on a mini-CD upon request. In
order to receive the PMR CD, you must have executed the Authorization to Release
records on the CD. A copy of your advance directive is not required
to be on file with SMA, but please provide this important document if at all
possible. The executed advance directive will then be available to a
physician through the PMR CD along with vital medical information. Both of
these documents can be downloaded by clicking on the two download links
below:
Advance Directive
PMR-CD Authorization Form
There is no charge for this
service! You can get more information on this new program from any SMA
health care center, or by calling (702) 877-5020 during normal business hours.
Your rights to managing
your medical records
The Health Information Management (HIM)
Department at SMA provides a full range of medical record services to its
patients. You may request a variety of services from us by contacting us
at one of the numbers below. In addition to the major services described
below, we are happy to answer your questions about any of the following rights
you have regarding your protected health information (PHI).
You have the following rights regarding
PHI we maintain about you:
Your right to inspect and
copy
You have the right to inspect and
receive a copy of your PHI that may be used to make decisions about you. A
service fee of 60 cents per page may be charged as allowed by law.
Your right to
amend
If you feel that the PHI we have
contains errors or is incomplete, you may ask us to amend the information.
You have the right to request an amendment for as long as the information is
kept by or for us. Your request must be made in writing and submitted to
the Health Information Management Department at the address listed below.
We may deny your request if the information:
- you ask us to amend is not part of
your PHI that we maintain;
- was not created by us, unless the
person or entity that created the information is no longer available to make
the amendment;
- is not part of the information that
you are permitted to inspect or copy; or
- is accurate and complete.
You will be provided with a copy of the
final determination.
Your right to
an accounting of disclosures
You have the right to request an
“accounting of disclosures” listing any disclosure of your PHI made for any
purpose other than treatment, payment, health care operations or other purposes
designated under the Federal Privacy Law. We have 60 days to respond to
your written request for an accounting of disclosures; we may take an additional
30 days in certain circumstances, in which case you will be notified of the
delay before the 60 days has elapsed. To request an accounting of
disclosures, you must make your request in writing to the Health Information
Management Department at the address listed below.
Your right to
request restrictions
You have the right to request a
restriction or limitation on the PHI we use or disclose about you for treatment,
payment or health care operations. You also have the right to request a
limit on the PHI we disclose about you to someone who is involved in your care
or the payment for your care, like a family member or friend. For example,
you could ask that we not use or disclose information about a surgery you
had. As with amendment requests, SMA is not required to agree to your
request, but we will attempt to comply if possible.
The HIM staff can also help you to
process one of the forms that you can download below.
Your right to request
confidential communications
You have the right to request that our
communications with you involving your PHI be carried out in a certain way or at
a certain location. For example, you may ask that we contact you only at
work.
Release of
information
Per NRS 629.061, there may be a charge
of up to 60 cents per page. For information or assistance regarding your
request for SMA medical records, please call (702) 877-8636.
Our
staff is happy to assist you with any questions you may have regarding our
release of information services, where we are located and what the turnaround
time is to process your request.
We can also assist you in obtaining
prior medical records from a non-SMA provider in order to give
SMA your complete medical history. Note that the contact number for
assistance with requesting your medical records is (702)
877-5041.
Positive identification is required in
order for Release of Information requests to be processed. The completed
form should be presented to the Medical Records service desk at the following
address:
Health Information Management
Release of Information
2300 W. Charleston Blvd., Ste.
162
Las Vegas , NV 89102
Request forms for
download:
SMA Release of
Information Request Form
English: Click here.
Spanish: Click here.
Please allow 7-10 days to fulfill a
release of information request.
Non-SMA Provider Release of Information Request Form
Request to obtain your medical records
from another provider
English/Spanish: Click here.
Amendment Form:
To request changes/corrections to your
medical records, click here.
Quick links to other
information of possible interest:
Nevada
State Vital Records: Click here.
Nevada
State Regulations: Click here.
My SMA Health OnlineSM
: Click here.
How to reach us:
Mailing Address:
Attn: Health Information
Management
PO Box 15645
Las Vegas,
NV 89114-5645
Phone: (702) 877-5111
Fax: (702) 258-2656
Hours of Operation: Monday through
Friday, 8:00 a.m. - 5:00 p.m.
Notice of
Privacy Practices
We understand that your PHI is personal.
That’s why we’re committed to protecting that information.
Click here to find out
more!
