Notice Of Privacy Practices

Cancer Center of Kansas, P.A. (CCK)

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.

If you have any questions about this Notice of Privacy Practices, please contact our Privacy Officer at 316-262-4467.  

For a PDF copy, please scroll to the bottom of this page.

Why we are providing this notice:

CCK compiles information relating to you and the treatment and services you receive. This information is called protected health information (PHI) and is maintained in a designated record set. We may use and disclose this information in various ways. Sometimes your agreement or authorization is necessary for us to use or disclose your information and sometimes it is not. This Notice describes how we use and disclose your protected health information and your rights. We are required by law to give you this Notice, and we are required to follow it. We may change this Notice at any time if the law changes or when our policies change. If we change the Notice you will be given a revised Notice. You may also access this Notice at our website:

Your Rights:

Get or send an electronic or paper copy of your medical record:
  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.   You can also ask to have an electronic or paper copy of your medical record or other health information be sent to a third party if you provide the name of such party and where to send it in writing.
  • To exercise these rights, ask us and we will provide you with the appropriate form to be completed in order to gather the requested information.
  • We will fulfill your request in a timely manner, within 30 days of receiving your request unless we notify you in writing of the need or reason for a delay.   We may charge a reasonable, cost-based fee.
Ask us to correct your medical record:
  • You can ask us to correct health information about you that you think is incorrect or incomplete.   Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications:
  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.
Ask us to limit what we use or share:
  • You can ask us not to use or share certain health information for treatment, payment, or our operations.  We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
  • We will say “yes” unless a law requires us to share that information.
  • To exercise this right ask us and we will provide you with the appropriate form to be completed in order to complete your request.
Get a list of those with whom we’ve shared information:
  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).  We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
  • To exercise this right ask us and we will provide you with the appropriate form to be completed in order to gather the requested information.
Get a copy of this privacy notice:
  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.  We will provide you with a paper copy promptly.
Choose someone to act for you:
  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated:
  • You can complain if you feel we have violated your rights by contacting our Privacy Officer using the contact information on page 1.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:
  • We will not retaliate against you for filing a complaint.

Your Choices:

In these cases, you have both the right and choice to tell us to:
  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory
  • Contact you for fundraising efforts.
  • If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
  • Marketing purposes, Sale of your information and or Most sharing of psychotherapy notes **This practice does not create or maintain psychotherapy notes**
In the case of fundraising:
  • We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures:

Treat you:
  • We can use your health information and share it with other professionals who are treating you.
Run our organization:
  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Bill for your services:
  • We can use and share your health information to bill and get payment from health plans or other entities.
Help with public health and safety issues:
  • We can share health information about you for certain situations such as:
    • Preventing disease
    • Helping with product recalls
    • Reporting adverse reactions to medications
    • Reporting suspected abuse, neglect, or domestic violence
    • Preventing or reducing a serious threat to anyone’s health or safety
Do research:
  • We can use or share your information for health research.
Comply with the law:
  • We will share information about you if state or federal laws require it,including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests:
  • We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director:
  • We can share health information with a coroner, medical examiner,or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests:
  • We can use or share health information about you:
    • For workers’ compensation claims
    • For law enforcement purposes or with a law enforcement official
    • With health oversight agencies for activities authorized by law
    • For special government functions such as military, national security, and presidential protective services
  • If under the custody of law, we can share your health information to the correctional institution or law enforcement official when necessary in order to provide you with health care or protect yours/ and or other’shealth and safety.
Respond to lawsuits and legal actions:
  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities:

We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing.   If you tell us we can, you may change your mind at any time.   Let us know in writing if you change your mind and no further use or sharing of your information will be made after such date.

For more information visit:

Changes to the term of this Notice:

We can change the terms of this notice, and the changes will apply to all information we have about you.  The new notice will be available upon request, in our office, and on our website.

This notice is effective February 22, 2017.

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