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Professional Radiology and Outpatient Imaging Services


Midwest Radiology Privacy Practices

Protected and secure, Midwest Radiology takes great care when using your medical information.


Medical information is used to provide, coordinate and manage optimal care and treatment for patients. For example, Midwest Radiology will release films and reports to another medical provider involved in your care as a patient.


Patient information is used to receive payment for services provided. For example, Midwest Radiology will disclose patient information to submit claims to insurance companies and/or Medicare or State funded plans on behalf of patients seen.

Health Care Operations

Information may be used for activities related to business functions of the medical practice. For example, Midwest Radiology may use or disclose information for quality assurance activities.

Appointment Reminders and Other Health Information

Patient information may be used when Midwest Radiology staff places appointment reminder calls or calls to reschedule an existing appointment when necessary. Also, information may be used to inform patients about new or alternative treatments options and/or other health care services.

Family Members or Other Responsible People

Patients of Midwest Radiology may agree to have verbal information about their treatment or diagnosis shared with a family member or designee. If you are unable to make health care decisions, Midwest Radiology will disclose relevant medical information to family members or other responsible people if deemed in the patient’s best interest to do so. For example, Midwest Radiology may provide limited medical information that would allow another family member to pick up films or a CD for the patient.

Other Uses or Disclosures

There may be special circumstances when sharing medical information is required. Disclosures or use of information in special circumstances includes: when required by law; for public health activities; relating to victims of abuse/neglect/domestic violence; for health oversight activities; for judicial and administrative proceedings to the extent permitted by law; for law enforcement purposes, as permitted or required by law; to coroners/medical examiners/funeral directors, as permitted by law; for organ donation purposes; for research purposes under certain circumstances; to avert a serious threat to health or safety; for certain specialized government functions, such as military discharge and national security and intelligence; and for workers’ compensation purposes.

Patient Privacy Rights

Midwest Radiology works closely with patients that have special requests to manage their medical information.

Restrict Use and Disclosure

Patients have the right to request that Midwest Radiology not use medical information in certain ways or for certain purposes. Patients may also request that Midwest Radiology not provide medical information to certain individuals. However, Midwest Radiology has the right to refuse a request, particularly when law requires it. In the case where emergency treatment is necessary, Midwest Radiology will ask the person(s) who receive the information not to further use or disclose the information.

Provide Confidentiality

Patients have the right to request that Midwest Radiology provide them with medical information in a confidential manner. For example, patients can request that Midwest Radiology send bills and other mailings to a different address or that Midwest Radiology notify them of this kind of information in another way, such as by telephone. Patients must make this request in writing and specify the alternate address or means of communication. Under certain circumstances, Midwest Radiology may deny a request, for legitimate reasons. Midwest Radiology will agree to requests to the extent practical, and still assure accuracy. Patient requests for such confidentiality may require that patients provide Midwest Radiology with information on how they intend to pay for any services rendered.


Under certain circumstances, Midwest Radiology may use and disclose medical information about its patients for research purposes. Midwest Radiology will only do this with a patient’s written authorization, or with the approval of a special board that will insure that there is only a minimal risk to patient privacy.

Inspection and Copy

Patients have the right to ask to see and copy their medical records, unless there is information protected by law. At Midwest Radiology, medical records are limited to films, reports, and billing information. There may be fees assessed that are associated with copying costs.

Change Information or Amend Medical Records

Patients have the right to request in writing that Midwest Radiology change information in their medical record if Midwest Radiology was the originator of the information. If a request is denied, patients can write a statement of disagreement with the denial that Midwest Radiology will keep with this medical information.

Accounting of Disclosures

Patients have the right to request an accounting of information disclosures. This would include releasing medical information about the patient, which was not related to treatment, payment, health care operations, or information requested to release to another facility or persons. Requests for accountings of disclosures are limited to the most recent seven year history, unless the patient is a juvenile.

Paper Copy of Midwest Radiology’s Patient Notice of Privacy Practices

Patients of Midwest Radiology receiving this notice of medical information privacy rights electronically, may ask Midwest Radiology to provide a paper copy of this notice.

Privacy Violations

If you feel your medical information privacy rights have been violated, you may file a complaint with the Secretary of Health and Human Services and/or with Midwest Radiology’s contact person listed below. Filing a complaint will not affect the quality of the services you receive from Midwest Radiology and you will not be retaliated against for filing a complaint.


Midwest Radiology Privacy Officer

2355 Highway 36 West,
Roseville, MN 55113

(T) 651.767.1439


The U.S. Secretary of Health and Human Services

200 Independence Avenue S.W.
Washington, D.C. 20201

(T) 202.619.0257 or Toll free: 1.877.696.6775

Midwest Radiology reserves the right to change this notice and will make the new information available to you in-person, online, and by posting it in our offices.