Privacy Policy and Medical Record Disclosure Regulations
privacy policy
●1) Personal information
Personal information refers to information about an individual, including "name," "address," "telephone number," "date of birth," "medical records," "medical claims," and other information that can identify a specific individual. The term "individual" here refers to the following:
Inpatient/outpatient, etc.
All employees, regardless of employment type, including full-time employees, part-time employees, and temporary staff.
Persons engaged in work within the hospital through outsourcing or other means.
●2) Collection and use of personal information
Our hospital collects personal information for medical purposes and uses it only to the extent necessary to provide appropriate treatment.
●3) Proper management of personal information
Our hospital has established internal regulations to prevent loss, destruction, alteration, leakage, and other security breaches, and we manage personal information by taking appropriate and necessary measures.
●4) Compliance with relevant laws and regulations concerning the protection of personal information
Our hospital complies with the Personal Information Protection Act and other relevant laws and regulations, has established personal information management regulations, and is committed to protecting personal information.
●5) Entrustment of personal information
Our hospital may entrust personal information to external parties. When entrusting personal information, we will enter into a contract to ensure proper handling and will conduct inspections of the implementation status.
●6) Disclosure, correction, and deletion of personal information
Our hospital will promptly respond to requests from individuals or their representatives for disclosure, correction, or deletion of their personal information. We will not disclose personal information to third parties without the individual's consent.
●7) Maintaining and improving personal information protection
Our hospital will continuously educate our staff to ensure the proper handling of personal information, and will review and improve our personal information protection practices.
Our hospital uses personal information for the following purposes and handles it with the utmost care.
●1) Provision of medical care
Provision of medical services at our hospital (e.g., designation in outpatient settings, room numbering)
Collaboration with other hospitals, clinics, midwifery centers, pharmacies, home care stations, and care service providers.
When seeking opinions and advice from external physicians, etc., for the treatment of a patient.
Outsourcing of specimen testing services and other outsourcing services.
Explanation of the patient's condition to family members
Other uses related to the provision of medical care to patients
●2) Administrative procedures for billing medical fees
Administrative work and outsourcing related to medical care, nursing care, workers' compensation insurance, and publicly funded medical care at our hospital.
Submission of claims to the review and payment agency
Responses to inquiries from review and payment organizations or insurers
Submission of medical claims to administrative agencies regarding publicly funded medical care, and responses to inquiries.
Other uses include billing for medical, long-term care, and workers' compensation insurance, as well as for publicly funded medical care.
●3) Management and operation of our hospital
Accounting and bookkeeping
Reporting of medical accidents, etc.
Improving medical services for the patient in question
Ward management, including admissions and discharges.
Other uses related to the management and operation of our hospital
Reporting the results of health checkups and other examinations conducted on behalf of companies and other organizations to those companies and other organizations.
Consultation or notification to medical professional organizations, insurance companies, etc., regarding medical malpractice insurance, etc.
Basic data for maintaining and improving medical and nursing care services and operations.
Cooperation with medical training conducted within our hospital
Case studies within our hospital aimed at improving the quality of medical care.
Providing information to external auditing bodies
* If you have any objections to the provision of information to other medical institutions or other organizations as described above, please let us know.
* Unless you inform us otherwise, we will assume that you have given your consent.
* You can withdraw or change these requests at any time.
● Customer Information Inquiry Desk
For inquiries regarding our privacy policy and patient information, please contact us at the following address.
Shiratori Clinic, Shiratori Medical Corporation
TEL: 03-3601-7181
Purpose of use of personal information at our hospital
Medical Record Disclosure Procedures
1. Disclosure Request
In accordance with these regulations, you may request disclosure of medical records held by this hospital (limited to those within the retention period stipulated by the Medical Care Act, etc.).
2. Disclosure Requester
The following persons may request disclosure:
① The patient who visited our hospital
② The principal's representative (legal representative, voluntary guardian, and representative appointed by the principal)
③ The deceased's surviving family members (the deceased's spouse, children, parents, and other persons equivalent thereto)
3. Identity Verification in Disclosure Requests
When a disclosure request is made, we will verify the identity of the person concerned, their representative, or a family member, and this verification will be carried out using the following documents.
(1) In the case of the patient who visited our hospital
Official identification documents such as a driver's license, health insurance card, or alien registration certificate.
(2) In the case of an agent, the following ① and ②
① Official identification documents such as a driver's license of the person or their representative.
② Official documents proving the legal representative's qualifications, such as a family register transcript, and a power of attorney.
(3) In the case of an heir, the following ① and ②
① Official identification documents such as the driver's license of the person concerned and the heir.
② Official documents such as a family register transcript that prove the identity of the person's spouse, child, parent, or equivalent person.
4. How to request disclosure
Requests for disclosure must be made using the medical record disclosure request form prescribed by this hospital.
5. Decision on disclosure or non-disclosure
(1) In response to a disclosure request, we will make a decision to disclose or not disclose the information.
(2) In the following cases, some or all of the medical records may not be made public:
① When there is a risk of significantly impairing the patient's physical or mental condition.
② When there is a risk of harming the interests of a third party.
③ When the retention period for medical records has expired.
6. Costs (from April 1, 2025)
The fees for disclosing medical records are as follows. These fees do not include consumption tax.
Basic disclosure fee: 10,000 yen per request
Medical record copying fee: 50 yen per page (black and white)
100 yen per sheet (color)
X-ray film copy fee: 1,000 yen per sheet
Other copying services, etc., will incur appropriate fees depending on the scope.
Doctor's explanation: 10,000 yen per 30 minutes (up to 1 hour).