Uses and Disclosures of Health Information

We use and disclose health information about you for only the following purposes:

Treatment

Payment

Healthcare Operations

Persons Involved in Care

Required By Law

Law Enforcement

Abuse or Neglect

Military, Veterans and National Security

Appointment Reminders

Workers' Compensation

Public Health Activities

Lawsuits and Disputes

We may also create and distribute “de-identified” health data by removing all references to individual information.

Any Other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.

Our Legal Duty

The Health Insurance Portability & Accountability Act of 1996 (“HIPAA”) is a federal program that requires that all health records about you are kept confidential. This Act gives you, the patient, new rights to understand and control how your health information is used. “HIPAA” provides penalties for organizations that misuse personal health information.

Patient Rights

This section describes your rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer:

Right to Inspect and Copy
You have the right to inspect and copy the personal health information in your medical and billing records, as outlined in InterCare’s HIPAA policies and procedures.

Right to Amend
If you feel that the health information we maintain about you is incorrect or incomplete, you may ask us to amend the information according to InterCare’s HIPAA policies and procedures.

Right to Receive an Accounting of Disclosures
You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than for treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003.

Right to Request Restrictions
You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care. We are not required to agree to your request for restrictions if it is not feasible for us to comply with your request or if we believe that it will negatively impact our ability to care for you. If we do agree, however, we will comply with your request according to InterCare’s HIPAA policies and procedures.

Right to Alternative Communication
You have the right to request that we communicate with you about health matters in a certain way. For example, you can ask that we only contact you at work or by mail to a specified address. We will accommodate all reasonable requests.

Right to a Paper Copy of this Notice
You have the right to receive a paper copy of InterCare’s privacy notice at any time. Copies are available at all our locations. You may also obtain a copy of this notice at our website, at www.intercare.org.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services.

For more information please contact:

Robin LaBrecque
Privacy Officer
InterCare Community Health Network
50 Industrial Park Dr.
Bangor, MI 49013
(269) 427-7937, Ext. 111

or

The U.S. Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775