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Patient Privacy

Our Legal Duty

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

  • Ensure that health information that identifies you is kept private in accordance with the relevant law.
  • Give you the notice of our privacy practices with respect to your personal health information.
  • Follow the terms of the notice of privacy practices in effect for all of your personal health information.
  • Notify you if your personal health information is accessed, acquired, used, or disclosed in a manner not permitted by law if it affects the privacy or security of your information.

USES AND DISCLOSURES OF HEALTH INFORMATION

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

Treatment: We may use or disclose your health information to a physician or other healthcare provider providing treatment to you. Examples include consulting with a specialist outside of the health center network who may have insight into specialty services you may need or disclosing to an emergency room physician treating you for a broken leg that you have diabetes, because diabetes can affect the healing process.

Payment: We may use and disclose your health information to obtain payment for services we provide to you. An example of this would be sending a bill for your visit to your insurance company for payment.

Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations. This includes quality assessment and improvement activities, reviewing the qualifications of healthcare professionals, evaluating provider performance, or implementing certain training programs.

Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on our professional judgment that is directly relevant to the person's involvement in your healthcare. We may also release health information about you to a friend or family member who helps pay for your care. However, you have the right to request a limit on the health information we disclose about you to someone who is involved in your care or payment for your care, such as a family member or friend.

Marketing and Fundraising: We will not use your health information for marketing or fundraising.

Sale of Personal Health Information: We will not sell your personal health information without your written permission.

Required by Law: We may use or disclose your health information when we are required to do so by federal, state, or local law.

Law Enforcement: We may release health information about you if asked to do so by a law enforcement official. An example of this would be a death we believe may be the result of criminal conduct.

Threat to Health or Safety: We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse or neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others. We would only disclose the information to someone able to help prevent the threat.

Military, Veterans, and National Security: If you are a member of the armed forces or separated/discharged from military services, we may disclose to military authorities your health information under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities.

Appointment Reminders: We may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters). You have the right to request that we communicate with you about your health matters in a certain way. For example, you can ask that we only contact you at home, or only by paper mail rather than by telephone. To do so, please make you request in writing and submit it to the Privacy Officer whose information is provided at the end of this notice.

Workers' Compensation: We may release health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Activities: We may disclose health information about you for public health activities. For example, we would notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

Lawsuits and Disputes: We may disclose health information about you in response to a court or administrative order. We may disclose health information about you in response to a subpoena, discovery request, or other lawful process that is not accompanied by a court or administrative order, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

We may also create and distribute de-identified health information by removing all references to individually identifiable 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.

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, or in any other group of records that we maintain and use to make health care decisions about you. This right does not include the right to inspect and copy psychotherapy notes, although we may, at your request and on payment of the applicable fee, provide you with a summary of these notes. To inspect and copy your personal health information, you must submit your request in writing to our privacy contact person identified at the end of this Notice. We may deny your request in certain very limited circumstances.

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. You have the right to request an amendment for any information that we maintain about you. To request an amendment, your request must be made in writing and must be contained on one piece of paper legibly handwritten or typed. In addition, you must provide a reason that supports your request for an amendment. We may deny your request under certain circumstances.

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 treatment, payment, healthcare operations, and certain other activities for the last 6 years, but not before April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding for these additional requests. Certain information may not be included in the accounting of disclosures, for example, disclosures made:

  • To carry out treatment, payment, and health care operations, as described in this notice.
  • To you or pursuant to your written authorization.
  • To a family member, other relative, or personal friend involved in your care or payment for your care when you have given us permission to do so.
  • To law enforcement officials.

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 or payment for your care, such as a family member or friend.

You have the right to request that we not disclose health information about you to a health plan. We will agree to your request if the protected health information involved pertains solely to a health care item or service for which you or someone acting on your behalf has paid us in full, unless we are required by law to make the disclosure.

Otherwise, 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 unless the information is needed to provide emergent treatment. In your request, you must tell us what information you want to limit and to whom you want limits to apply.

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 not ask you the reason for the request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.

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

We reserve the right to change this notice and to make the changed notice effective for all of the health information that we maintain about you, whether it is information that we previously received about you or information we may receive in the future. We will post a copy of our current notice in our facility and will provide you with a copy of our current notice upon your request.

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. You may file a complaint by mailing us a written description of your complaint or by telling us about your complaint in person or over the telephone:

Judy Rayman, Privacy Officer
InterCare Community Health Network - 50 Industrial Park Drive - Bangor, MI 49013
(269) 427-7937

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