HIPAA Privacy Notice

hf triad – health first 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 your rights get 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 ask us how to do this we will provide a copy or a summary of your health information, usually within 30 days of your request 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 only if you pay for a service or health care item out of pocket, in full, at the time of service, can we comply with your request not to share that information for the purpose of payment or our operations with your health insurer (i e comply with your request not to file your claims to your insurance company) otherwise, we will say “yes” unless a law requires us to share that information 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 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 us you can file a complaint with the u s department of health and human services office for civil rights by sending a letter to 200 independence avenue, s w , washington, d c 20201, calling 1 877 696 6775, or visiting www hhs gov/ocr/privacy/hipaa/complaints/ we will not retaliate against you for filing a complaint your choices for certain health information, you can tell us your choices about what we share if you have a clear preference for how we share your information in the situations described below, talk to us tell us what you want us to do, and we will follow your instructions 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 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 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 how do we typically use or share your health information? we typically use or share your health information in the following ways treat you we can use your health information and share it with other professionals who are treating you example a doctor treating you for an injury asks another doctor about your overall health condition run our organization we can use and share your health information to run our practice, improve your care, and contact you when necessary example we use health information about you to manage your treatment and services bill for your services we can use and share your health information to bill and get payment from health plans or other entities example we give information about you to your health insurance plan so it will pay for your services how else can we use or share your health information? we are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research we have to meet many conditions in the law before we can share your information for these purposes for more information www hhs gov/ocr/privacy/hipaa/understanding/consumers/index html http //www hhs gov/ocr/privacy/hipaa/understanding/consumers/index html 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; and, 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 we can also use or share health information about you with health oversight agencies for activities authorized by law for special government functions such as military, national security, and presidential protective services 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 for more information www hhs gov/ocr/privacy/hipaa/understanding/consumers/noticepp html changes to the terms 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 web site effective september 23, 2013 to present