| |
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 READ IT CAREFULLY.
Greeley Medical Clinic is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information.
Effective Date of This Notice: April 14, 2003.
I. How Greeley Medical Clinic May Use or Disclose Your Health Information
Greeley Medical Clinic collects health information from you and stores it in a chart and on a computer. This is your medical records. The medical record is the property of Greeley Medical Clinic. Greeley Medical Clinic protects the privacy of your health information. The law permits Greeley Medical Clinic to use or disclose your health information for the following purposes, including but not limited to:
- Treatment. Sharing test results with other health care providers for confirmation of a diagnosis.
- Payment. Providing your diagnosis or other information about your health to your insurance provider.
- Regular Health Care Operations. Reviewing patient information as part of our quality improvement program.
- Providing you with information related to your health.
- Notification. Contacting you by phone or other means regarding appointments, information about treatment alternatives, or other health related services.
- Communication with family and others. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
- Required by law. As required by law, we may use and disclose your health information.
- Public health. As required by law, we may disclose your health information to public health authorities for the purposes related to: preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problem with products and reactions to medications; and reporting disease or infection exposure.
- Health oversight activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
- Judicial and administrative proceedings. We may disclose your health information in the course of any administrative or judicial proceedings.
- Law enforcement. We may disclose your health information in the course of any administrative or judicial proceeding.
- Deceased person information. We may disclose your health information to coroners, medical examiners and funeral directors.
- Organ donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.
- Research. We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board or Greeley Medical Clinic?s privacy board.
- Public safety. We may disclose your health information to appropriate person in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
- Worker?s Compensation. We may disclose your health information as necessary to comply with worker?s compensation laws.
- Marketing. We may contact you to provide appointment reminders or to give you information about other treatments or health-related benefits and services that may be of interest to you.
II. When Greeley Medical Clinic May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, Greeley Medical Clinic will not use or disclose your health information without your written authorization. If you do authorize Greeley Medical Clinic to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
III. Your Health Information Rights
- You may request that certain uses and disclosures of your protected health information be restricted. To do so, you must provide the request in writing using the Request for Restriction on Use or Disclosure form available from our Medical Records offices. Greeley Medical Clinic will determine if the information constitutes required information to carry out treatment, payment or health care operations. If, in our sole opinion, your request does not involve information that is required by us to carry out treatment, payment or health care operations, we will accept your request for restrictions and will notify you if your request will be honored within 30 days or as required by law.
- Inspection and copying?You may request a report containing your health information that has been collected by Greeley Medical Clinic for you to inspect or copy. Such requests shall be made at Greeley Medical Clinic Medical Records Office and will be processed within 30 days or as required by law. You will be notified in writing of Greeley Medical Clinic?s receipt of the request and the date upon which the information will be available to you. There will be a cost to the patient for copying medical records.
- Amendment or correction?You may request that we amend or correct your health information that has been collected by Greeley Medical Clinic. Such request shall be made at the Greeley Medical Clinic Records Office. If agreed to by your health care provider, requests to amend health information will be honored within 30 days or as required by law, and you will be notified in writing of Greeley Medical Clinic?s action taken.
- Accounting of the disclosures?You may request that we supply you with a listing of the disclosures of your protected health information which have been made by Greeley Medical Clinic except those made for treatment, payment or health care operations, those required by the Final Privacy Rule or made pursuant to other law, and those made pursuant to your explicit authorization. Such requests shall be made at Greeley Medical Clinic Medical Records Office and will be honored within 30 days or as required by law, and you will be notified in writing of the date on which the accounting will be available to you.
- You have a right to a paper copy of this Notice of Privacy Practices.
IV. Greeley Medical Clinic Duties
Subject to limitations outlined by law, Greeley Medical Clinic has certain duties related to your protected health information, including:
- Greeley Medical Clinic is required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information
- Greeley Medical Clinic is required to abide by the terms of the privacy notice that is currently in effect.
- Greeley Medical Clinic reserves the right to change a privacy practice described in this notice and to make such change effected for all protected health information. Revised notice will be posted in our office and available upon request.
V. Concerns
If you believe your privacy rights have been violated, you may make a complaint by contact us: Greeley Medical Clinic Administration Chief of Privacy Officer, Greeley Medical Clinic, 1900 16th Street, Greeley, CO 80631.
If you are not satisfied with the manner in which Greeley Medical Clinic handled your complaint, you may submit a formal complaint to: Secretary for the Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201. No individual will be retaliated against for filing a complaint.
Greeley Medical Clinic reserves the right to revise this Notice of Privacy Practices at any time without prior notification. You may request a copy of the revised notice and we will provide it to you.
|
