|Madison County Health Department|
|Notice of Privacy Practices of Madison County
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.
Effective: April 14, 2003
If you have any questions or requests, please refer to the contact list at the end of this Notice.
WE HAVE A LEGAL DUTY TO PROTECT HEALTH INFORMATION ABOUT YOU.
We are required to protect the privacy of health information about you and that can be identified with you, which we call “protected health information,” or “PHI” for short. We must give you notice of our legal duties and privacy practices concerning PHI:
This Notice describes the types of uses and disclosures that we may make and gives you some examples. In addition, we may make other uses and disclosures which occur as a byproduct of the permitted uses and disclosures described in this Notice.
We are required to follow the procedures in this Notice. We reserve the right to change the terms of this Notice and to make new notice provisions effective for all PHI that we maintain by first:
A. WE MAY USE AND DISCLOSE PHI ABOUT YOU WITHOUT YOUR AUTHORIZATION IN THE FOLLOWING CIRCUMSTANCES.
1. We may use and disclose PHI about you to provide health care treatment to you.
We may use and disclose PHI about you to provide, coordinate or manage your health care and related services. This may include communicating with other health care providers regarding your treatment and coordinating and managing your health care with others, including transfer of PHI via radio or telephone to the hospital or ambulance dispatch center. For example, we may use and disclose PHI about you when you need a prescription, lab work, an x-ray, or other health care services. In addition, we may use and disclose PHI about you when referring you to another health care provider. To protect your health information, all business associates sign an agreement to maintain patient confidentiality and take appropriate measures to safeguard your health information.
EXAMPLE :Your doctor may share medical information about you with another health care provider. For example, if you are referred to another doctor, that doctor will need to know if you are allergic to any medications. Similarly, your doctor may share PHI about you with a pharmacy when calling in a prescription.
2. We may use and disclose PHI about you to obtain payment for services.
Generally, we may use and give your medical information to others to bill and collect payment for the treatment and services provided to you. Before you receive scheduled services, we may share information about these services with your health plan(s). Sharing information allows us to ask for coverage under your plan or policy and for approval of payment before we provide the services. We may also share portions of your medical information with the following:
EXAMPLE: Let’s say you are receiving maternity care from us. We may need to give your health plan(s) information about your condition, supplies used nd services you received. The information is given to our billing department and your health plan so we can be paid or you can be reimbursed.
3. We may use and disclose your PHI for health care operations.
We may use and disclose PHI in performing business activities, which we call “health care operations”. These “health care operations” allow us to improve the quality of care we provide and reduce health care costs. Examples of the way we may use or disclose PHI about you for “health care operations” include the following:
4. We may use and disclose PHI under other circumstances without your authorization.
We may use and/or disclose PHI about you for a number of circumstances in which you do not have to consent, give authorization or otherwise have an opportunity to agree or object. Those circumstances include:
5. You can object to certain uses and disclosures.
Unless you object, we may use or disclose PHI about you in the following circumstances:
6. We may contact you to provide appointment reminders.
We may use and/or disclose PHI to contact you to provide a reminder to you about an appointment you have for treatment or medical care.
7. We may contact you with information about treatment, services, products or health care providers.
We may use and/or disclose PHI to manage or coordinate your healthcare. This may include telling you about treatments, services, products and/or other healthcare providers. We may also use and/or disclose PHI to give you gifts of a small value.
EXAMPLE: If you are diagnosed with diabetes, we may tell you about nutritional and other counseling services that may be of interest to you.
** ANY OTHER USE OR DISCLOSURE OF PHI ABOUT YOU REQUIRES YOUR WRITTEN AUTHORIZATION **
Under any circumstances other than those listed above, we will ask for your written authorization before we use or disclose PHI about you. If you sign a written authorization allowing us to disclose PHI about you in a specific situation, you can later cancel your authorization in writing. If you cancel your authorization in writing, we will not disclose PHI about you after we receive your cancellation, except for disclosures which were being processed before we received your cancellation.
B. YOU HAVE SEVERAL RIGHTS REGARDING PHI ABOUT YOU.
1. You have the right to request restrictions on uses and disclosures of PHI about you.
You have the right to request that we restrict the use and disclosure of PHI about you. We are not required to agree to your requested restrictions. However, even if we agree to your request, in certain situations your restrictions may not be followed. These situations include emergency treatment, disclosures to the Secretary of the Department of Health and Human Services, and uses and disclosures described in subsection 4 of the previous section of this Notice. You may request a restriction by submitting a written request.
2. You have the right to request different ways to communicate with you.
You have the right to request how and where we contact you about PHI. For example, you may request that we contact you at your work address or phone number or by email. Your request must be in writing. We must accommodate reasonable requests, but, when appropriate, may condition that accommodation on your providing us with information regarding how payment, if any, will be handled and your specification of an alternative address or other method of contact. You may request alternative communications by submitting a written request.
3. You have the right to see and copy PHI about you.
You have the right to request to see and receive a copy of PHI contained in clinical, billing and other records used to make decisions about you. Your request must be in writing. We may charge you related fees. Instead of providing you with a full copy of the PHI, we may give you a summary or explanation of the PHI about you, if you agree in advance to the form and cost of the summary or explanation. There are certain situations in which we are not required to comply with your request. Under these circumstances, we will respond to you in writing, stating why we will not grant your request and describing any rights you may have to request a review of our denial. You may request to see and receive a copy of PHI by submitting a written request.
4. You have the right to request amendment of PHI about you.
You have the right to request that we make amendments to clinical, billing and other records used to make decisions about you. Your request must be in writing and must explain your reason(s) for the amendment. We may deny your request if: 1) the information was not created by us (unless you prove the creator of the information is no longer available to amend the record); 2) the information is not part of the records used to make decisions about you; 3) we believe the information is correct and complete; or 4) you would not have the right to see and copy the record as described in paragraph 3 above. We will tell you in writing the reasons for the denial and describe your rights to give us a written statement disagreeing with the denial. If we accept your request to amend the information, we will make reasonable efforts to inform others of the amendment, including persons you name who have received PHI about you and who need the amendment. You may request an amendment of your PHI by submitting a written request.
5. You have the right to a listing of disclosures we have made.
If you ask our contact person in writing, you have the right to receive a written list of certain disclosures of PHI about you. You may ask for disclosures made up to six (6) years before your request (not including disclosures made prior to April 14, 2003). We are required to provide a listing of all disclosures except the following:
The list will include the date of the disclosure, the name (and address, if available) of the person or organization receiving the information, a brief description of the information disclosed, and the purpose of the disclosure. If, under permitted circumstances, PHI about you has been disclosed for certain types of research projects, the list may include different types of information.
If you request a list of disclosures more than once in 12 months, we can charge you a reasonable fee. You may request a listing of disclosures by submitting a written request.
6. You have the right to a copy of this Notice.
You have the right to request a paper copy of this Notice at any time by requesting verbally or in writing. We will provide a copy of this Notice no later than the date you first receive service from us after the effective date of this notice (except for emergency services, and then we will provide the Notice to you as soon as possible).
We reserve the right to change our privacy practices and to make the new provisions effective for all protected health information we maintain. Should our privacy practices change, a notice of this change will be displayed. Revised copies will be made available upon verbal or written request.
C. YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES
If you think your privacy rights have been violated by us, or you want to complain to us about our privacy practices, you may contact the following:
You may also send a written complaint to the United States Secretary of the Department of Health and Human Services.
Region IV, Office of Civil Rights, US Dept. of Health and Human Services
Atlanta Federal Center, Suite 3B70
61 Forsyth St., SW
Atlanta, GA 30303-8909
If you file a complaint, we will not take any action against you or change our treatment of you in any way.
Madison County Health Department staff respect your privacy and want to make every effort to keep your visit private and your personal health information confidential. We follow rules and regulations about the confidentiality of medical records and maintain any information we receive about you in a secure and professional manner.
Information can be disclosed to us as the public health department from laboratories, physicians, local registrars, hospitals, and other professionals as required by law in the area of communicable disease, inspections, public health preparedness and related activities necessary for the health department to meet its mission as a governmental unit.
We are committed to protecting the public’s health. Statistical information collected by the health department is necessary to track the spread of disease in the population, determine leading causes of death, investigate disease sources, and obtain information to activities in prevention and treatment. By working together with other providers, we can ensure the public’s health is maintained.
Rules and regulations related to the protection of personal health information include Public Law 104-191 (HIPAA). General Statutes that require individual health information to remain confidential includes: NC General Statutes 130A-12; 130A-93; 130A-131; 130A-143; 130A-212; 130A-374; 130A-441; 130A-460; 131E-214; 132.1; and 143B-139.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) recognizes the need to balance public responsibility and patient privacy and includes language and provisions that permit certain disclosures, without individual authorization. The HIPAA Privacy rule, effective April 2003, allows for the following disclosures without an individual’s authorization:
- Disclosures required by law
- Disclosures to public health authorities authorized by law to collect information to aid in protecting the health of the public
- Disclosures to health oversight agencies for oversight activities authorized by law
- Public health reporting mandated by law has not been changed by HIPAA.
HIPAA Privacy Notice
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