Health Information Portability and Privacy Act (HIPPA) Notice
This NOTICE describes how information about you may be used, disclosed and how you can get access to this information review it carefully.
Understanding your Health Record / Information
Each time you visit a hospital, physician or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examinations, test results, diagnoses, treatment, and a plan for the future care or treatment. This information, often referred to as your health or medical record, serves as a;
Basis for planning your care and treatment.
Means of communication among the many health professionals who contribute to your care.
Legal document describing the care you received.
Means by which you or a third party payer can verify that services billed were actually provided.
A tool in educating health professionals.
A source of data for medical research.
A source of information for public health officials charged with improving the health of the nation.
A source of data for facility planning and marketing.
A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Understanding what is in your record and how your health information is used helps you to:
Ensure its accuracy
Better understand who, what, when, where, and why others may access your health information.
Make more informed decisions when authorizing disclosure to others.
Your health information rights
Although your health record is the physical property of the health care practitioner of facility that compiled it, the information belongs to you.
You have the right to:
Request a restriction on certain uses and disclosures of certain parts of your protected health information for the purposes of treatment, payment, or health care operations. You may also request that we not disclose your health information to family members or friends who may be involved in your care, or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
(The practice is not required to agree to a restriction that you may request. We will notify you that we deny your request to a restriction. We may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. Under certain circumstances, we may terminate our agreement to a restriction. You may request a restriction by contacting the
Office Manager/Privacy Officer.
You have the right to:
Obtain a paper copy of the Notice of Information Practices upon request.
Inspect and have a copy of your health record.
Amend your health record if appropriate.
Obtain an accounting of disclosures of your health information.
Request communications of your health information by alternative means or at alternative to use or disclose information except to the extent that action has already been taken.
This organization is required to:
Maintain the privacy of your health information.
Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
Abide by the terms of this notice.
Notify you if we are unable to agree to a reasonable restriction.
Accommodate reasonable requests you may have to communicate health information by alternative means of at alternative locations.
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will provide a revised notice upon your next visit to the practice.
We will not use or disclose your health information without your authorization, except as described in this notice.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact the Office Manager/Privacy Officer at (989)224-3000
If you believe your privacy rights have been violated, you can file a complaint with the Office Manager of Secretary of Health and Human Service.
Example of Disclosures for Treatment, Payment, and Health Operations
We will use your health information for treatment.
For example: Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you.
We will use your health information for payment.
For example: A bill may be sent to you or a third-party payer. The information on or accompanying that identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health operations.
For example: Members of the medical staff, the Risk of Quality Improvement Manger, of members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used quality and effectiveness of the health care and service we provide.
Business Associates: There are some services provided in our organization through contacts with business associates. Examples include with physician services in the Emergency Department and radiology, certain laboratory tests, and copy services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered.
To protect your health information, however, we require the business associates to appropriately safeguard your information.
Directory: Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation to other people who ask for you by name.
Communication with Family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Organ Procurement Organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to provide appointment reminders, information about treatment alternatives, or other health related benefits and services that may be of interest to you.
Fund Raising: we may contact you as part of a fund-raising effort.
Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Public Health: As required by law, we may disclose your health information to public health or legal authorities charged either preventing or controlling disease, injury, or disability.
Correctional Institutions: Should you be an inmate of a correctional Institution, we may disclose to the institution, or agents thereof, health information necessary for your health and safety of other individuals.
Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your information to be released to an appropriate health oversight agency , public health authority or attorney, provided that a work force member or business associate believes in good faith that we have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.