This notice describes how information about you may be used and disclosed and how you can gain access to this information.
Please review it carefully.
Fredericksburg Christian Health Center may use and disclose protected health information for treatment, payment, and healthcare operations. Examples of these include, but are not limited to, requested preschool, or sports physicals, referral to nursing homes, foster care homes, home health agencies and/or referral to other providers for treatment. Payment examples include, but are not limited to, insurance companies for claims including coordination of benefits with other insurers, or collection agencies. Healthcare operations include, but are not limited to, internal quality control and assurance including auditing of records. Fredericksburg Christian Health Center is permitted or required to use or disclose protected health information without the individual's written consent or authorization in certain circumstances. Two examples of such are public health requirements or court orders. Fredericksburg Christian Health Center will not make any other use or disclosure of a patient's protected health information without the individual's written authorization. Such authorization may be revoked at any time. Revocation must be written.
Fredericksburg Christian Health Center will abide by the terms in this notice currently in effect at the time of the disclosure.
Fredericksburg Christian Health Center reserves the right to change the terms of its notice to make new notice provisions effective for all protected health information that it maintains. Fredericksburg Christian Health Center will provide each patient with a copy of any revisions of its Notice of Information Practices at the time of their next visit, at their last known address if there is a need to use or disclose any protected health information of the patient. Copies may also be obtained at any time at our offices.
Any patient, guardian, or personal representatives has the right to:
- Object to the use of their health information for directory purposes.
- Inspect and obtain copies of their medical records.
- Request amendments be made to their medical record.
- Request a six-year accounting of all disclosures of their medical record, unless records of a minor child, including immunizations, must be maintained until the child reaches the age of 18 or becomes emancipated, with a minimum time for record retention of six years from the last patient encounter regardless of the age of the child.
- The history will be provided within 30 days of the request and reasonable charge may be assessed for any copies after the first requested in a 12-month period.
- Request restrictions as to how their health information may be used or disclosed to carry out treatment, payment, or healthcare operations. The Practice is not required to agree to the restrictions requested, but if the Practice does agree, the Practice must abide by those restrictions.
- Any person/patient may file a complaint to the Practice and to the Secretary of Health and Human Services if they believe their privacy rights have been violated. To file a complaint with the Practice, please contact the Privacy Officer at the following address and/or phone number: Fredericksburg Christian Health Center, 1129 Heatherstone Drive, Fredericksburg, VA 22407, Telephone 540-785-8500, Fax 540-785-5328. All complaints will be addressed, and the results will be reported to the Privacy Officer.
It is the policy of Fredericksburg Christian Health Center that no retaliatory action will be made against any individual who submits or conveys a complaint of suspected or actual non-compliance of the privacy standards.
Fredericksburg Christian Health Center may call the patient's home or other designated location and leave a message on voice mail or in person in reference to any items that assist the practice in carrying out healthcare operations, such as appointment reminders, insurance items, and any call pertaining to the patient's clinical care, including laboratory results among others.
FCHC Notice of Information Practices