The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures
we will explain what we mean and try to give some examples. Not every used or disclosure in a category will be listed. However, all of
the ways we are permitted to use and disclose information will fail within one of the categories.
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Treatment.
We may use medical information about you to provide you with the medical treatment or services. We may disclose medical
information about you to doctors, nurses, technicians, health care students, or other Provide personnel who are involved in taking care
of you at the Provider. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may
slow the helping process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for
appropriate meals. Different departments of the Provider also may share medical information about you in order to coordinate different
items, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people outside the Provider
who may be involved in your medical care after you leave the Provider.
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Payment.
We may use and disclose medical information about you so that the treatment and services you receive at the Provider may be
billed and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan
information about surgery you received at the Provider so your health plan will pay us or reimburse you for the procedure. We may also
tell your health plan about a prescribed treatment to obtain prior approval or to determine whether your plan will cover the treatment.
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Healthcare Operations.
We may use and disclose medical information about you for Provider operations. These uses and disclosures are necessary to run
the Provider and make sure that all of our patients receive quality care. For example, we may use medical information to review
our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information
about many Provider patients to decide what additional services the Provider should offer, what services are not needed, and whether
certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, health care students, and
other Provide personnel for review and learning purposes. We may also combine medical information about many Provider personnel for
review and learning purposes. We may also combine the medical information we have with medical information from other Providers to
compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that
identifies you from this set of medical information so others may use it to study health care and health care delivery without
learning a patient’s identity.
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Appointment Reminders.
We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care
at the Provider.
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Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible
treatment options or alternatives that may be of interest to you.
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Health-Related Benefits and Services.
We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
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Fundraising Activities.
We may use information about you to contact you in an effort to raise money for the Provider and its operations.
We may disclose information to a foundation related to the Provider so that the foundation may contact you about raising
money for the Provider. We only would release contact information, such as your name, address and phone number and the dates
you received treatment or services at the Provider. If you do not want the Provider to contact you for fundraising efforts,
you must notify us in writing and you will be given the opportunity to ‘Opt-out’ of these communications.
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Authorizations Required.
We will not use your protected health information for any purposes not specially allowed by Federal of State laws or regulations
without your written authorization, this includes uses of your PHI for marketing or sales activities.
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Emergencies. We may use or disclose your medical information if you need emergency treatment or if we are required
by law to treat you but are unable to obtain your consent. If this happens, we will try to obtain your consent as soon as we reasonably
can after we treat you.
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Psychotherapy Note. Psychotherapy notes are accorded strict protections under several laws and regulations.
Therefore, we will disclosure psychotherapy notes only upon your written authorization with limited exceptions.
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Communication Barriers.
We may use and disclose your health information if we are unable to obtain your consent because of substantial communication barriers,
and we believe you would want us to treat you if we could communicate with you.
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Provider Directory.
We may include certain limited information about you in the Provider directory while you are a patient at the Provider.
This information may include your name, location in the Provider, your general condition (e.g. fair, stable, etc.) and your
religious affiliation. The directory information, except for your religious affiliation, may also be released to people who
ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or a rabbi, even if
they do not ask for you by name. This is your family, friends and clergy can visit you in the Provider and generally know how you are doing. |
Individuals Involved in Your Care or Payment for Your Care.
We may release medical information about you to a friend or family member who is involved in your medical care and we may
also give information to someone who helps pay for your care, unless you object in writing and ask us not to provide this
information to specifics individuals. In addition, we may disclose medical information about you to an entity assisting in
a disaster relief effort so that your family can be notified about you condition, status and location.
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Research. Under certain circumstances, we may use and disclose medical information about you for research purposes.
For example, a research project may involve comparing the health and recovery of all patients who received one meditation to those
who received another, for the same condition. All research projects, however, are subject to a special approval process.
This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients
need for privacy of their medical information. Before we use or disclose medical information for research, the project will have
been approved through this research approval process, but we may, however, disclose medical information about you to people preparing
to conduct a research project, for example, to help them look for patients with specific medical need, so long as the medical
information they review does not leave the Provider. We will almost always generally ask for your specific permission if the researcher
will have access to your name, address or other information that reveals who you are, or will be involved in your care at the Provider.
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As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.
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To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary
to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however,
would only be to someone able to help prevent the threat.
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E-mail Use.
E-mail will only be used following this organization’s current policies and practices and with your permission. The use of secured,
encrypted e-mail is encouraged.
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In response to a court order, subpoena, warrant, summons or similar process; |
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To identify or locate a suspect, fugitive, material witness, or missing person; |
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About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; |
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About a death we believe may be the result of criminal conduct; |
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About criminal conduct at the Provider, and |
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In emergency circumstances, to report a crime; the location of the crime or victims; or the identity, description or location of
the person who committed the crime.
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Coroners, Medical Examiners and Funeral Directors.
We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased
person or determine the cause of death. We may also release medical information about patients of the Provider to funeral
directors as necessary to carry out their duties.
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National Security and Intelligence Activities.
We may release medical information about you to authorized federal officials for intelligence, counterintelligence,
and other national security activities authorized by law.
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Protective Services for the President and Others.
We may disclose medical information about you to authorized federal officials so they may provide protection to the president,
other authorized persons or foreign heads of state or conduct special investigations.
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Inmates.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical
information about you to the correctional institution or law enforcement official. This release would be necessary for the
institution to provide you with health care, to protect your health and safety or the health and safety of others, or for the
safety and security of the correctional institution.
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You have the following rights regarding medical information we maintain about you:
Right to Access, Inspect, and Copy.
You have the right to access, inspect and copy the medical information that may be used to make decisions about your care,
with few exceptions. Usually, this includes medical and billing records, but may not include psychotherapy notes.
If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated
with your request.
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We may deny your request to inspect and copy medical information in certain very limited circumstances. If you are denied access
to medical information, in some cases, you may request that the denial be reviewed. Another licensed health care professional chosen
by the Provider will review your request and the denial. The person conducting the review will not be the person who denied your request.
We will comply with the outcome of the review.
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Right to Amend.
If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information.
You have the right to request an amendment for as long as the information is kept by or for the Provider.in addition, you must
provide a reason that supports your request.
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We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition,
we may deny your request if you ask us to amend information that:
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Right to an Accounting of Disclosures.
You have the right to request an ‘Accounting of Disclosures’. This is a list of the disclosures we made of medical information
about you. Your request must state a time period which may not be longer than six years and may not include dates before
April 14, 2003. Your request should indicate in what form you want the accounting (for example, on paper or electronically,
if available). The first accounting you request within a 12 month period will be complimentary. For additional lists, we may change
you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your
request at that time before any costs are incurred.
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Right to Request Restrictions.
You have the right to request a restriction or limitation on the medical information we use or disclose about you for payment
or healthcare operations. You also have the right to request limit on the medical information we disclose about you to someone
who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not
use or disclose information about a surgery you had.in your request, you must tell us what information you want to limit, whether
you want to limit our use, disclosure or both, and to whom you want the limits to apply ( for example, disclosures to your spouse).
We are not required to agree to these types of request. We will not comply with any requests to restrict use or access of your
medical information for treatment purposes.
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You also have the right to restrict use and disclosure of your medical information about a service or item for which you have paid
out of pocket, for payment (i.e. health plans) and operational (but not treatment) purposes, if you have completely paid your bill for
this item or service. We will not accept your request for this type of restriction until you have completely paid your bill
(zero balance), that is your responsibility.
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Right to Receive Notice of a Breach. We are required to notify you by first class mail or by email( if you have
indicated a preference to receive information by email), of any breaches of Unsecured Protected Health Information as soon as
possible, but in any event, no later than 60 days following the discovery of the breach.” Unsecured Protected Health Information”
is information that is not secured through the use of a technology or methodology identified by the Secretary of the U.S. Department
of Health and Human Services to render the Protected Health Information unusable, unreadable, and undecipherable to unauthorized users.
The notice is required to include the following information:
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