HEALTH INSURANCE PORTABILITY
AND ACCOUNTABILITY ACT OF 1996
The following notice describes how
your medical information may be used
and disclosed, and how you can get access
to this information. Please review
the information carefully.
· Your confidential healthcare information may be released to other healthcare professionals within the hospital for the purpose of providing you with quality healthcare.
For example: All information obtained by a nurse, physician, or other member of the healthcare team will be documented in your record and used to communicate with other members of the healthcare team involved in your care.
· Your confidential healthcare information may be released to your insurance provider for the purpose of the hospital receiving payment for providing you with needed healthcare services.
For example: A bill may be sent to you or your health care insurance company. Information on the bill includes identifying information along with a diagnosis and procedures rendered.
· Your confidential healthcare information may be released for routine healthcare facility operations.
For example: Your health information will be reviewed by medical staff and other professionals in an effort to continually improve the quality of healthcare and services we provide. Storing the information involves entering some of the data into databases as well as filing and storing the paper documents in your chart. These functions may be handled by a number of different employees in the facility.
· Your confidential healthcare information may be released to public or law enforcement officials in the event of an investigation in which you are a victim of abuse, a crime or domestic violence.
· Your confidential healthcare information may be released to other healthcare providers in the event you need emergency care.
· Your confidential healthcare information may be released to a public health organization or federal organization in the event of a communicable disease or to report a defective device or untoward event to a biological product (food or medication).
· Your confidential healthcare information may be released for workers compensation or similar programs.
· Your confidential information may be released to business associates of Bigfork Valley. (Examples: Vendors, Collection Agency, Auditors) In order for them to perform the work we have asked them to do, we may need to disclose some health information. We require business associates to safeguard information in the same manner we do.
· The healthcare center has an agreement with Scenic Rivers Health Services - Bigfork that allows them to do required committee work for the healthcare center. Some of that committee work will require that physicians review records on patients not under their care. Your records could be included in those reviews. In accordance with the special agreement between the healthcare center and the clinic, the physicians are required to extend all privacy protections to these records, too.
· Your confidential healthcare information may not be released without your written authorization for any purpose other than that stated above.
· You may revoke your permission to release confidential healthcare information at any time. If you wish to revoke your authorization, please do so in writing and submit to: Director of Health Information Systems/Privacy Officer, Bigfork Valley, PO Box 258, Bigfork, MN 56628.
· You may be contacted by the healthcare center to remind you of any appointments, healthcare treatment options or other health services that may be of interest to you.
· You may be contacted by Bigfork Valley or the Bigfork Valley Foundation for the purposes of raising funds to support the healthcare centers operations or to benefit the Northern Itasca Hospital District and the communities it serves. If you do not want Bigfork Valley or the Bigfork Valley Foundation to contact you for fund raising efforts, you must notify the healthcare center at (218) 743-3177.
· The healthcare center will not require individuals to waive their right to file a complaint with the Secretary of Health and Human Services in order to receive treatment and/or payment.
You have specific rights regarding confidential information about you created by us or kept here in either your medical records or your billing records.
Right to Request Restrictions
You have the right to request restrictions on the use of your confidential healthcare information. However, the hospital may chose to refuse your restriction if it is in conflict with providing you with quality healthcare or in the event you have an emergency situation.
To request restrictions, you must make your request in writing to: Director of Health Information Systems/Privacy Officer, Bigfork Valley, P.O. Box 258, Bigfork, MN 56628
In your request, you must tell us: (1) What information you want to limit, (2) Whether you want to limit our use, disclosure or both; and (3) To whom you want the limits to apply.
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. (For example, you can ask that we only contact you at work or by mail.)
We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to Inspect and Copy
You have the right to review, inspect, and receive a photocopy of any/all portions of your healthcare information. This includes medical and billing records.
To inspect and/or receive a photocopy of your healthcare information you must submit your request in writing to: Director of Health Information Systems/Privacy Officer, Bigfork Valley, P.O. Box 258, Bigfork, MN 56628.
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.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by the hospital 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.
Right to Amend
You have the right to request changes to your healthcare information. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.
To request an amendment, your request must be made in writing and submitted to: Director of Health Information Systems/Privacy Officer, Bigfork Valley, P.O. Box 258, Bigfork, MN 56628. In addition, you must provide a reason that supports your request.
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:
- Was not created by us;
- Is not part of the medical information kept by or for the healthcare center;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
Right to an Accounting of Disclosures
You have the right to know who has accessed your confidential healthcare information and for what purpose.
To request an accounting of disclosures, you must submit your request in writing to: Director of Health Information Systems/Privacy Officer, Bigfork Valley, P.O. Box 258, Bigfork, MN 56628.
Your request must state a time period which may not be longer than six (6) years and may not include dates before April 14, 2003.
Right to a Paper Copy of this Notice
You have the right to possess a copy of this Privacy Notice upon request. You may ask us to give you a copy of this notice at any time. This copy can be in the form of an electronic transmission or on paper.
To obtain a paper copy of this notice, please contact Director of Health Information Systems/Privacy Officer at (218) 743-4149. Or you may download a copy in pdf format here (size: 364KB) and print it off.
We reserve the right to change this notice and make the new terms effective for all confidential health information we maintain. We will post a current copy of the notice in the healthcare center. The notice will contain on the first page, in the top right hand corner, the last revision date.
HEALTH CARE CENTER DUTIES
The healthcare center is required by law to protect the privacy of its patients. It will keep confidential any and all patient healthcare information and will provide patients with a list of duties or practices that protect confidential healthcare information as required by law. The healthcare center is required to abide by the terms of this notice.
The medical staff are independent healthcare professionals and are not under the control of the Health Care Center.
You have the right to complain to the health care center or with the Secretary of the Department of Health and Human Services if you believe your rights to privacy have been violated.
To file a complaint, please contact Bigfork Valley Administration at (218) 743-3177.
All complaints will be investigated. There will be no retaliation for filing a complaint.
This notice is effective as of April 14, 2003.
Revised August 2008.