NOTICE OF PRIVACY PRACTICES
This Notice Describes How Medical Information about You May Be Used and Disclosed and How You Can Get Access to This Information
PLEASE REVIEW CAREFULLY.
If you have any questions about this notice, please contact the Facility Privacy Officer at the contact information listed at the end of this notice.
This notice describes the facility’s practices and that of:
We understand that medical information about you and your healthcare is personal. We are committed to protecting medical information about you.
A record is created of the care and services you receive at this facility. This record is needed to provide the necessary care and to comply with legal requirements. This notice applies to all of the records of your care generated by the facility. The terms "information" and "medical information" in this notice include any information that we maintain that reasonably can be used to identify you and that relates to your physical or mental health condition, the provision of health care to you, or the payment for your health care.
Your personal physician may have different policies or notices regarding the physician’s use and disclosure of your medical information in the physician’s office or clinic.
This notice will tell about the ways in which the facility may use and disclose medical information about you. Also described are your rights and certain obligations we have regarding the use and disclosure of medical information.
The law requires the facility to:
The following categories describe different ways we may use and disclose medical information about you. Not every possible use or disclosure within a category will be listed or explained. However, all of the ways we are permitted to use and disclose medical information will fall within one of these categories. Except with respect to Highly Confidential Information (described below), we are permitted to use and disclose your health information for the following purposes:
Please note we will comply with your request not to disclose your health information to your health plan if the information relates solely to a healthcare item or service for which you have paid out of pocket and in full to us. This restriction does not apply to the use or disclosure of your health information for your medical treatment.
Federal and/or State law require special privacy protections for certain highly confidential information about you, including your health information that is maintained in psychotherapy notes. Similarly, Federal and/or State law may provide greater protections than HIPAA for the following types of information, in which case we will comply with the law that provides your information with the greatest protection and you with the greatest privacy rights: (1) mental health and developmental disabilities; (2) alcohol and drug abuse prevention, treatment and referral; (3) HIV/AIDS testing, diagnosis or treatment; (4) communicable diseases; (5) genetic testing; (6) child abuse and neglect; (7) domestic or elder abuse; and/or (8) sexual assault. In order for your highly confidential information to be disclosed for a purpose other than those permitted or required by law, your written authorization is required.
We will first obtain your written authorization before using or disclosing your medical information for any purpose not described above, including disclosures that constitute the sale of protected health information or for marketing communications paid for by a third party (excluding refill reminders, which the law permits without your authorization). If you provide the facility permission to use or disclose your medical information, you may revoke that permission, in writing to the Facility Privacy Officer, at any time. If you revoke your permission, we will no longer use or disclose your medical information for the reasons covered in your written authorization. You understand that we are unable to take back any disclosures already made with your permission, and that we are required to retain our records of the care that the facility provided to you.
You have the following rights regarding medical information the facility maintains about you:
** NOTE: All Requests Must Be Submitted in Writing to the Facility Privacy Officer.
To inspect and copy medical information or to receive an electronic copy of the medical information, you must submit a written request. You may direct the facility to transmit the copy to another entity or person that you designate provided the choice is clear, conspicuous, and specific. If you request a paper copy of your information, we may charge a fee for the cost of copying, mailing or other supplies associated with your request.
If the facility uses or maintains an electronic health record with respect to your medical information, you have the right to obtain an electronic copy of the information if you so choose. The facility may charge a fee equal to its labor cost in providing the electronic copy (e.g., costs may include the cost of a flash drive, if that is how you request a copy of your information be produced).
If you request an electronic copy of your information, we will provide the information in the format requested if it is feasible to do so.
Please be aware that if you request us to share medical information by unencrypted e-mail, there is some risk that it could be read or accessed by a third party. We will confirm that you want to receive medical information by unencrypted e-mail before sending it to you.
We may deny your request to inspect and copy in some limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Depending on the reason for the denial, another licensed health care professional, other than the person who denied your request, may be chosen by the facility to review your request and the denial.
The facility will comply with the outcome of the review.
To request an amendment, you must submit a written request to the Facility Privacy Officer. You must also provide a reason that supports your request.
Your request for an amendment may be denied if:
To request this list or accounting of disclosures:
The first list you request within a 12-month period will be free. For additional lists, we may charge 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.
To request restrictions, you must make your request in writing to the FPO or HIM Director on the Written Request for Restrictions Form. In your request, you must tell us:
Henderson County Community Hospital complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
If you have any questions about this notice, please contact the Facility Privacy Officer at 1-731-968-1811. Additionally, you can contact the FPO in writing at the following address:
Henderson County Community Hospital
Facility Privacy Officer
200 WEST CHURCH STREET
LEXINGTON, TN 38351