HIPAA 私隐实务通知

HIPAA NOTICE OF PRIVACY PRACTICES

(生效日期:2013年9月1日)

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. 请仔细审阅.

这个通知适用于谁

本通知适用于所有承保实体的服务地点，包括:

1. 168 S. Howell Street, 希尔斯代尔，密歇根州49242
2. 451 Hidden Meadows Drive, 希尔斯代尔，密歇根州49242
3. 61 W. Carleton Road, 希尔斯代尔，密歇根州49242
4. 143 S. 主街，雷丁，密歇根州49274
5. 535 Marshall Street, Litchfield, MI 49252
6. 医务人员、雇员和其他承保实体工作人员.

我们的责任

承保实体认真对待委托给我们的健康信息的隐私, as both an ethical and a legal obligation. 法律要求我们:

1. Maintain the privacy of health information.
2. Provide you with this 私隐实务通知 (“Notice”), 这说明了我们在保护健康信息方面的职责和做法.
3. Abide by the terms of the Notice that is currently in effect.
4. 在泄露影响您的不安全运行状况信息后通知您.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following categories describe different ways Covered Entity may use and disclose your health information without your written authorization. 健康信息最常用于提供治疗, 获得治疗费用, 或者用于医疗保健业务. 我们将提供这些类别所涵盖的使用类型的示例. Not every use or disclosure in a category will be listed. 在适当的情况下，“您”和“您的”信息也包括您孩子的信息.

1. 治疗. 承保实体可使用和披露健康信息以提供治疗, health care or other related services. Health information may be used by or disclosed to doctors, 护士, 助手, or other healthcare providers who are involved in taking care of you. 另外, 承保实体可使用或披露健康信息来管理或协调治疗, health care or other related services. 例如, we may use or disclose health information about you for treatment purposes such as when you are referred to a specialist for care or when we send a prescription to a pharmacy to be filled for you.
2. 付款. Covered Entity may use and disclose health information to bill and collect for the treatment and services we provide to you. 我们可能会将健康信息发送给您的保险公司或其他第三方付款人用于付款目的. 例如, we may use and disclose health information about you for payment purposes such as when we send claims to your HMO for payment or to find out whether proposed treatment is covered.
3. 医疗保健业务. 受保实体可为医疗保健业务使用和披露健康信息. These uses and disclosures are necessary to run Covered Entity and to maintain and improve the quality of health care we provide. 例如, we may use and disclose health information about you for health care operations purposes such as accreditation renewals, 品质改善活动, 以及教学目的.
4. 医院目录. Covered Entity may include limited information about you in the hospital directory while you are a patient at Covered Entity. 这些信息包括您的姓名、在医院的位置、您的一般情况.g.公平的，稳定的等.)和你的宗教信仰. 目录信息可能会透露给那些询问您姓名的人, except for your religious affiliation, which may only be disclosed to clergy members. 您有权不将您的信息纳入医院目录(“选择退出”)。. 要选择退出医院目录，我们要求您在患者注册时提出此请求.
5. Individuals Involved in Your Care or Payment for Your Care. Covered Entity may disclose to your family member, 相对, close personal friend or other person identified by you, health information that is directly relevant to that person’s involvement with your care or payment for your care. Covered Entity will not share this information with these individuals if we are aware of your desire not to have this information shared.
6. Appointment Reminders and Health-Related Benefits or 服务. We may use health information to provide you appointment reminders, information about treatment alternatives, or information about other health care services or benefits we offer.
7. 筹款. We may use or disclose health information for the purpose of raising funds to help support the Covered Entity mission. 您有权选择不接收筹款通讯.
8. 研究. 在某些情况下, 受保实体可出于研究目的使用和披露健康信息. 例如, a research project may involve comparing the health and recovery of all individuals who receive one medication to those who receive another. All research projects are subject to a special approval process.
9. 免疫接种记录. 承保实体可能会向您现在或即将成为学生的学校披露免疫记录, 如果法律要求学校为入学目的提供免疫证明. 受保实体将首先获得您的口头或书面许可才能进行此披露.
10. 为了公众健康. 承保实体可为公共卫生活动披露健康信息. 例如, public health activities include: preventing and controlling disease, injury or disability; reporting births and deaths; and reporting defective medical devices or problems with medications.
11. 网上澳门永利博彩官网受虐者. Covered Entity may disclose your health information to notify the appropriate government authority if we believe you have been the victim of abuse, 忽视或家庭暴力. 只有在您同意或法律要求或授权的情况下，我们才会披露此信息.
12. 卫生监督活动. Covered Entity may disclose health information to a health oversight agency for health oversight activities authorized by law. 这些活动包括审计, 调查, licensure and disciplinary actions, and related activities to monitor the health care system, 政府福利计划, and compliance with civil rights laws.
13. Judicial and Administrative Proceedings. 受保实体可应传票披露健康信息, 法院命令, 或者行政命令, 如果满足某些要求.
14. 执法. 如果法律要求披露，受保实体可以向执法部门披露健康信息, necessary to identify or locate a suspect or missing person, about criminal conduct at Covered Entity, about a victim of crime under certain circumstances, and in certain emergency situations.
15. To Avert a Serious Threat to Health or Safety. Covered Entity may use and disclose health information when Covered Entity believes it is necessary to prevent a serious threat to the individual’s health and safety or the health and safety of the public or another person. 只有那些能够帮助防止或减轻威胁的人才会透露这些信息, 或者给执法部门.
16. Coroner, Medical Examiners, and Funeral Directors. Covered Entity may disclose health information to a coroner or medical examiner for the purpose of identifying a deceased person, 确定死因, 法律规定的其他职责. Covered Entity may disclose health information to a funeral director, 符合法律, to permit the funeral director to carry out his/her duties.
17. 器官捐赠目的. Covered Entity may disclose health information to organ procurement organizations and others engaged in procurement, banking or transplantation of cadaveric organs, 眼睛, 或组织, for the purposes of facilitating organ donation and transplantation.
18. 军人和退伍军人. If you are a member of the armed forces, 我们可能会根据军事指挥当局的要求公布您的健康信息. We may also release health information about foreign military personnel to the appropriate foreign military authority.
19. National Security and Intelligence Activities. 承保实体可向授权的联邦官员发布健康信息以供参考, 法律授权的反情报和其他国家安全活动.
20. Protective 服务 for the President and Others. Covered Entity may disclose health information to authorized federal officials so they may provide protection to the President or other authorized persons, or for the conduct of special 调查 authorized by law.
21. 犯人. 如果你是一名囚犯或被惩教机构或执法机构拘留, Covered Entity may disclose health information to the correctional institution or law enforcement official for treatment and safety purposes.
22. 工人的补偿. Covered Entity may disclose health information as authorized by and to the extent necessary to comply with worker’s compensation laws or laws relating to similar programs.
23. 按法律规定. 受保实体将在联邦政府要求时披露健康信息, 州或地方法律.

卫生信息交流

Covered Entity participates in a health information exchange organization (“HIE”) that permits computer-based transfer of health information directly between healthcare providers at different locations and institutions to facilitate your care and treatment. If you do not want your information to be shared in this way, you can opt-out by submitting your request 以书面形式.

SPECIAL RESTRICTIONS UNDER STATE AND OTHER FEDERAL LAWS

We will also comply with all other applicable state and federal laws. 例如, 根据州法律, 在何时披露艾滋病毒和艾滋病信息方面有更多的限制. 根据其他联邦法律, 对于何时披露药物或酒精滥用治疗信息有更多的限制. We abide by all applicable state and federal laws.

其他用途及披露

Any other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your Authorization.

DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION

An Authorization is a special written permission from you that grants authority to Covered Entity to use or disclose your health information.

1. 我们必须获得您的授权才能使用或披露心理治疗记录. 心理治疗笔记只能用于有限的目的，例如由治疗专业人员使用. Disclosures are permitted only as required by law, for certain health oversight activities, or to avert a serious threat to health or safety.
2. 我们必须获得您的授权才能出于营销目的使用或披露健康信息, or for disclosures that constitute the sale of medical information.
3. 如果您向我们提供使用或披露您的健康信息的授权, you may revoke that Authorization, 以书面形式, 在任何时候. 如果您撤销您的授权, we will no longer use or disclose health information about you for the reasons covered by your Authorization.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

对于我们保留的有关您的健康信息，您拥有以下权利:

1. 要求限制的权利. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, 支付或医疗保健业务. 在大多数情况下, we are not required to agree to your request. 如果我们同意, 我们将遵从您的要求，除非该信息是为您提供紧急处理所需. 如果你已自付医疗费，我们必须同意你的要求, 您要求我们不要向您的健康计划提交有关该护理的信息.
2. Right to Request Confidential Communications. 通常, we communicate with you regarding your health care either by calling your home phone or sending mail to your home address. 您有权要求我们以另一种方式或在特定地点与您沟通. 如需保密通讯，我们要求您提出要求 以书面形式. 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.
3. 查阅权. 在大多数情况下, you have the right to access your health information by requesting to inspect and/or obtain a copy of your health information, 除了有限的例外. We ask that your request be made in 写作. 您可以要求以摘要格式提供您的健康信息副本. 您也可以要求以纸质(“硬拷贝”)或电子形式或格式提供副本. Covered Entity will also transmit a copy of your health information to another person designated by you 以书面形式. Covered Entity may charge reasonable fees for copies.
4. 要求修改的权利. You have the right to ask us to amend your health information. To request an amendment, we ask that your request be made in 写作. In addition, you must provide a reason that supports your request. We may deny your request in certain circumstances; such as if the information was not created by us, or we believe the information is already accurate and complete. If we deny your request, you may appeal the denial.
5. Right to an Accounting of Disclosures. 您有权要求我们提供您的健康信息披露清单. 你的请求必须说明一个不超过6年的时间段. The first list you request within a twelve-month period will be free. 对于该等12个月期间的额外清单，承保实体可能向贵方收取合理费用.
6. 违约通知权. Covered Entity must notify you if your unsecured protected health information has been the subject of a breach.
7. Right to a Paper Copy of this Notice. You may ask us to give you a copy of this Notice 在任何时候. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice. You may also obtain a printable copy of this Notice here:
   PDF HIPAA 私隐实务通知

本通知的更改

We reserve the right to make changes to this Notice. 我们保留修改后的通知对我们已经掌握的健康信息有效的权利, as well as any information we receive or create in the future. The Notice will contain the current effective date. 我们将在我们的办公地点和网站上张贴当前通知的副本. The Notice is also available to you upon request.

投诉

If you believe your privacy rights have been violated, you may file a complaint with Covered Entity or with the Secretary of the Department of Health and Human 服务. To file a complaint with Covered Entity, contact our Privacy Officer. You will not be penalized for filing a complaint. 为确保我们有足够的资料，我们要求投诉以书面形式提交. If you have any questions about this Notice, please contact:

澳门永利线上博彩娱乐场
助理:私隐主任
南豪厄尔街168号
希尔斯代尔，密歇根州49242

517-437-5232