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THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET
ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
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Cabarrus Health Alliance
NOTICE OF PRIVACY PRACTICES
Effective: April 14, 2003
Cabarrus Health Alliance collects and maintains health information
about you and is required by law to protect the privacy of your
health information. We are required to provide you with this 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 IT CAREFULLY.
How We May Use and Disclose Medical
Information About You.
We use and disclose medical information about you for a number of
different purposes. Each of those purposes is described below.
● For Treatment.
We may use medical information about you to provide, coordinate or
manage your health care and related services by both us and other
health care providers. We may disclose medical information about you
to doctors, nurses, hospitals and other health facilities who become
involved in your care. For example, we may consult with other health
care providers concerning you and as part of the consultation, share
your medical information with them. Similarly, we may refer you to
another health care provider and as part of the referral share
medical information about you with that provider.
● For Payment.
We may use and disclose medical information about you so we can be
paid for the services we provide to you. This can include billing
you, your insurance company, or a third party payor, or collection
agency. For example, we may need to give your insurance company
information about the health care services we provide to you so your
insurance company will pay us for those services or reimburse you
for amounts you have paid. We also may need to provide your
insurance company or a government program, such as Medicare or
Medicaid, with information about your medical condition and the
health care you need to receive to determine if you are covered by
that insurance or program.
● For Health Care Operations.
We may use and disclose medical information about you for our own
health care operations. These are necessary for us to operate
Cabarrus Health Alliance and to maintain quality health care for our
patients. For example, we may use medical information about you to
review the services we provide and the performance of our employees
in caring for you. We may disclose medical information about you to
train our staff, volunteers and students working in Cabarrus Health
Alliance. We also may use the information to study ways to more
efficiently manage our organization.
● How We Will Contact You.
Unless you tell us otherwise in writing, we may contact you by
either telephone or by mail at either your home or your workplace.
At either location, we may leave messages for you on the answering
machine or voice mail.
● Appointment Reminders.
We may contact you to remind you of an appointment you have with us.
● Individuals Involved in Your Care.
We may disclose to a family member, other relative, a close personal
friend, or any other person identified by you, medical information
about you that is directly relevant to that person=s involvement
with your care or payment related to your care. If the patient is a
minor, we may disclose medical information about the minor to a
parent, guardian or other person responsible for the minor except in
limited circumstances. We also may use or disclose medical
information about you to notify, or assist in notifying, those
persons of your location, general condition, or death. You may ask
us at any time not to disclose medical information about you to
persons involved in you care. We will agree to your request and not
disclose the information except in certain circumstances (such as
emergencies) or if the patient is a minor. If the patient is a
minor, we may or may not be able to agree with your request. If
there is a family member, other relative, or close personal friend
that you do not want us to disclose medical information about you
to, please notify Privacy Officer, 300 Mooresville Road Kannapolis,
NC 28081 or tell our staff member who is providing care to you.
● Disaster Relief.
We may use or disclose medical information about you to a public or
private entity authorized by law or by its charter to assist in
disaster relief efforts. This will be done to coordinate with those
entities in notifying a family member, other relative, close
personal friend, or other person identified by you of your location,
general condition or death.
● Required by Law.
We may use or disclose medical information about you when we are
required to do so by law.
In special circumstances we may
be permitted or required to disclose your information for:
Public Health Activities; Victims
of Abuse, Neglect or Domestic Violence; Health Oversight Activities;
Judicial and Administrative Proceedings; Disclosures for Law Enforcement
Purposes; Coroners and Medical Examiners; Funeral Directors; Organ, Eye or
Tissue Donation; Research; To Avert Serious Threat to Health or Safety to
you or others; Military and veteran=s activities; National security and
intelligence activities; Protective service for the president and others;
Correctional institutions and other law enforcement custodial situations;
Worker=s compensation or other similar programs; and to the government to
demonstrate our compliance with the Privacy Rule.
Other Uses and Disclosures.
Other uses and disclosures will be made only with your written
authorization. You may revoke such an authorization at any time by
notifying Cabarrus Health Alliance 300 Mooresville Road Kannapolis,
NC 28081 Attn: Privacy Officer in writing of your desire to revoke
it. However, if you revoke such an authorization, it will not have any
affect on actions taken by us in reliance on it.
Your Rights With Respect to Medical Information About You.
You have the following rights with respect to medical information that we
maintain about you.
● Right to Request Restrictions.
You have the right to request that we restrict the uses or disclosures of
medical
information about you.
We are not required to agree to any requested restriction. Even if we
agree to a restriction, either you or we can later terminate the
restriction.
● Right to Receive Confidential Communications.
You have the right to request that we communicate medical information
about you to you in a certain way or at a certain location. Example: You
may prefer to have all written information mailed to your work address
rather than your home address.
● Right to Inspect and Copy.
With a few very limited exceptions, you have the right to inspect and
obtain a copy of medical information about you.
● Right to Amend.
You have the right to ask us to amend medical information about you. You
have this right for so long as the medical information is maintained by
us.
If we deny your request, we will inform you of the basis for the denial.
You will have the
right to submit a statement disagreeing with our denial.
● Right to an Accounting of Disclosures.
You have the right to receive an accounting of disclosures of medical
information about you. The accounting may be for up to six (6) years prior
to the date on which you request the accounting but not before April 14,
2003.
● Right to Copy of this Notice.
You have the right to obtain a paper copy of our Notice of Privacy
Practices. You may obtain a paper copy even though you agreed to receive
the notice electronically. You may request a copy of our Notice of Privacy
Practices at any time.
You may obtain a copy of our Notice of Privacy Practices over the Internet
at our web site, www.CabarrusHealth.org
To exercise these rights, you must submit your request in writing to:
Privacy Officer, Cabarrus Health Alliance 300 Mooresville Road
Kannapolis, NC 28081
Our Duties
● Generally.
We are required by law to maintain the privacy of medical
information about you and to provide you with this notice of our
legal duties and privacy practices with respect to medical
information.
We are required to abide by the terms of our Notice of Privacy
Practices in effect at the time.
● Our Right to Change Notice of Privacy Practices.
We reserve the right to change this Notice of Privacy Practices. We
reserve the right to make the new notice=s provisions effective for
all medical information that we maintain, including that created or
received by us prior to the effective date of the new notice.
● Availability of Notice of Privacy Practices.
A copy of our current Notice of Privacy Practices will be posted in
lobby areas. A copy of the current notice also will be posted on our
web site, www.CabarrusHealth.org. Patients will receive a revised
notice on their next agency contact following any amendment to this
notice.
At any time, you may obtain a copy of the current Notice of Privacy
Practices by contacting Privacy Officer, Cabarrus Health
Alliance, 300 Mooresville Road Kannapolis, NC 28081.
● Complaints.
You may complain to us and to the United States Secretary of Health
and Human Services if you believe your privacy rights have been
violated. All complaints should be submitted in writing.
To file a complaint with us, contact Privacy Officer, Cabarrus
Health Alliance, 300 Mooresville Road Kannapolis, NC 28081.
To file a complaint with the federal government: Region IV
Office for Civil Rights, US Dept of Health and Human Services,
Atlanta Federal Center, Suite 3B70,
61 Forsyth St. SW, Atlanta, GA 30303-8909
You will not be retaliated against for filing a complaint.
● Questions and Information.
If you have any questions or want more information concerning this
Notice of Privacy Practices, please contact Privacy Officer,
Cabarrus Health Alliance, 300 Mooresville Road Kannapolis, NC 28081 Ph:704-920-1000. |
Notice of Privacy
Practices
