THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
BY ACCESSING AND USING THIS SERVICE, YOU ACCEPT AND AGREE TO BE BOUND BY THE TERMS AND PROVISION OF THIS AGREEMENT. IN ADDITION, WHEN USING THESE PARTICULAR SERVICES, YOU SHALL BE SUBJECT TO ANY POSTED GUIDELINES OR RULES APPLICABLE TO SUCH SERVICES. ANY PARTICIPATION IN THIS SERVICE WILL CONSTITUTE ACCEPTANCE OF THIS AGREEMENT. IF YOU DO NOT AGREE TO ABIDE BY THE ABOVE, PLEASE DO NOT USE THIS SERVICE.
1. Purpose: Wind River Family & Community Health Care and employees (who will be referred to as WRFCHC) follow the privacy practices that are described in this notice. WRFCHC is required by law to keep your medical information (also known as patient health information or PHI/ePHI) private. This notice describes the ways that WRFCHC may disclose your information but will not list every possible use and disclosure. Your health information is being stored electronically and may be electronically disclosed.
2. Organized Health Care Agreement: WRFCHC and its medical staff work together in an organized health care arrangement to provide you with care. This Notice applies to providers and other members of the medical staff who have agreed to abide by its terms concerning the services they perform at WRFCHC. This notice does not create any sort of joint venture or legal relationship between those covered by this notice. Because of this arrangement, WRFCHC may share your medical information as necessary for treatment, payment and health care operations relating to the organized health care arrangement.
3. Uses and Disclosures for Treatment, Payment, and Health Care Operations: We will use and disclose your medical information for treatment, payment, and health care operations. Treatment involves providing and coordinating for your care. An example of how we may use your medical information is disclosing your information to a specialist to help diagnose or treat you.
Payment involves uses and disclosures to help us receive payment for treating you. Another example of disclosing your information is submitting your information to health plans or other payors to determine whether you are enrolled with the payor or if you are eligible for health benefits.
Health care operations involves our set of standard internal operations, such as quality assurance, peer review, arranging for legal services, providing appointment reminders, and training.
4. Other Uses and Disclosures Not Requiring an Authorization: Your medical information may be used and disclosed in the following ways:
- Family members or close friends involved in your care or payment for your treatment.
- A government disaster relief agency if you are involved in a disaster relief effort.
- To inform you of treatment alternatives or benefits or services related to your health. If we receive anything of value for making these communications, we will notify you, and you will also be given the opportunity to opt out of future communications.
- As required by law.
- Public health activities, including disease prevention, injury or disability; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medications or product problems; notifications of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect, or domestic violence (if you agree or as required by law).
- Health oversight activities (e.g., audits, inspections, investigations, and licensure activities).
- Lawsuits and disputes (e.g., as required by a court or administrative order or in response to a subpoena or other legal process).
- Law enforcement (e.g., in response to legal process or as required or allowed by law).
- Coroners, medical examiners, and funeral directors.
- Organ and tissue donation organizations.
- Certain research projects as approved by an Institutional Review Board or if certain conditions are met.
- To prevent a serious threat to health or safety.To military authorities if you are a member of the armed forces.
- National security and intelligence activities.
- Protection of the President or other authorized person or foreign heads of state, or to conduct special investigations.
- Inmates or others in custody to a correctional institution or law enforcement.
- Workers’ Compensation (in compliance with applicable laws).
- To business associates(individuals or entities that perform functions on our behalf) (e.g., to install a new computer system) provided they agree to safeguard the information.
For more information see:
5. Substance Abuse Information: There are special privacy protections in place for substance and alcohol abuse information. WRFCHC will not disclose any information that identifies an individual as being a substance abuse patient or will not provide any medical information relating to the patient’s substance abuse treatment unless (i)the patient consents in writing; (ii)a court order requires disclosure of the information; (iii)medical staff needs the information to meet a medical emergency; (iv)qualified personnel use the information for the purpose of conducting scientific research, management audits, financial audits, or program evaluation; or (v)it is necessary to report a crime of a threat to commit a crime, or to report abuse or neglect as required by law.
6. Your Authorization Is Required for Other Uses and Disclosures: With the exception of the reasons listed above, we will not use or disclose your medical information unless you authorize (permit) WRFCHC, in writing, to use or disclose your information. Subject to compliance with limited exceptions, we will not use or disclose psychotherapy notes, use or disclose your health information for marketing purposes or sell your health information, unless you have signed an authorization. You may revoke your authorization and stop any futures uses and disclosures by notifying us in writing.
7. Your Medical Information Rights: You have the following rights regarding your medical information, provided that you make a written request to invoke the right on the form provided by WRFCHC.
- Right to request restriction. You may request limitations on how we use or disclose your medical information for health care treatment, payment, or operations (e.g., you may ask us not to disclose that you have had a particular surgery). We are not required to agree to your request, except for requests to restrict disclosures to a health plan for purposes of payment or health care operations when you have paid in full out-of-pocket for the item or service covered by the request and when the disclosure is not required by law. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
- Right to confidential communications. You may request communications in a certain way or at a certain location, but you must specify how or where you wish to be contacted and how payment will be handled.
- Right to inspect and copy. You have the right to look at and obtain a copy of your medical records, billing records, and other records used to make decisions about your care.We may charge you a fee for our postage and labor costs and supplies used to create the copy. Under limited circumstances, your request may be denied and you may comply with the outcome of the review. If your information is stored electronically and you request an electronic copy, we will provide it to you in a readable electronic format.
- Right to request an amendment. If you believe that the medical information we have about you is incorrect or incomplete, you have the right to request that your records be amended. Under limited circumstances, WRFCHC may deny your request for amendment. If denied, you will receive an explanation for the decision and information explaining your options.
- Right to accounting of disclosures. You may request a list of instances where we have disclosed your medical information for certain types of disclosures. The accounting will not include disclosures that we are not required to record, such as disclosures made pursuant to an authorization. The first accounting you request within a 12-month period is free, but we will charge a fee for any additional lists requested within the same 12-month period.
- Right to a copy of this notice. You may request a paper copy of this notice at any time, even if you have been provided with an electronic copy. You may obtain an electronic copy of this notice at our website, http://www.windrivercares.com/home.
8. Other Obligations: WRFCHC is required by law to provide you with this notice. We will be governed by this notice for as long as it is in effect. We are also required to comply with any federal or state laws that impose stricter standards than those described in this notice. WRFCHC may change this notice at any time and these changes will be effective for medical information we have about you as well as any information we receive in the future. We will post a copy of the current notice in the clinic and on our website. You may also get a current copy by contacting our Privacy Officer at the phone number at end of this notice. We are required by law to notify affected individuals following a breach of unsecured medical information.
9. Complaints: If you believe your privacy rights have been violated, you may file a complaint with WRFCHC or with the Secretary of the United States Department of Health and Human Services. You will not be penalized or retaliated against in any way for making a complaint to WRFCHC or the Department of Health and Human Services.
Contact WRFCHC’s Compliance and Privacy Officer at (307) 857-9492 if:
- You have a complaint;
- You have any questions about this notice; or
- You wish to obtain a form to exercise your individual rights described in section 7 of this notice.