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.
Uses and Disclosures
Treatment. Your health information
may be used by staff
members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing
treatment. For example, results
of laboratory tests and
will be available in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Payment. Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example,
your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.
Health care operations. Your health information may be used as necessary to support
the day-to-day activities and management of Rural Health Development.
For example, information on the services you received may
be used to support budgeting and financial reporting, and activities to evaluate and promote quality.
Law enforcement. Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate
law-enforcement investigations, and to comply with government mandated
Public health reporting. Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
Other uses and disclosures require your authorization. Disclosure of your health information or its use for any purposes other than those
listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke
the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.
Without your authorization, we are expressly prohibited to use or disclose your protected health information for marketing purposes when financial remuneration is involved. We may not sell your protected health information without your authorization. We may not use or disclose most psychotherapy notes contained in your protected health information. We will not use or disclose any of your protected health information that contains genetic information that will be used for underwriting
Additional Uses of Information
Appointment reminders. Your health information will be used by our
staff to send
you appointment reminders.
Information about treatments. Your health information may be used to send you information on the treatment and management of your medical condition that you may find interesting.
We may also send you information describing other
health-related products and services that we believe may interest you.
Fundraising. Unless you request
us not to,
we will use your name
and address to support our fund-raising efforts. If you do not want to participate in fund-raising efforts, please check off the following box.
- Please do not use my information for fund-raising purposes
Marketing. Unless you request us not to, there are some
marketing activities for which we may use your name and address, to provide you with information about
services available at our practice. If you’d rather not receive marketing
communication from our practice, please check off the following box:
- Please do not use my information for marketing purposes
You have certain rights under the federal privacy standards. These include:
- The right to request restrictions on the use and disclosure of your protected health information
- The right to receive confidential communications concerning
your medical condition and treatment
- The right to inspect and copy your protected health information
- The right to amend or submit corrections to your protected health information
- The right to receive an accounting of how and to whom your protected health information has been disclosed
- The right to receive a printed copy of this notice
Rural Health Development Duties
We are required by law to maintain the privacy of your protected
health information and to provide you with this notice
of privacy practices. We also are required to abide
by the privacy policies and practices outlined in this notice. In the event of a breach
of unsecured protected health information, if your information has been compromised it is our duty to notify you.
Right to Revise Privacy Practices
As permitted by law, we
reserve the right to amend or
modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request,
we will provide you with the most recently revised notice
on any office visit.
The revised policies and practices will be applied to all protected health information we maintain.
to Inspect Protected Health
You may generally inspect or copy the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting Anna McClain or Tory Moghadam. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.
If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter
outlining your concerns to:
Privacy Official at Rural Health Development 6130 S58th Street, Suite C Lincoln, NE 68516
If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter
cause of your concern to the same address. You will not be penalized or otherwise retaliated against for filing a complaint.
The name and address of the person you may contact for further information concerning our privacy practices is:
Rural Health Development
6130 S58th St., Suite C
Lincoln, Nebraska 68516
In February 2014, the Department
of Health and Human Services (HHS) posted to its website
models of the notice
of privacy practices in an effort to
make the Notice of Privacy Practices (NPP) less cumbersome, and to improve
patient’s experience and understanding of their rights and how their PHI is managed,. These notices
are written in clear, user-friendly language and reflect the recent
regulatory changes to HIPAA.
There are two sets of notices available, one specific for health plans and one for health care providers. These are available to all covered entities and may be customized with an organization’s specific information.
Each sample is provided in English and Spanish with three formatted options
(booklet, layered, full page) and one text-only option. For detailed instructions on how to customize these “plain” language NPPs, go to the HHS website at http://www.hhs.gov/ocr/privacy/hipaa/modelnotices.html.