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HIPPA
NOTICE OF PRIVACY PRACTICES
THIS NOTICE IS REQUIRED BY LAW (FEDERAL REGULATION 45 CFR PARTS 160 & 164)
AND DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION.
THIS NOTICE IS IN EFFECT ON AND AFTER APRIL 1, 2003 AND APPLIES TO ALL
PROGRAMS WITHIN THE LAKE COUNTY HEALTH DEPARTMENT.
Uses and Disclosures of Health Information
We use health information about you for treatment (diagnostic testing,
medical prescription, referral, etc.), to obtain payment (submit claims
and/or encounters to billing services and/or clearinghouses, and/or
collection agencies, etc.), for healthcare operations (reporting,
utilization management, etc.) and to evaluate the quality of care that you
receive.
We may use or disclose identifiable health information about you without
your authorization for other purposes such as auditing and research studies
when the research has been approved by an institutional review board. As
required by law, we may disclose your health information to public health or
legal authorities charged with prevention or controlling disease, injury, or
disability.
Your Health Information Rights
• You have the right to inspect and obtain a copy of your health record with
a signed authorization as provided in 45 CFR 164.524.
• You have the right to request in writing that we restrict and/or not use
or disclose your protected health information as provided in 45 CFR 164.522
but we do not have to agree to accept your restrictions.
• You have the right to request in writing that your physician amend your
protected health information as provided in 45 CFR 164.528.
• You have the right to request in writing to receive confidential
communications from us by alternative means or at an alternative location as
provided by 45CFR 164.522
• You have the right to obtain a list of instances (accounting of
disclosures) where we have disclosed your protected health information for
purposes other than treatment, payment or health care operations as provided
in 45 CFR 165.528.
• You have the right to revoke your authorization to use or disclose health
information except to the extent that action has already been taken as
provided in 45 CFR 164.508.
Our Responsibilities
• We are required by law to maintain the privacy of your health information.
• We are required by law to provide you with this notice about our privacy
practices.
• We are required by law to follow the privacy practices that are described
in this notice; however, we reserve the right to change or modify our
practices and to make the new provisions effective for all protected health
information (PHI) we maintain. Should our information practices change, we
will post the revised privacy notice.
Questions/Complaints
If you have questions or if you are concerned that we have violated your
privacy rights, you may contact the privacy officer. You may also file a
complaint with the U.S. Secretary of Health and Human Services. There will
be no retaliation against you for filing a complaint.
Privacy Officer Telephone: (406) 883-7289 or Toll Free: 1-888-445-3269
Location: Lake County Health Department
Attn: Privacy Officer
Mailing Address: 802 Main Street, Suite A, Polson, MT 59860
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