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.
Protected health information is health information we have collected from you or received from other health care providers, health plans, your employer or a health care clearinghouse. It may include information about your past, present or future physical or mental health or condition, the provision of your health care, and payment for your health care services.
We are required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to your health information. We are also required to comply with the terms of our current Notice of Privacy Practices.
We reserve the right to change the terms of our Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information we already have about you as well as any health information we receive in the future.
We will post a copy of the current Notice at each site where we provide care. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice. You have the right to obtain a paper copy of this Notice at any time.
Treatment: We may use and disclose your health information to provide your health care and any related services. We may also use and disclose your health information to coordinate and manage your health care and related services. For example, we may need to disclose information to a case manager who is responsible for coordinating your care. We may also disclose your health information among our clinicians and other staff who work at our agency. For example, our staff may discuss your care at a case conference. In addition, we may disclose your health information to another health care provider (for example, your primary care physician or a laboratory) working outside of our agency.
Payment: We may use and disclose your health information for payment purposes. For example, we may need to obtain authorization from your insurance company or other third-party payors before providing certain types of treatment. We will submit bills and maintain records of payments from your health plan.
Health Care Operations: We may use and disclose your health information in connection with our healthcare operations. These may include, but are not limited to, quality assessment and improvement, reviewing the performance of our clinicians, training, licensing, accreditation, business planning and general administrative activities.
We may use and disclose your health information to contact you to remind you of your appointment. We may use and disclose your health information to inform you about possible treatment options or alternatives that may be of interest to you.
Persons Involved in Your Care: We may use or disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. In limited circumstances, we may disclose health information about you to a friend or family member who is involved in your care. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person’s involvement in your healthcare.
Emergencies: We may use and disclose your health information in an emergency treatment situation. We will attempt to obtain your Consent as soon as reasonably practicable after we provide you with emergency treatment.
Communication Barriers: We may use and disclose your health information if we attempt to obtain Consent from you, but are unable to do so due to substantial communication barriers. We will only use or disclose your health information if we determine in our professional judgment that, absent the communication barriers, you likely would have consented to use or disclose information under the circumstances.
As Required by Law: We may disclose health information about you when required to do so by federal, state or local law.
To Avert Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious and imminent threat to your health or safety or to the health or safety of the public or another person. We will only disclose health information to someone who is able to help prevent or lessen the threat.
Public Health Activities: We may disclose health information about you as necessary for public health activities.
Health Oversight Activities: We may disclose health information about you to a health oversight agency for activities authorized by law.
Disclosures in Legal Proceedings: We may disclose information in response to an appropriate subpoena or court order.
Law Enforcement Activities: Subject to certain restrictions, we may disclose information required by law enforcement officials.
Military and Veterans: We may disclose your health information as required by military command authorities.
National Security: We may disclose health information about you to authorized federal officials required for lawful intelligence, counterintelligence, and other national security activities.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose health information about you to the correctional institution or law enforcement official.
Workers’ Compensation: We may disclose health information about you to comply with the state’s Workers’ Compensation Law.
In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose. If you give us an authorization, you may revoke it in writing at any time. Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reasons except those described in this Notice.
You have the right to inspect or copy your health information. This would include clinical and billing records, but not psychotherapy notes. You must submit your request in writing using the contact information listed at the end of this Notice. We will charge you $0.25 per copy, $25 per hour for staff time to locate and copy your health information, and postage if you want the copies mailed to you. We may deny your request to inspect or copy your health information in certain limited circumstances. In some cases, you will have the right to have the denial reviewed by a licensed health care professional not directly involved in the original decision to deny access. We will inform you in writing if the denial of your request may be reviewed.
Right to Amend: You have the right to request that we amend your health information. This would include clinical and billing records, but not psychotherapy notes. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances.
Accounting of Disclosures: You have the right to request that we provide you with a list of disclosures we have made of your health information for purposes other than treatment, payment and health care operations. This request must be in writing, and should not be for a period longer than six years and not include dates before April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.
Restrictions: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).
Confidential Communications: You have the right to request that we communicate with you about your health information only in a certain location or through a certain method. Your request must be in writing.
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. All complaints must be in writing. We support your right to the privacy of your health information. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
Contact Officer: Duane R. Majeres, M.S., 357 Kansas SE, Huron, SD 57350; (605)352-8596