HIPAA Notice of Privacy
THIS NOTICE DESCRIBES HOW PERSONAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. REVIEW IT CAREFULLY.
This agency keeps personal health records that may include information to identify you, and that relates to your past, present, or future physical or mental health condition and related health care services in order to assist you to have the best possible health care. These records contain information from physicians and clinics that diagnose, treat, and prescribe medications and treatments for you. These records also contain information the agency keeps about your health, medications, and prescribed treatments. This notice applies to all the records of your care generated or maintained by the agency. Your personal doctors or clinics may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic.
Kalix is required by law to maintain the privacy of your personal health information and provide you a description of our privacy practices. Kalix will abide by the terms of this notice and notify you if we cannot agree to a requested restriction. Kalix will accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
The following categories describe examples of the way Kalix may use and disclose personal health information:
For treatment: Kalix may use personal health information about you to coordinate or manage your health care and any related services. We may disclose medical information about you to doctors, nurses, technicians, medical students and your health care provider. We may disclose information to agency personnel who are involved in taking care of your health needs. For example: Any time you go to the Doctor we will tell the Doctor about the medications you are taking or any allergies you may have so your Doctor will know this before he or she prescribes any different or new medication; or if your Doctor orders Physical Therapy, the nursing staff or Program Director will need to discuss your care and treatment with specialists such as Physical Therapists, a Dietician, or Audiologist. Different programs of our agency also may share medical information about you in order to coordinate the different things you may need, such as supporting you to take your medications, get the treatments that you need, and getting to your health care appointments. We may provide your physician with reports that assist him or her in treating you.
For Payment: The agency may disclose personal health information about you in order to collect payment for services provided to you.
For Health Care Operations: Agency staff may use information in your record to assess the care and outcomes in your case and others like it. The results may then be used to continually improve the quality of care for all of the people served by the agency. The agency may combine personal health information about many people receiving services to evaluate the need for new additional funding, services, treatments, or equipment.
The agency may also use and disclose medical information:
Organ Procurement Organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Food and Drug Administration (FDA): Kalix may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects or post marketing surveillance information to enable product recalls, repairs or replacement.
Workers Compensation: Kalix may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Public Health: As required by law, Kalix may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.
Correctional Institution: Should you be an inmate of a correctional institution, Kalix may disclose to the institution or agents thereof, health information necessary for your health, and the health and safety of other individuals.
Law Enforcement: Kalix may disclose health information for law enforcement purposes as required by law, or in response to a valid subpoena.
Federal Law makes provision for your health information to be released to an appropriate health oversight agency, public health authority, or attorney, provided that a workforce member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.
Your Health Information Rights
Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the agency will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by our facility. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial.
An Accounting of Disclosures: You have the right to request an accounting of disclosures. This is a list of the disclosures we make of personal health information about you.
Request Restrictions: You have the right to request a restriction or limitations on the personal health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the personal health information disclosed about you to someone who is involved in your care or payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
Request Confidential Communications: You have the right to request that we communicate about personal health matters in a certain way or at a certain location. We will agree to the request to the extent that it is reasonable for us to do so. For example, you can ask that we use a different address to send mail about your health.
Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
You may obtain a copy of this notice at our website: www.kalixnd.org To exercise any of your rights, please obtain the required forms from the Privacy Officer and submit your request in writing. You may ask your Program Director for assistance.
CHANGES TO THIS NOTICE
Kalix reserves the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted at all program areas and include the effective date. In addition, if you leave agency services and re-enroll we will offer you a copy of the current notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with the agency by calling (701) 852-1014 and asking for the Privacy Officer or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You may ask your Program Director or any one else of your choice for assistance. You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided you.
This notice is published and effective no later than April 14, 2003.
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