Notice of Privacy Practices | townshiphealthdpc

Notice of Privacy Practices
Your Information. Your Rights. Our Responsibilities.

Other Uses and Disclosures in Certain Special Circumstances

Public Health Risks – (i.e., vital statistics, child abuse/neglect, exposure to communicable diseases, reporting reactions to drugs or problems with products or devices.)
Health Oversight Activities
Lawsuits and Similar Proceedings – You may use or disclose them in response to a court or administrative order if you are involved in a lawsuit or similar proceeding or response to a discovery request, subpoena, or another lawful process.
Deceased Patients – may be required to be released to a medical examiner or coroner. We may also release information for the funeral director to perform their jobs if necessary.
Organ and Tissue Donation
Serious Threats to Health or Safety
Military – If you are a member of the U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
National Security
Inmates – Our practice may disclose your health information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure would be necessary for the institution to provide health care services to you, for the safety and security of the institution, and/or to protect your health and safety or the health and safety of others.
Worker’s Compensation
Disclosures of your health information or its use for any purpose other than those listed above require your specific written authorization. Suppose you change your mind after authorizing the use or disclosure of your information. In that case, 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.

Your Rights in Accordance With Federal Privacy Standards

You have the right to request restrictions on using and disclosing your protected health information for treatment, payment, or healthcare operations. You have the right to restrict our disclosure to only specific individuals involved in your care or the payment for your care, such as family members and friends. You can amend or submit corrections to your protected health information. Requests must be made in writing and submitted to the Privacy Officer with reasons to support your request. We may deny your request if you ask us to amend information that is, in our opinion, a) accurate and complete; b) not part of the health information kept by or for the practice; c) not part of the health information which you are permitted to inspect and copy; or d) not created by our practice, unless the individual or entity that created is not available to amend the information. We will provide a written explanation for any denial in 60 days. The right to receive confidential communications concerning your medical condition and treatment

You have the right to inspect and copy your protected health information. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of the denial.

You have the right to receive an accounting of how and to whom your protected health information has been disclosed. We will include all the disclosures except those about treatment, payment, health care operations, and certain other disclosures (such as any that you asked us to make). We will provide one accounting a year for free but charge a reasonable, cost-based fee if you ask for another within 12 months. The right to receive a printed copy of this notice, even if you have agreed to receive the notice electronically. We are not required to agree to your request; however, if we do not agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. You must write your request to the attention of the Privacy Officer. Your request must be described clearly and concisely: a) the information you wish restricted; b) whether you are requesting to limit our practice’s use, disclosure, or both; and c) to whom you want the limits to apply.

Requests to Inspect Protected Health Information

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 your physician and/or privacy officer. Your request will be reviewed and generally approved unless there are legal or medical reasons to deny the request.

Township Health DPCs 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 that are outlined in this notice.

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.

Complaints

Township Health DPC, PC

113 S Water Street

Silverton Or 97381

503-8367-455

If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address. You will not be penalized or otherwise retaliated against for filing a complaint.

This notice is effective on or after 3/15/17