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NOTICE OF PRIVACY PRACTICES |
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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.
This notice applies to the privacy practices of Samaritan Healthcare and
the members of the Samaritan Healthcare Medical Staff. These physicians
and providers participate in an Organized Health Care Arrangement (OHCA).
They may share with each other your medical information and the medical
information of others they service for the healthcare operation of their
OHCA.
Samaritan Healthcare respects your privacy. We understand that your personal
health information is very sensitive. We will not disclose your information
to others unless you tell us to do so, or unless the law authorizes or requires
us to do so.
The law protects the privacy of the health information we create and obtain
in providing our care and services to you. For example, your protected
health information includes your symptoms, test results, diagnoses,
treatment, health information from other providers, and billing and payment
information relating to these services. Federal and state law allows us to
use and disclose your protected health information for purposes of
treatment and healthcare operations. State law requires us to get your
authorization to disclose this information for payment purposes.
Examples of Use and Disclosures of Protected Health Information for
Treatment, Payment, and Healthcare Operations
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For treatment:
- Information obtained by a nurse, physician, or other member of our
health care team will be recorded in your medical record and used to
help decide what care is right for you.
- We may also provide information to others providing you car. This
will help them stay informed about your care
For payment:
- We request payment from your health insurance plan. Health plans
need information from us about your medical care. Information provided
to health plans may include your diagnoses, procedures performed, or
recommended care.
For healthcare operations:
- We use your medical records to assess quality and improve services.
- We may use and disclose medical records to review the qualifications
and performance of our healthcare providers and to train our staff.
- We may contact you to remind you about appointments and give you
information about treatment alternatives or other health-related benefits
and services.
- We may use and disclose your information to conduct or arrange for
services, including:
- medical quality review by your health plan;
- accounting, legal, risk management, and insurance services;
audit functions, including fraud and abuse detection and compliance
programs.
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Your Health Information Rights
The health and billing records we create and store are the property of
the practice/health care facility. The protected health information in
the record, however, generally belongs to you.
You have a right to:
- Receive, read, and ask questions about this notice;
- Ask us to restrict certain uses and disclosures of information. You
must deliver this request in writing to us. We are not required to
grant the request. But we will comply with any request granted;
- Request and receive from us a paper copy of the most current Notice
of Privacy Practices for Protected Health Information ("Notice");
- Request that you be allowed to see and get a copy of your protected
health information. You make this request in writing. We have a form
available for this type of request. If you request a copy of the
information, we may charge a fee for the cost of copying, mailing,
or other supplies associated with your request.
- Have us review a denial of access to your health information-except
in certain circumstances;
- Ask us to change your health information. You may give us this
request in writing. You may write a statement of disagreement if your
request is denied. It will be stored in your medical record, and
included with any release of your records.
- At your request, we will give you a list of disclosures of your
health information. The list will not include disclosures to third
party payers. You may receive this information without charge once
every 12 months. We will notify you of the cost involved if you request
this information more than once in 12 months.
- Ask that your health information be given to you by another means
or at another location. Please sign, date, and give us your request in
writing.
- Cancel prior authorizations to use or disclose health information
by giving us a written revocation. Your revocation does not affect
information that has already been released. It also does not affect
any action taken before we have it. Sometimes, you cannot cancel an
authorization if its purpose was to obtain insurance payments.
For help with these rights during normal business hours, please contact:
Director of Health Information Management
Samaritan Healthcare
801 E. Wheeler Road
Moses Lake, WA 98837
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Our Responsibilities
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We are required to:
- Keep your protected health information private;
- Give you this Notice;
- Follow the terms of this Notice
We have the right to change our practices regarding the protected health
information we maintain. If we make changes, we will update this Notice.
You may receive the most recent copy of this Notice by calling and asking
for it, viewing it on our website or by visiting our Health Information
Management Center (Medical Records) to pick one up.
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To Ask for Help or Complain
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If you have questions, want more information, or want to report a problem
about the handling of your protected health information, you may contact:
Director of Health Information Management
Samaritan Healthcare
801 E. Wheeler Road
Moses Lake, WA 98837
If you believe your privacy rights have been violated, you may discuss
your concerns with any staff member. You may also deliver a written
complaint to Rebecca McPheeters, RHIT at Samaritan Healthcare. You may
also file a complaint with the U.S. Secretary of Health and Human Services.
We respect your right to file a complaint with us or with the U.S.
Secretary of Health and Human Services. If you complain, we will not
retaliate against you.
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Other Disclosures and Uses of Protected Health Information
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Notification of Family and Others
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Unless you object, we may release health information about you to a
friend or family member who is involved in your medical care. We may
also give information to someone who helps pay for your care. We may
tell your family or friends your condition and that you are in a
hospital. In addition, we may disclose health information about you
to assist in disaster relief efforts.
Information may be provided to people who ask for you by name. We may
use and disclose the following information in a hospital directory:
- Your name
- Location
- General condition, and
- Religion (only to clergy)
You have the right to object to this use or disclosure of your
information. If you object, we will not use it or disclose it. This
is called “opt out.”
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We may use and disclose your protected health information without your authorization as follows:
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- With medical researchers – if the research has been
approved and has policies to protect the privacy of your health
information. We may also share information with medical researchers
preparing to conduct a research project.
- To Funeral Directors/Coroners consistent with applicable
law to allow them to carry out their duties
- To Organ Procurement Organizations (tissue donation and
transplant) or persons who obtain, store, or transplant organs
- To the Food and Drug Administration (FDA) relating to
problems with food, supplements, and products
- To comply with workers' compensation law - if you make a
workers' compensation claim
- For Public Health and Safety purposes as allowed or
required by law:
- to prevent or reduce a serious, immediate threat to
the health or safety of a person or the public.
- To public health or legal authorities
- to protect public health and safety
- to prevent or control disease, injury, or disability
- to report vital statistics such as births and deaths.
- To report suspected Abuse or Neglect to public authorities
- To Correctional Institutions if you are in jail or prison,
as necessary for your health and the health and safety of others
- For Law Enforcement purposes such as when we receive a subpoena,
court order, or other legal process, or you are the victim of a crime
- For Health and Safety oversight activities - For example,
we may share health information with the Department of Health.
- For Disaster Relief Purposes - For example, we may share
health information with disaster relief agencies to assist in
notification of your condition to family or others.
- For Work-Related Conditions That Could Affect Employee Health.
For example, an employer may ask us to assess health risks on a job site.
- To the Military Authorities of U.S. and Foreign Military Personnel.
For example, the law may require us to provide information necessary to a
military mission.
- In the Course of Judicial/ Administrative Proceedings
at your request, or as directed by a subpoena or court order.
- For Specialized Government Functions.
For example, we may share information for national security
purposes.
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Other Uses and Disclosures of Protected Health Information |
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Uses and disclosures not in this Notice will be made only as
allowed or required by law or with your written authorization.
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Effective Date: April 14, 2003
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