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Our Privacy Policy.....
NORTHERN COUNTIES HEALTH CARE, INC. (NCHC)
P.O. Box 388
St. Johnsbury, VT 05819
Caledonia Home Heath Care & Hospice • Island Pond Health
Center
Caledonia Internal Medicine • Northern Counties Dental Center
Concord Health Center • St. Johnsbury Family Health Center
Danville Health Center • Hardwick Area Health Center
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.
NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
This Notice describes the privacy practices of Northern Counties Health Care, which is composed
of the service providers listed above.
PURPOSE OF THIS NOTICE
Northern Counties Health Care has always maintained the privacy of
your personal health information. We are now required by law to maintain
the privacy of your personal health information and to give you this
Notice of our privacy practices, our legal duties, and your rights
concerning your private health information. This Notice will take
effect on April 14, 2003, and will remain in effect until it is replaced.
Northern Counties Health Care reserves the right to revise this Notice
at any time. Any such revision will affect information we already
have about you and any information we may receive in the future. If
there are significant changes in our privacy practices, this Notice
will be changed and the new Notice will be available upon request.
A copy of the current Notice will be also available on our website
at www.nchcvt.org.
If you have any questions regarding this Notice or if you wish to
receive another copy, please contact:
HIPAA Privacy Officer
Northern Counties Health Care, Inc.
P. O. Box 388
St. Johnsbury, VT 05819
(802) 748-9405
Uses and Disclosures of Your Health Information
Northern Counties Health Care uses and discloses your personal health
information for purposes of treatment, payment, and health care operations.
For example:
Treatment: We may use or disclose your personal health information
to a physician, lab, or other providers who provide treatment to you
as well as family members you designate.
Health Care Operations: We may use or disclose your personal
health information in connection with our operations, for such things
as professional review; accreditation; fraud and abuse detection programs;
audit; quality assurance; efforts to reduce health care costs; care
management and coordination; contacting health care providers and
patients with information about treatment alternatives and other related
functions that do not include treatment; NCHC training programs including
those in which students, trainees, or practitioners in health care
learn under supervision; NCHC training of non-health care professionals;
and medical, legal, and compliance audits.
Payments: Your medical information may be used or disclosed
to determine and receive proper payment for covered services under
your insurance plan, as well as to obtain required prior approval
from your insurance plan.
Required by Law: We may use or disclose your health information
when we are required to do so by law. For example, to comply with
a court order, an administrative order, a subpoena, a discovery request
or other lawful processes, such as mandated reporting of abuse or
neglect.
Other Disclosures: NCHC does not disclose your personal health
information for marketing purposes nor does it sell your information
for any purpose. Any use of your personal health information for other
than treatment, payment, or healthcare operations or as required by
law, will require your written authorization. You may revoke any authorization
you have given at any time. NCHC may provide your personal health
information for workers’ compensation or similar programs that
provide benefits for work related injury or illness.
Your Rights Regarding Health Information We
Maintain About You
Right to Inspect and Copy: You have the right to inspect and
copy your health information, which NCHC maintains. If you would like
to inspect and/or copy your health information, please contact the
Privacy Officer at the address or telephone number given above. If
you request a copy of the information, we may charge a fee for the
cost of copying, mailing, or other supplies needed to fulfill your
request.
Right to Amend: If you feel your health information maintained
by NCHC is incorrect or incomplete, you may ask us, in writing, to
amend the information by contacting the Privacy Officer at the address
and telephone number listed above. You may request the amendment as
long as the information is maintained by NCHC. Your request may be
denied if it does not include a reason to support the request. In
addition, it may be denied if you request to amend information that:
• is not part of the health information maintained by NCHC,
• was not created by NCHC unless the person or entity is no
longer available to make the amendment,
• is not part of the information you would be permitted to inspect
or copy,
• is determined by NCHC to be accurate and complete.
Right to an Accounting of Disclosures: You have the right to
request an “accounting of disclosures” if any such disclosure
was made for any purpose other than treatment, payment, or health
care operations. To request an accounting of disclosures, you must
submit your request in writing to the Privacy Officer listed above.
Your request must state a time period no longer than ten (10) years
and may not include dates prior to April 14, 2003.
Right to Request Restrictions: You have the right to request
a restriction on the health information we use or disclose about you
for treatment, payment, or health care operations. However, we are
not required to agree to your request. Your request to limit or restrict
use of your health information must be made in writing to the Privacy
Officer listed above and the request must include the
information you wish to limit, whether you wish to limit use or disclosure
or both and to whom the restrictions apply; for example, disclosures
to your spouse.
Right to Request Confidential Communcations: You have the right
to request that we communicate with you concerning your health information
only in certain ways or at certain locations. For example, you may
request that we only contact you at work or by mail. Any such request
must be made in writing to the Privacy Officer.
Right to a Paper Copy of This Notice: Even if you have received
this Notice electronically, you have the right to receive a paper
copy of this Notice. A request for a copy of the Notice should be
sent to the Privacy Officer at the address above. You may also obtain
a copy of this at our website at www.nchcvt.org
How to File a Complaint: If you believe your privacy rights
have been violated by NCHC, you may file a complaint addressed to
the Privacy Officer. The complaint must be in writing. Or, you may
file a written complaint with the Secretary of the Department of Health
and Human Services. You will not be penalized or retaliated against
for filing a complaint.
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Northern Counties Health Care Inc. - PO Box 388 - 165 Sherman
Dr. - St. Johnsbury, VT 05819 |
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