||Joint Notice of Privacy Practices|
JOINT NOTICE OF PRIVACY PRACTICES
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.
North Valley Hospital (NVH) is required by law to maintain the privacy of your protected health information, to notify you of our legal duties and privacy practices with respect to your health information, and to notify affected individuals following a breach of unsecured health information. This Notice summarizes our duties and your rights concerning your information. Our duties and your rights are set forth more fully in 45 CFR Part 164. NVH is required to abide by the terms of our Notice that is currently in effect.
NVH provides health care to our patients and clients in partnership with physicians and other professionals in an Organized Health Care Arrangement known as an OHCA. The information privacy practices in this notice will be followed by:
- Any health care practitioner who treats you at any of NVH's locations, including members of the Hospital's Medical Staff and other allied health care practitioners who are granted privileges or other authorization to practice at NVH;
- All departments and units of our organization, including all off-campus units and departments;
- All medical practices operated by the Hospital;
- All employed associates, staff or volunteers of NVH with whom NVH share medical information; and
- Any business associate with whom NVH shares medical information.
Rather than have you read and sign different Notices of Privacy Practices for each health care practitioner that treats you at NVH, this Joint Notice of Privacy Practices will serve as authority for all health care practitioners who treat you to have access to, and to share, your medical information with each other, and all members of the OHCA, as described in this Joint Notice.
Unless your doctor is affiliated with one of the NVH medical practices, this notice does not apply to the use and disclosure of your medical information in connection with treatment you receive at your doctor's private office, payment for services provided at your doctor's own office, or your doctor's health care operations. Your personal doctor may have different policies regarding his or her use and disclosure of the medical information that is created or maintained in his or her office. Your personal doctor will provide you with a separate Notice of Privacy Practices that pertains to the use and disclosure of your medical information in connection with treatment, payment or health care operations at his or her office.
If your doctor is affiliated with one of the NVH medical practices, this Notice of Privacy Practices will apply to the use and disclosure of your medical information created or maintained at that office.
1. Uses And Disclosures NVH May Make Without Written Authorization. NVH may use or disclose your health information for certain purposes without your written authorization, including the following:
Treatment. NVH may use or disclose your information for purposes of treating you. For example, NVH may disclose your information to another health care provider so they may treat you; to provide appointment reminders; or to provide information about treatment alternatives or services NVH offers.
Payment. NVH may use or disclose your information to obtain payment for services provided to you. For example, NVH may disclose information to your health insurance company or other payer to obtain pre-authorization or payment for treatment.
Healthcare Operations. NVH may use or disclose your information for certain activities that are necessary to operate our hospital and ensure that our patients receive quality care. For example, NVH may use and disclose medical information to review our treatment and services and to evaluate the performance of our staff in caring for you or to accrediting agencies that evaluate our performance.
Other Uses or Disclosures. NVH may also use or disclose your information for certain other purposes allowed by 45 CFR § 164.512 or other applicable laws and regulations, including the following:
- To avoid a serious threat to your health or safety or the health or safety of others.
- As required by state or federal law such as reporting abuse, neglect or certain other events.
- As allowed by workers’ compensation laws for use in workers’ compensation proceedings.
- For certain public health activities such as reporting certain diseases.
- For certain public health oversight activities such as audits, investigations, or licensure actions.
- In response to a court order, warrant or subpoena in judicial or administrative proceedings.
- For certain specialized government functions such as the military or correctional institutions.
- For research purposes if certain conditions are satisfied.
- In response to certain requests by law enforcement to locate a fugitive, victim or witness, or to report deaths or certain crimes.
- To coroners, funeral directors, or organ procurement organizations as necessary to allow them to carry out their duties.
2. Disclosures NVH May Make Unless You Object. Unless you instruct us otherwise, NVH may disclose your information as described below.
- To a member of your family, relative, friend, or other person who is involved in your healthcare or payment for your healthcare. NVH will limit the disclosure to the information relevant to that person’s involvement in your healthcare or payment.
- To maintain our facility directory. If a person asks for you by name, NVH will only disclose your name, general condition, and location in our facility. NVH may also disclose your religious affiliation to clergy.
- To contact you to raise funds for NVH. You may opt out of receiving such communications at anytime by notifying the Privacy Officer identified below.
3. Uses and Disclosures With Your Written Authorization. Other uses and disclosures not described in this Notice will be made only with your written authorization, including most uses or disclosures of psychotherapy notes; for most marketing purposes; or if NVH seeks to sell your information. You may revoke your authorization by submitting a written notice to the Privacy Officer identified below. The revocation will not be effective to the extent NVH has already taken action in reliance on the authorization.
4. Your Rights Concerning Your Protected Health Information. You have the following rights concerning your health information. To exercise any of these rights, you must submit a written request to the Privacy Officer identified below.
- You may request additional restrictions on the use or disclosure of information for treatment, payment or healthcare operations. NVH is not required to agree to the requested restriction except in the limited situation in which you or someone on your behalf pays for an item or service in full prior to the service being delivered and you request that information concerning such item or service not be disclosed to a health insurer.
- NVH normally contacts you by telephone or mail at your home address. NVH may contact you for appointment reminders. You may request that NVH contact you by alternative means or at alternative locations. NVH will accommodate reasonable requests.
- You may inspect and obtain a copy of records that are used to make decisions about your care or payment for your care, including an electronic copy. NVH may charge you a reasonable cost-based fee for providing the records. NVH may deny your request under limited circumstances, e.g., if NVH determines that disclosure may result in harm to you or others.
- You may request that your protected health information be amended. NVH may deny your request for certain reasons, e.g., if NVH did not create the record or if NVH determines that the record is accurate and complete.
- You may receive an accounting of certain disclosures NVH has made of your protected health information. You may receive the first accounting within a 12-month period free of charge. NVH may charge a reasonable cost-based fee for all subsequent requests during that 12-month period.
- You may obtain a paper copy of this Notice upon request. You have this right even if you have agreed to receive the Notice electronically.
5. Changes To This Notice. NVH reserves the right to change the terms of this Notice at any time, and to make the new Notice effective for all protected health information that NVH maintains. If NVH materially changes our privacy practices, NVH will post a copy of the current Notice in our reception area and on our NVH website. You may obtain a copy of the operative Notice from our receptionist or Privacy Officer.
6. Complaints. You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by notifying our Privacy Officer. All complaints must be in writing. NVH will not retaliate against you for filing a complaint.
7. Contact Information. If you have any questions about this Notice, or if you want to object to or complain about any use or disclosure or exercise any right as explained above, please contact:
Privacy Officer: Traci Waugh
Address: 1600 Hospital Way
Whitefish, MT 59937
8. Effective Date. This Notice is effective June 3, 2013.