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|  | 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.
Who Will Follow This Notice
North Valley Hospital (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, including the following: North Country Medical Clinic;
- All employed associates, staff or volunteers of NVH with whom we share medical information; and
- Any business associate with whom we share 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 listed above, 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 offices. 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 the NVH medical practices listed above, this Notice of Privacy Practices will apply to the use and disclosure of your medical information created or maintained at that office.
Our Pledge Regarding Medical Information
We understand that medical information about you is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive to provide quality care and to comply with legal requirements. This notice applies to all of the records relating to your health that we maintain, whether created by our staff or your personal doctor.
We are required by law to:
- Give you this notice of our legal duties and privacy practices with respect to medical information about you;
- Keep medical information about you private;
- Abide by the terms of the Joint Notice of Privacy Practices that is currently in effect.
Changes to This Notice
We may change the terms of our notice at any time. The new notice will be effective for all medical information that we maintain at that time, as well as new information after the change occurs. Before we make a significant change in our policies, we will change our notice and post the new notice in the hospital and on our website at www.nvhosp.org. You can receive a copy of the current notice at any time. You will be given a current notice each time you register at the hospital for treatment. You will also be asked to acknowledge in writing your receipt of this notice.
How We May Use and Disclose Medical Information
Treatment: We may use and disclose medical information about you to provide you with medical treatment or services. For example, we may disclose medical information about you to doctors, nurses, technicians, medical students, and others involved in your care at NVH. Different departments of the hospital may also share medical information about you in order to coordinate things you need, such as prescriptions, lab work, and x-rays.
Payment: We may use and disclose medical information about you so that the treatment and services you receive at the hospital may be billed to, and payment may be collected from you, an insurance company, or a third party. We may also tell your health plan about a treatment you are going to receive in order to obtain prior approval or to determine whether your plan will cover the treatment. For example, we may need to give your health plan information about surgery you received at the hospital so your health plan will pay us or reimburse you for the surgery.
Health Care Operations: We may use and disclose medical information about you for the support of our health care operations. These uses and disclosures are necessary to run the hospital and make sure that all our patients receive quality care. For example, we 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.
We may use or disclose medical information about you without your authorization for several other reasons. Subject to certain requirements, we may disclose medical information without your authorization for public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements and organ donation, workers’ compensation purposes, and emergencies. We also disclose medical information when required by law, such as in response to a request from law enforcement in specific circumstances, or in response to valid judicial or administrative orders. We may also contact you to advise you of doctors participating in our health plan network or products or services included as health plan benefits. We may disclose medical information about you to a friend or family member who is involved in your medical care or involved in payment related to your care or to disaster relief authorities so that your family can be notified of your location and condition.
We may also contact you for appointment reminders, or to tell you about or recommend possible treatment options, alternatives, health-related benefits or services that may be of interest to you, or to support fundraising efforts.
If admitted as a patient, unless you tell us otherwise, we will list in the facility directory your name, location in the hospital, general condition, and your religious affiliation, and will release all but your religious affiliation to anyone who asks about you by name.
In any other situation not covered by this Notice, we will ask for your written authorization before using or disclosing medical information about you. You may revoke this authorization, at any time, by notifying us in writing of your decision, except to the extent that we have taken action in reliance on your authorization.
Your Rights
In most cases, you have the right to inspect and obtain a copy of medical information about you that we maintain for as long as we maintain information. If you request copies, we may charge a fee for the cost of copying, mailing or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for review of that decision.
You have the right to request that we not use or disclose any part of your medical information for purposes of treatment, payment or health care operations or to persons involved in your care except when specifically authorized by you, when required by law, or in an emergency. We are not required to agree to a restriction that you request. We will inform you of our decision on your request.
Under certain circumstances, you have the right to receive confidential communications of medical information from us by alternative means or at alternative locations upon request.
You have the right, upon written request, to receive a list of instances where we have disclosed medical information about you for purposes other than for treatment, payment, health care operations, or where you specifically authorized a disclosure upon written request. The request must state the time period desired for the accounting, which must be less than 6 years from the date of the request.
If you believe information that we maintain about you is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information. We may deny your request to amend the information if it was not created by us, if we do not maintain the information, or we determine that the information is accurate. You may appeal, in writing, a decision by us not to amend a record.
You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
All written requests or appeals should be submitted to the Privacy Officer.
Complaints
If you are concerned that we have violated your privacy right or you disagree with a decision we make about access to your records, you may contact the Privacy Officer. You also may send a written complaint to the U.S. Department of Health and Human Services. The Privacy Officer can provide you with the appropriate address upon request.
You may contact our Privacy Officer, Traci Waugh, at (406) 863-3508 for further information about the complaint process.
Under no circumstances will you be penalized or retaliated against for filing a complaint.
This notice was published and becomes effective on April 14, 2003.
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Admissions
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