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GREAT RIVER RECOVERY RESOURCES
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.
Disclosures for Treatment Payment and Healthcare 0perations Purposes
Following are examples of the types of uses and disclosures of your protected health care information that GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER is permitted to make, These examples are not meant to be exhaustive, but to put you on notice of the types of uses and disclosures that are permitted or required by applicable law,
Treatment Disclosures
We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party, consultation between Great River Recovery Resources and/or Family Resource Centers relating to your treatment or referral to another health care provider for services.
For example, if your physician refers you to another physician or health care provider for services, we may disclose your protected health information to that physician or health care provider so that you can obtain appropriate treatment.
Payment Disclosures
Your protected health information will be used, as needed, to permit us to obtain reimbursement for the provision of health care. This may include the disclosure of protected health information for purposes of determining eligibility or coverage, risk adjustment, billing and claims management, review of health care services with respect to medical necessity and appropriateness of care, utilization review activities and disclosure to consumer reporting agencies.
For example, we may disclose your protected health information to your insurance company in order to determine whether your health plan covers the services that you are seeking. Your protected health information may also be included on the claim for payment that we submit to your insurer.
Healthcare Operations Disclosures
We may use or disclose, as-needed, your protected health information in order to support our operations as a health care Great River Recovery Resources and/or Family Resource Center. These activities include, but are not limited to, quality assessment, improving health or reducing health care costs, case management and care coordination, employee review, training of medical students, licensing and credentialing and business planning and development.
For example, we may disclose your protected health information to medical school students who see patients at our facility. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may use or disclose protected health information to carry out treatment, payment or health care operations:
1) in an emergency treatment situation, if GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER attempts to obtain any required consent as soon as reasonably practicable after the delivery of treatment;
2) if Great River Recovery Resources and/or Family Resource Center is required by law to treat you and GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER attempts to obtain any required consent but is unable to obtain such consent;
3) if GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER attempts to obtain any required consent but are unable to obtain such consent due to substantial barriers to communicating with you, and GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER determines, in the exercise of professional judgment, that your consent to receive treatment is clearly inferred from the circumstances.
Other Uses of Disclosures or Required Without Authorization
Business Associate
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information to a business associate and may allow a business associate to create or receive protected health information on its behalf if GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER obtains satisfactory assurance that the business associate will appropriately safeguard the information. Business associate is defined as a person who, on GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER'S behalf, performs or assists in the performance of a function or activity, or performs a service, involving the use or disclosure of individually identifiable health information. Whenever an arrangement between GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER and a business associate involves the use or disclosure of individually identifiable health information, we will have a written contract that contains terms that will protect the privacy of this information.
Required by Law
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. If required by law, you will be notified of any such uses or disclosures. GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER must also disclose your protected health information when requested by the Secretary to investigate or determine our compliance with the Privacy Rule.
Health Oversight
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. The protected health information may not be removed from the program, and the health oversight agency must agree to comply with limitations concerning redisclosure of information. Oversight agencies seeking this information include agencies that provide financial assistance to GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER, government benefit programs and government agencies that oversee the health care system.
Abuse or Neglect
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information to a public health authority that is authorized by law to receive reports of child or elder abuse or neglect. However, the information is limited to only that which is necessary to make the initial mandated report.
Food and Drug Administration
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information to a person or company required by the Food and Drug Administration to report methadone program violations, or when the FDA determines there is an error in the packaging or manufacturing of a drug used in substance abuse treatment that may endanger the health of patients.
Related to Decedents
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information regarding deceased patients to a coroner or medical examiner for determining cause of death or in connection with laws requiring the collection of death or other vital statistics or permitting inquiry into the cause of death.
Research
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information to researchers when a) their research has been approved by an institutional review board that has reviewed the research proposal; b) protocols to ensure the privacy of the protected health information have been established; c) the researchers agree to maintain the security of your protected health information in accordance with applicable laws and regulations and d) the researchers agree not to redisclose the protected health information except to
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER.
Legal Proceedings
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may disclose protected health information if the court issues an appropriate order.
Criminal Activity
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may also disclose protected health information in a manner consistent with applicable federal and state laws if a crime has been committed on program premises or against program personnel
Government Activities
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of eligibility for benefits, or (3) for the provision of care to veterans.
Uses and Disclosures With Written Authorization
Other uses and disclosures of your protected health information will be made only with your written authorization. You may revoke this authorization, at any time, in writing,except to the extent that GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER has taken action in reliance on the use or disclosure indicated in the authorization or you have been mandated to treatment by a court or other applicable criminal justice agency and you have signed a criminal justice consent. "
Contact with Patients Initiated by GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may use protected health information to contact you to remind you about appointments or to provide information to you about treatment alternatives or other health-related benefits and services that may be of interest to you. GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER may also use or disclose demographic information and dates of health care provided to you for purposes of raising funds for GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER'S benefit. GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER' S fund raising materials will, however, provide an option for you to "opt-out" of receiving any further information regarding these fundraising activities.
Your Rights Regarding Your Protected Health Information
You have the right to request restrictions on certain uses and disclosures of protected health information to the extent that the information has already been released, or is otherwise prohibited by law. You have the right to receive confidential communications of protected health information. You have the right to review and receive copies of protected health information, and have these records reflect any amendments you would like to submit providing this is done according to policy set forth in your client handbook. You have the right to receive an accounting of disclosures of protected health information. You have the right to receive a copy of this notice upon request.
GREAT RIVER RECOVERY RESOURCES AND/OR FAMILY RESOURCE CENTER'S Duties Regarding Your Protected Health Information
The Great River Recovery Resources and/or Family Resource Center is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information; The Great River Recovery Resources and/or Family Resource Center is required to abide by the terms of the notice currently in effect.
Modification of Notice
The Great River Recovery Resources and/or Family Resource Center reserves the right to change the terms of the notice and to make the new notice provisions effective for all protected health information, upon revisions. Great River Recovery Resources and/or Family Resource Center will post the notice in a clear prominent area within the agency, and if applicable, on the web-site.
Complaint Process and Contact Information
If you have questions regarding privacy procedures, please contact the Privacy Officer at (217)224-6300. If you believe that your privacy rights have been violated, you may complain to the Secretary of the Department of Health and Human Services Office of Civil Rights, 200 Independence Ave. SW. Washington, DC, 20201.without retaliation by the Great River Recovery Resources and/or Family Resource Center. Include a brief description.
Effective Date
This Privacy Notice will be effective April 14, 2003
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