HIPAA PRIVACY NOTICE
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO YOUR MEDICAL HEALTH INFORMATION
The Practice of Park DuValle Community Health Center, Inc. is required by applicable federal and state laws to maintain the privacy of your health information. Protected health information (PHI) is the information we create and maintain in the course of providing our services to you. Such information may include demographic information, documentation of your symptoms, examination and test results, diagnoses and treatment protocols. It also may include billing documents for those services.
RESPONSIBILITIES OF PARK DUVALLE COMMUNITY HEALTH CENTER
It is the policy of Park DuValle Community Health Center that:
- We are permitted by federal privacy law (the Health Insurance Portability & Accountability Act of 1996 (HIPAA)), to use and disclose your PHI, without your written authorization, for purposes of treatment, payment, and health care operations.
- There are some services in our department that are provided through business associates/contact providers. We may share your health information with these agencies so they can perform services requested and bill you or your insurance payer for services provided. To protect your health information, we require the business associates/contract providers to safeguard your information in the same manner as we do.
Contacting You We may contact you by either telephone or by mail at your home or work. You may also be contacted by our automated telephone service that is used to remind you of scheduled appointments, unless you tell us otherwise, in writing.
Research We may share information with researchers when an Institutional Review Board (IRB) has approved their research. This board reviews research proposals and establishes rules that ensure the privacy of your health information.
Communication with Your Family Our medical staff, using their best judgment, may share health information necessary for your health and the health and safety of other individuals with the institution and/or its agencies.
Funeral Director/Coroners and Medical Examiners When required by law, we will release information to funeral directors. We may also provide medical information about you to a coroner or medical examiner to identify a deceased person and determine cause of death.
Parents and Minors State laws or other laws may decide whether parents will be provided health information on their children. With limited exceptions based on state or other laws, parents control the health information of their children.
Government Agencies We may share health information about you with a government agency when there is a harmful event with food, supplements, products or product defects.
Persons in Custody/Inmates If you are or become an inmate of a correctional institution, we may share health information necessary for your health and the health and safety of other individuals with the institution and/or its agencies.
Workers Compensation We may share health information that is permitted and necessary as required by workers’ compensation law related to work related injuries or illness.
For Fundraising We may share your demographic and date of service information for fundraising purposes without your authorization. We may contact you for fundraising purposes, unless you tell us in writing that you wish to opt-out of possible fundraising communications.
YOUR HEALTH CARE RIGHTS
Patients/clients have the following rights with respect to medical information:
- Receive a written privacy notice.
- Ask that only certain parts of your personal health information be given to others.
- Withdraw your consent to use health information unless that action has already been taken.
- Receive confidential communications of your personal health information.
- Request communication of your personal health information by alternative means or at an alternative location.
- Correct or add to your personal health information (your request must be in writing, specifying a reason for the changes).
- Review or receive a copy of your personal health information.
- Receive an accounting of all who receive your personal health information.
- Pay out-of-pocket for a service and request that we do not submit your health information to your health plan.
You may file a complaint without cost or penalty if you believe your privacy rights have been violated. To file a complaint with Park Duvalle Community Health Center or the Department of Health and Human Services, please contact:
Park DuValle Community Health Center HIPAA Privacy Officer, 3015 Wilson Ave. Louisville, KY 40211: Phone (502) 774-4401 Email firstname.lastname@example.org
Office of Civil Rights, U.S. Department of Health and Human Services
200 Independence Avenue SW, Washington, D.C. 20201
REQUIRED BY LAW
We may disclose your health information for law enforcement purposes as required by law including the following:
Public Health Services – Federal and state law requires certain health information to be given to an appropriate health oversight agency, public health authority, or government agency. The law permits these agencies to collect or receive this information for purposes of preventing or controlling disease and disaster occurrences.
Victims of Abuse, Neglect or Domestic Violence – If we believe you or your child is a victim of abuse, neglect, or violence, we are required to report such information to the appropriate state enforcement agency.
Breach of Unsecured Protected Health Information- Park Duvalle Community Health Center has a duty to notify affected individuals following a breach of unsecured Protected Health Information in accordance with the HIPAA Law.
PLEASE DIRECT ALL QUESTIONS OR CONCERNS REGARDING YOUR PERSONAL HEALTH CARE INFORMATION TO: PARK DUVALLE COMMUNITY HEALTH CENTER’S: HIPAA PRIVACY OFFICER, 3015 WILSON AVE, LOUISVILLE, KY 40211, PHONE: (502)774-4401.