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JOINT NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
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.The following organizations use health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive.
Organizations Covered by this Joint Notice:
Casa Grande Regional Medical Center
The Pavilion
Desert Reflections Imaging Center
Regional Care Physicians
Unless they provide you with their own notice of privacy practices, the following organizations/groups are also covered by this Joint Notice:
Physician and Practitioner members of the CGRMC Medical Staff
Allied Health Professionals who are granted privileges by the CGRMC Medical Staff
Ambulance and emergency personnel
Other health care providers not employed by the organization How We May Use or Disclose Your Health Information
Without your consent, by law we may use health information about you for treatment (such as sending your medical information to a specialist physician as part of a referral,) to obtain payment for treatment (such as sending billing information to a health insurance plan,) and to perform health care operations (such as assessing the quality of care provided or to improve quality of care.)
We may use or disclose identifiable health information about you without your authorization for several other reasons. Subject to certain requirements, we may give out health information without your authorization for public health purposes, abuse or neglect reporting, auditing purposes, research studies, funeral arrangements, and organ donation, workers’ compensation purposes, and emergencies. We also provide information when otherwise required by law such as to assist law enforcement officials. We may also contact you about appointment reminders or treatment alternatives or to raise funds.
We may use or disclose the following information about you in order to maintain a directory of individuals in the facility: your name; your location (room number) in the facility; your condition, described in general terms that does not communicate specific medical information; and your religious affiliation, if you have provided us with that information. This information will be disclosed only to people who specifically ask for you by name, or members of the clergy. You may ask us to exclude you from the directory, in which case we will not give out any of the above-noted information to anyone.
In any other situation, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures.
We may change our policies at any time. Before we make a significant change in our policies, we will change our notice and post the new notice in waiting areas, registration areas, and on our Web site. You can request a copy of our notice at any time.
Your Rights Relating to Your Health Information
In most cases, you have the right to look at or get a copy of health information about you that we use to make decisions about you. If you request copies, you will be charged for the copies.
You also have the right to receive a list of instances where we have disclosed health information about you for reasons other than treatment, payment, or health care operations, or without your written permission. If you believe that information in your record 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.
You have the right to request that your health information be communicated to you in a confidential manner. For example, you may request that we contact you at an office number or that we send mail to an address other than at your home. You have a right to obtain a paper copy of this notice.
You may request in writing that we not use or disclose information for treatment, payment, or administrative purposes or to persons involved in your care except when specifically authorized by you, when required by law, or in emergency circumstances. We will consider your request but are not legally required to accept it.
Complaints
If you are concerned that we have violated your privacy rights, or you disagree with a decision we made about access to your records, you may contact the person listed below. You may also send a written complaint to the U.S. Department of Health and Human Services. The person listed below can provide you with the appropriate address upon request. We have an anti-retaliation policy, and you will not be retaliated against for filing a complaint.
Our Legal Duty
We are required by law to protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice.
If you have any questions or complaints, please contact:
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Privacy Officer & Director of Health Information Management |
Casa Grande Regional Medical Center |
1800 E. Florence Boulevard |
Casa Grande, AZ 85222 |
(520) 381-6420 |
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