Your Information. Your Rights. Our Responsibilities. 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.
Your Rights: When it comes to your health information, you have certain rights. This section explains your rights, and some of our responsibilities, to help you:
- You may ask to see or get an electronic or paper copy of your information we have in our medical record.
- We will provide a copy or summary of your health information, usually right away, but no later than 30 days of your request. We prefer your request be in writing, and we may elect to charge a reasonable, cost-based fee. For information we do not have in our record, you will need to contact your doctor.
- You may ask us to correct health information about you that you think is incorrect or incomplete.
- Please make your request in writing. We may say “no” to your request, but we will tell you why in writing within 60 days. If you disagree, we will include the disagreement with your medical record.
- You may ask us for confidential communications such as contacting you in a specific way, for example, home or office phone, or to send mail to a different address. We will say “yes” to all reasonable requests.
- You may ask us to limit what we use or share.
- You may ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request and may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you may ask us not to share that information with your health insurer for the purpose of payment or our operations. Please make your request in writing. We will say “yes” unless a law requires us to share that information.
- You may ask for an accounting of those with whom we’ve shared your information in the past 6 years, and why.
- We will include all disclosures except those for treatment, payment and health care operations, and any disclosures you asked us to make, or those required by law or pursuant to your written authorization.
- We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. Please make your requests in writing.
- You may ask for a paper copy of this notice at any time, even if you have received it electronically.
- You may choose someone to act for you by telling us who your personal representatives are.
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
- You may complain if you feel your rights are violated by contacting us directly. We are happy to hear from you!
- Or you can file a complaint with U.S. Dept of Health & Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We are prohibited from retaliating against you.
Your Choices: In certain situations, you can choose what health information we share.
- You may tell us to share information with certain family, close friends, or others involved in your care or share information in a disaster relief situation. We may ask you to tell us in writing or, in certain situations, by consent if you are present or on the phone.
- If you are not able to tell us your preference, for example if you are unconscious, we may share limited information if we believe it is in your best interest. We may also share your information to lessen a serious and imminent threat to health or safety.
- In the following cases, we never share your information without your written permission:
- Marketing purposes, except limited marketing of our own services directly to our patients; sale of your information; most sharing of psychotherapy notes
- For cases of fundraising, we may contact you, but you can tell us not to contact you again.
Our Uses and Disclosures: We are allowed to use or share your health information in the following ways:
- Treatment. We may use your health information and share it with other professionals who are treating you.
- Payment. We may use and share your health information to bill for payment from health plans or other entities.
- Healthcare operations. We may use and share your information to run our practice, improve your care, and contact you when necessary.
- Patient care:
- With your permission, and with the email or phone provided, we may communicate with you directly about your care using electronic forms of contact. We recognize that while electronic communications are more convenient for everyone, they can also be risky and prone to intercept, hacking, and viewing by others despite every precaution. You may change your mind about your choice to receive electronic communications at any time. Please let us know in writing.
- We may also use your email or phone, when provided, to send periodic newsletters providing valuable patient care information and our current offers to help you afford services. You may ask us to stop these types of communication at any time.
We are allowed or required to share your information in other ways:
- To help with public health and safety issues such as preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, preventing or reducing a serious threat to anyone’s health or safety, and to follow state and federal law, we may use or share your health information:
- For health research or with health oversight agencies for activities authorized by law.
- For workers’ compensation claims.
- With organ procurement organizations.
- With a coroner, medical examiner, or funeral director when an individual dies.
- For law enforcement purposes or with an authorized law enforcement official.
- In response to a court or administrative order, or to respond to a subpoena.
- To follow state and federal laws for the reporting of abuse, neglect or domestic violence.
- To follow state and federal laws regarding substance abuse treatment, psychotherapy notes, and HIV/AIDS.
- For special government functions such as military, national security, and presidential protective services
- For public health and research, we must meet conditions in the law before we share your information for these purposes. For more information: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
- We are required by law to maintain the privacy and security of your protected health information.
- We must inform you promptly of a breach that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and provide availability of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. You may change your mind any time by letting us know in writing. It may not always be possible to reverse prior actions taken under your original authorization, but we will honor your requests going forward.
- For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice: We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Effective date of this notice: May 1, 2022
Privacy Officer: Raeanne Orton
Mailing address: Legrande Health, 343 East 400 North, Rexburg, ID 83440. Phone: (855) 498-1272