| 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.
We make a record of the health care we provide and may receive such
records from others. We use these records to provide or help other
health care providers to provide quality health care, to obtain payment
for services provided, and for administrative and operational purposes.
The health record is the property of the agency. This notice covers
records from North Rock Medication Clinic, Red Rock Behavioral Health
Services, and Oklahoma Behavioral Health Pharmacy.
HOW WE MAY USE OR DISCLOSE YOUR
HEALTH INFORMATION
For Treatment.
We use health information about you to provide your health care. We may
disclose health information to our employees and others who are involved
in providing the care you need. For example, we may share your health
information with physicians or other healthcare providers who will
provide services. We may share your health information with a
pharmacist who needs it to fill a prescription for you or a laboratory
that performs testing. We may also disclose health information to
members of your family or others who can help you when you are sick or
injured.
For Payment.
We use and disclose health information about you to obtain payment for
the services you receive. For example, a bill may be sent to you and/or
to a third-party payor, such as an insurance company, health plan or the
State.
For Health Care Operations.
We may use and disclose health information about you to operate this
agency. For example, we may use and disclose this information to review
and improve the quality of care we provide, or the competence and
qualifications of our professional staff. We may use and disclose
health information about you to get your health plan to authorize
services or referrals. We may also share your health information with
our business associates, such as a billing service, that perform
administrative services for us. We have a written contract with each
business associate that contains terms requiring them to protect the
confidentiality of your health information.
Appointment Reminders.
We may use and disclose health information to contact and remind you
about appointments. We may phone your home. If you are not home, we may
leave the date and time of your appointment on your answering machine or
in a message left with the person answering the phone.
Sign-in Sheet.
We may use information about you by having you sign in when you arrive
at our office. We may also call out your name when we are ready to see
you.
Notification and Communication
with Family. We may disclose
your health information to notify or assist in notifying a family
member, your personal representative, or another person responsible for
your care about your location, your general condition, or in the event
of your death. In the event of a disaster, we may disclose information
to a relief organization so they may coordinate these notification
efforts. We may also disclose information to someone who is involved
with your care. If you are able and available to agree or object, we
will give you the opportunity to object prior to making these
disclosures, although we may disclose health information in a disaster
even over your objection if we believe it is necessary to respond to the
emergency circumstances. If you are unable and unavailable to agree or
object, our health professionals will use their best judgment in
communication with your family and others.
Required by Law.
We may use and disclose health information about you as required by
law. For example, in certain circumstances, we may be required to
disclose information for the following purposes:
To report information
related to victims of abuse, neglect or domestic violence;
To assist law
enforcement officials in their duties;
To respond to judicial and
administrative proceedings or, in the course of judicial proceedings, if
you have waived your rights to confidentiality under Oklahoma law; and,
To help health oversight agencies
during the course of audits, investigations, inspections, licensure, and
other proceedings, subject to the limitations imposed by federal and
Oklahoma law.
Lawsuits and Disputes.
If you are involved in a lawsuit or a dispute, we may disclose health
information about you in response to a court or administrative order.
If the lawsuit is a health negligence action, your health information
may be disclosed without a court order. We may also disclose health
information about you in response to a subpoena, discovery request, or
other lawsuit process by someone else involved in the dispute, but only
if efforts have been made to tell you about the request or to obtain an
order protecting the information requested.
Public Health and Safety.
Your health information may be used or disclosed for public health
activities such as assisting public health authorities or other legal
authorities prevent or control disease, injury, or disability, or for
other health oversight activities. Your health information may be
disclosed to appropriate persons in order to prevent or lessen a serious
and imminent threat to the health and safety of a particular person or
the general public.
Specialized Government Functions.
We may disclose your health information for military or national
security purposes or to correctional institutions or law enforcement
officers that have you in their lawful custody.
Coroners/Funeral Directors.
We may disclose your health information to coroners in connection with
their investigations of death or to funeral directors to enable them to
carry out their lawful duties.
Workers’ Compensation.
Your health information may be used or disclosed as necessary in order
to comply with laws and regulations related to workers’ compensation.
Change of Ownership.
In the event that this agency is sold or merged with another
organization, your health information will become the property of the
new owner, although you will maintain the right to request that copies
of your health information be transferred to another provider.
Marketing.
We may contact you to give you information about products or services
related to your treatment, case management or care coordination, or to
direct or recommend other treatments or health-related benefits and
services that may be of interest to you. We may also encourage you to
purchase a product or service when we see you. We will not use or
disclose your health information for marketing purposes without your
written authorization.
Research.
We may use your health information for research purposes when an
institutional review board or privacy board has reviewed the research
proposal and established protocols to ensure the privacy of your health
information and has approved the research.
By Oklahoma law we are required to
notify you . . . that your health information used or disclosed as
described in this Notice of Privacy Practices may include records
which may indicate the presence of a communicable or venereal disease
which may include, but are not limited to, diseases such as hepatitis,
syphilis, gonorrhea and the human immunodeficiency virus, also known as
Acquired Immune Deficiency Syndrome (AIDS).
WHEN WE MAY NOT USE OR DISCLOSE YOUR
HEALTH INFORMATION
Except as described in this Notice
of Privacy Practices, this agency will not use or disclose health
information that identifies you without your written authorization. If
you do authorize this agency to use or disclose your health information
for another purpose, you may revoke your authorization in writing at any
time.
YOUR HEALTH INFORMATION RIGHTS
You have the right:
To a paper copy of this Notice of
Privacy Practices.
To request restrictions on certain
uses and disclosures of your health information by written request
specifying what information you want to limit and what limitations on
our use or disclosure of that information you wish to have imposed. We
reserve the right to accept or reject your request and will notify you
of our decision.
To request that you receive health
information in a specific way or at a specific location. For example,
you may ask that we send information to your work address. We will
comply with all reasonable requests submitted.
To obtain access to or a copy of your
health information, with limited exceptions. A reasonable fee may be
charged for making copies. Under current Oklahoma law, fees of 25˘ per
page are allowed. We may also charge for postage if the copies are to
be mailed. If we deny your request for access or copies, you will be
informed of your rights to appeal our decision.
To request that we amend your health
information you believe is incorrect or incomplete. Your request to
amend must be in writing and include the reasons you believe the
information is inaccurate or incomplete. We are not required to change
your health information and if we do not, we will provide you with
information about this agency’s denial and how you can disagree with the
denial. You also have the right to request that we add to your record a
statement of up to two hundred and fifty (250) words concerning any
statement or item you believe to be incomplete or incorrect.
To receive an accounting of
disclosures made of your health information by this agency unless the
disclosures were for purposes of treatment, payment, health care
operations, certain government functions, or pursuant to your written
authorization. You have the right to revoke your authorization to use
or disclose health information except to the extent that this use or
disclosure has already occurred.
IF YOU WOULD LIKE TO HAVE A MORE DETAILED EXPLANATION OF THESE
RIGHTS, OR IF YOU WOULD LIKE TO EXERCISE ONE OR MORE OF THESE RIGHTS,
CONTACT OUR PRIVACY OFFICER AT THE NUMBER LISTED BELOW.
OBLIGATIONS OF THIS AGENCY
We are required to maintain the
privacy of your confidential health information, provide you with this
notice of our legal duties and privacy practices with respect to your
health information, abide by the terms of this notice, notify you if we
are unable to agree with a requested restriction on how your information
is used or disclosed, accommodate reasonable requests you make to
communicate health information by alternative means or alternative
locations and obtain your written authorization to use or disclose your
health information for reasons other than those listed above and
permitted under law. We reserve the right to change or amend this
Notice of Privacy Practices at any time in the future. After an
amendment is made, the revised Notice of Privacy Practices will
apply to all health information that we maintain. A copy of any Revised
Notice of Privacy Practices will be made available to you at each
appointment.
CONFIDENTIALITY OF
ALCOHOL AND DRUG ABUSE CLIENT RECORDS
The confidentiality of
alcohol and drug abuse client records maintained by this program is
protected by Federal law and regulations. Generally, the program may
not say to a person outside the program that a client attends the
program, or disclose any information identifying a client as an alcohol
or drug abuser Unless:
(1) The client consents
in writing:
(2) The disclosure is
allowed by a court order; or
(3) The disclosure is
made to healthcare personnel in a healthcare emergency or to qualified
personnel for research, audit, or program evaluation.
Violation of the
Federal law and regulations by a program is a crime. Suspected
violations may be reported to appropriate authorities in accordance with
Federal regulations. Federal law and regulations do not protect any
information about a crime committed by a client either at the program or
against any person who works for the program or about any threat to
commit such a crime. Federal laws and regulations do not protect any
information about suspected child abuse or neglect from being reported
under State law to appropriate State or local authorities.
COMPLAINTS
You will not be penalized for filing
a complaint. Complaints about this Notice of Privacy Practices
or how this agency handles your health information should be directed
to:
Red Rock Behavioral Health Services
Attn: Privacy Officer
4400 North Lincoln Blvd.
Oklahoma City, OK 73105
(405) 424-7711
If you are not satisfied with the
manner in which this office handles a complaint, you may submit a formal
complaint to:
The Department of Health and Human
Services
Office of Civil Rights
Herbert H. Humphrey Building, Room
509 F
200 Independence Avenue, S.W.
Washington, D.C. 20201
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