THE FOLLOWING NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INORMATION. PLEASE REVIEW THE INFORMATION CAREFULLY.*Your confidential healthcare information may be released to other healthcare professionals within the hospital for the purpose of providing you with quality healthcare.
*Your confidential healthcare information may be released to your insurance provider for the purpose of the hospital receiving payment for providing you with needed healthcare services unless patient requests information not to be sent to insurer and payment is made in full at the time of treatment.
*Your confidential healthcare information may be released to public or law enforcement officials in the event of an investigation in which you are a victim of abuse, a crime or domestic violence.
*Your confidential healthcare information may be released to other healthcare providers in the event you need emergency care.
*Your confidential healthcare information may be released to a public health organization or federal organization in the event of a communicable disease or to report a defective device or untoward event to a biological product (food or medication).
*Your confidential healthcare information may not be released for any other purpose than that which is identified in this notice.
*Your confidential healthcare information only after receiving written authorization from you. You may revoke your permission to release confidential healthcare information at any time.
*Your confidential healthcare information will not be used or disclosed for marketing or fundraising purposes without your authorization. You may be contacted by the hospital for the purpose of raising funds to support the hospital hospital's operations, but you may opt out of either of these practices when asked.
*Your confidential healthcare information regarding psychotherapy notes will not be used or disclosed without your authorization.
*The hospital will notify you in the event of a breach of your confidential healthcare information.
*A health care plan may not use genetic information in connection with its underwriting activities.
*You may be contacted by the hospital to remind you of any appointments, healthcare treatment options or other health services that may be of interest to you.
*You have the right to restrict the use of your confidential health care information. However, the hospital may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of an emergency situation.
*You have the right to receive confidential communication about your health status.
*You have the right to review and photocopy any/all portions of your healthcare information or receive it in an electronic format if available.
*You have the right to make changes to your healthcare information.
*You have the right to know who has accessed your confidential healthcare information and for what purpose.
*You have the right to possess a copy of this Privacy Notice upon request. This copy can be in the form of an electronic transmission or on paper.
*The hospital is required by law to protect the privacy of its patients. It will keep confidential any and all patient healthcare information and will provide patients with a list of duties or practices that protect confidential healthcare information.
*The hospital will abide by the terms of this notice. The hospital reserves the right to make changes to this notice and continue to maintain the confidentiality of all healthcare information. Patients will receive a mailed copy of any changes to this notice within 60 days of making the changes.
*You have the right to complain to the hospital if you believe your rights to privacy have been violated. If you feel your privacy rights have been violated, please mail your complaint to the hospital:
ATTN: Kasey Lucas, CEO, AdministratorSalem Memorial District Hospital
P.O. Box 774
Salem, MO. 65560
*All complaints will be investigated. No personal issue will be raised for filing a complaint with the hospital.
*For further information about this Privacy Notice, please contact:
HIPAA Privacy Officer
(573)-729-5917, Ext. 4210
This notice is effective as of April 4, 2003. This date must not be earlier than the date on which this notice is printed or published. This notice was revised on August 2, 2013.