of Privacy Practices
The PRC is committed to protecting your
private health information
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective September 1, 2016
A. PURPOSE OF THE NOTICE
The Pregnancy Resource Center of Marion County is committed to preserving the privacy and confidentiality of health information that is created and/or maintained at our facility. State and federal laws and regulations require to implement policies and procedures to safeguard the privacy of your health information. This notice will provide you with information regarding our privacy practices. It applies to all of your health information created and/or maintained at our facility, including any information that we receive from other health care providers or facilities. This notice describes the ways in which we may use or disclose your health information and also describes your rights and our obligations concerning such uses and disclosures.
We will abide by the terms of this notice, including any further revisions that may make to the notice as required or authorized by law. We reserve the right to change this notice and to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facility
identifying its effective date and we will give you a copy to read upon request.
The privacy practices described in this notice applies to:
All staff and volunteers employed or contracted by this facility who are authorized to enter information into your health record or who have access to your health information.
The individuals identified above will share your health information with each other for purposes of treatment, and healthcare operations, as further described in this notice.
B. ONLY WITH YOUR CONSENT WILL WE USE OR DISCLOSE HEALTH INFORMATION FOR TREATMENT, AND OTHER HEALTHCARE OPERATION.
1.Treatment and Other Healthcare Operations: We may use your health information to provide you with healthcare treatment and services. We may disclose your health information to doctors, nurses, assistants, technicians, ultrasound technicians, and other personnel who are involved in your healthcare.
2. Operations: We may use or disclose your health information in order to perform the necessary administrative, educational, quality assurance, and business functions of our facility. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also use your health information to evaluate whether certain services offered by our facility are effective.
C. USES AND DISCLOSURES OF HEALTH INFORMATION IN SPECIAL SITUATIONS.
Appointment Reminders: We may use or disclose your health information for the purposes of contacting you to remind you of a healthcare appointment. We will call you only with your permission but will not leave our name, only our phone number. We may leave a short message on your answering machine, with a family member, or other person who may answer the telephone at the number you have given us.
1. Family Members and Friends: You may request that a family member or friend participate in your individual appointments. It is our policy that you designate these individuals by name on our consent form prior to your appointment. Please understand that during your appointment, confidential information will be discussed. Should that be the situation, the Pregnancy Resource Center of Marion County cannot be held responsible for any re-disclosure by that third party. We also reserve the right to decline your request based on our
judgment to protect you or another from imminent injury.
D. OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES OF HEALTH INFORMATION.
We may disclose or release your health information only with your specific written authorization with the following exceptions:
1. As required by federal, state, and local law.
2. In the case of an emergency
3. When there is a threat of imminent danger to you or others
4. To State and Federal Agencies who provide compliance, audits, investigation, or that which is necessary for licensure or certification.
E. USES AND DISCLOSURES PURSUANT TO YOUR WRITTEN AUTHORIZATION.
We will not use or disclose your health information for any other purposes unless we have your specific written
authorization. You have the right to revoke a written authorization at any time as long as you do so in writing. If you revoke your authorization or consent, we will no longer use or disclose your health information for the purposes identified in that permission, except to the extent that we have already taken some action in reliance upon your authorization.
F. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION.
You have the following rights regarding your health information. You may exercise each of these rights, in writing, by providing us with a completed form which you can obtain from the Pregnancy Resource Center of Marion County. In some instances, we may charge you for the costs associated with providing you with the requested information.
1. Right to Inspect and Copy: You have the right to inspect and copy health information that may be used to make decisions about your care. We may deny your request to inspect and copy your health information in certain limited circumstances. If you are denied access to your heath information, you may request the denial be reviewed.
2. Right to Amend: You have the right to request an amendment of your health information that is maintained by or for our facility and is used to make health care decisions about you. We may deny your request if it is not properly submitted or it does not include a reason to support your request.
We may also deny your request if the information sought to be amended:
a) was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
b) is not part of the information that is kept by or for our facility;
c) is not part of the information which you are permitted to inspect or copy; or
d) is accurate and complete.
3. Right to an Accounting of Disclosures: You have the right to request an accounting of the disclosures of your health information made by us. This accounting will not include disclosures of health information made for purposes of treatment, or healthcare operations or pursuant to a written authorization that you have signed.
4. Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment or healthcare operations. You also have the right to request a limit on the health information we may disclose about you to someone, such as a family member or friend, who is involved in your care. For example, you could ask that we not use or disclose information regarding a particular treatment you received. We are not required to agree to your request. If we do agree, that agreement must be in writing and signed by both you and the director.
5. Right to Request Confidential Communications: You have the right to request that we communicate with you about your healthcare in a certain way or at a certain location. For example, you may ask that we only contact you at work or by email.
6. Right to a Paper Copy of this Notice: You have the right to receive a paper copy of this notice and may ask our staff to give you a copy of this notice at any time.
G. QUESTIONS OR COMPLAINTS If you have any questions regarding this notice or wish to receive additional information about our privacy practices, or if you believe your privacy rights have been violated, you may file a complaint with our facility or with the Secretary of Department of Health and Human Services, Office of Civil Rights.
36 Mountain Park Dr, Fairmont, WV 26554
All requests must be submitted in writing.
You will not be penalized for filing a complaint.