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NOTICE OF PRIVACY PRACTICES
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THIS NOTICE DESCRIBES THE PRIVACY PRACTICES OF BROWN COUNTY GENERAL HOSPITAL AND THE PHYSICIANS WHO PROVIDE SERVICES TO PATIENTS AT THIS FACILITY.
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. |
PROTECTED HEALTH INFORMATION
Under federal law, your patient health information is protected and confidential. Patient health information includes information about your symptoms, test results, diagnosis, treatment, and related medical information. Your health information also includes payment, billing, and insurance information.
HOW WE USE YOUR PROTECTED HEALTH INFORMATION
We use health information about you for treatment, to obtain payment, and for health care operation, including administrative purposes and evaluation of the quality of care that you receive. Under some circumstances, we may be required to use or disclose the information even without your consent.
EXAMPLES OF TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS
Treatment: We will use and disclose information about your health or services. For example, nurses, physicians, and other members of your treatment team will record information in your record and use it to determine the most appropriate course of care. We may also disclose the information to other health care providers who are participating in your treatment and to family members who are helping with your care.
Payment: We will use and disclose your health information for payment purposes. For example, we may need to obtain authorization from your insurance company before providing certain types of treatment. We will submit bills and maintain records of payment from your health plan.
Health Care Operations: We will use and disclose your health information to conduct our standard internal operations, including proper administration of records, evaluation of the quality of treatment, and to assess the care and outcomes of your case and others like it.
SPECIAL USES
We may conduct our standard internal operation, including proper administration of records, evaluation of the quality of treatment, and to assess the care and outcomes of your case and others like it.
OTHER USES AND DISCLOSURES
We may use or disclose identifiable health information about you for other reasons, even without your permission. Subject to certain requirements, we are permitted to give out health information without your permission for the following purposes:
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Required by Law: We may be required by law to disclose vital statistics, diseases, information related to recalls of dangerous products, and similar information to public health authorities. |
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Public Health Activities: As required by law, we may disclose vital statistics, diseases, information related to recalls of dangerous products, and similar information to public health authorities. |
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Health Oversight: We may be required to disclose information to assist in investigations and audits, eligibility for government programs, and similar activities. |
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Judicial and Administrative Proceedings: We may disclose information in response to an appropriate subpoena or court order. |
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Law Enforcement Purposes: Subject to certain restrictions, we may disclose information required by law enforcement officials. |
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Deaths: We may report information regarding deaths to coroners, medical examiners, funeral directors, and organ donation agencies. |
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Serious Threat to Health or Safety: We may use and disclose information when necessary to prevent a serious threat to your health and safety or the public or another person. |
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Military and Special Government Functions: If you are a member of the armed forces, we may release information as required by military command authorities. We may also disclose information to correctional institutions or for national security purposes. |
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Research: We may use or disclose information for approved medical research. |
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Workers Compensation: We may release information about you for workers compensation or similar programs providing benefits for work-related injuries or illness. |
We may also ask if we can disclose limited information about you to clergy or include you in the Hospital Directory. Under limited circumstances, we may disclose information to notify or locate your relatives or to assist disaster relief agencies.
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.
INDIVIDUAL RIGHTS
You have the following rights with regard to your health information. Please contact the person listed below to obtain the appropriate forms for exercising these rights.
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Request Restrictions: You may request restrictions on certain uses and disclosures of your health information. Federal law prohibits certain situations in which we may not be able to accommodate your request.
We are not required to agree to such restrictions, but may agree under certain or situations. |
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Inspect and Obtain Copies: In most cases, you have the right to look at or get a copy or your health information. There may be a small charge for the copies. |
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Amended Information: 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. |
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Accounting of Disclosures: You may request a list of instances where we have disclosed health information about you for reasons other than treatment, payment, or health care operations. |
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Choice of Health Information Sent: You have the right to request that we send information to you to an alternative address (example work address versus home address) or by alternative means (example, e-mail versus regular mail). We must agree to your request if we have the capabilities. |
OUR LEGAL DUTY
We are required by law to protect and maintain the privacy of your health information, to provide this notice about our legal duties and privacy practices regarding protected health information, and to abide by the terms of the notice currently in effect.
CHANGES IN PRIVACY PRACTICES
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 the admissions areas. You can also request a copy of our notice at any time. For more information about our privacy practices, contact the person listed below.
COMPLAINTS
If you are concerned that we have violated your privacy rights, or if you disagree with a decision we made about your records, you may contact the person listed below. You also may send a written complaint to the U.S. Department of Health and Human Services. The person listed below will provide you with the appropriate address upon request. You will not be penalized in any way for filing a complaint.
CONTACT PERSON
If you have any questions, requests, or complaints, please contact:
Privacy Officer
Brown County General Hospital
425 Home Street
Georgetown, OH 45121
(937) 378-7645
INDEPENDENT CONTRACTORS
Brown County General Hospital and the physicians who practice at the hospital are independent contractors and do not hereby assume any liability for the services or conduct of each other.
Effective Date: The effective date of this Notice April 14, 2003. |
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 See Archived News Stories
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| Find out more about the services available at Brown County Hospital by browsing the drop-down list below. |
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| Find a physician at Brown County Hospital by browsing the drop-down list of specialties below. |
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