Privacy Policy

USES AND DISCLOSURE OF HEALTH INFORMATION TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS

Company uses and discloses your protected health information for treatment, payment, and health care operations. Some examples of when our office may use or disclose your health care information for these purposes include:

• Sharing test results with other health care providers for confirmation of a diagnosis
• Providing your diagnosis or other information about your health to your insurance provider or our billing service to obtain payment for the health care services we provide
• Reviewing information as part of our quality improvement program

OTHER USES AND DISCLOSURES

Company may also use or disclose your protected health information, in compliance with guidelines outlined by law, for the following purposes:

• Providing you with information related to your health
• Contacting you regarding appointments, information about Company or other health-related services
• Incidental uses or disclosures (e.g., listing your name on a sign-in sheet, etc.)
• Compliance with all laws (including reports of suspected abuse, neglect, or violence)
• Providing certain specified information to law enforcement or correctional institutions
• Information disclosed in the course of a visit by a licensing/regulatory/accrediting body
• Public health activities when requested by a public health authority or the FDA. Responding to health oversight agencies
• Responding to court or administrative tribunal orders, subpoenas, discovery requests, or other lawful process
• Research activities
• When necessary to avert a serious threat to health or safety
• Military affairs, veterans affairs, national security, intelligence, Department of State, or presidential protective service activities
• Providing information regarding your location, general condition, or death, to public or private disaster relief agencies
• Providing information to a family member, other relative, or close personal friend, relative to your location, general condition, or death
• To assist in your health care (e.g. pick-up prescriptions or other documents, note follow-up care instructions, etc.)

AUTHORIZATION FOR OTHER USES

Company will make other uses and disclosure of your protected health information only after obtaining your written authorization. If you authorize a use not contained in this notice, you may revoke your authorization at any time by notifying us that you wish to revoke your authorization.

YOUR RIGHTS REGARDING THE PRIVACY OF YOUR HEALTH INFORMATION

Subject to limitations outlined by law, you have certain rights related to use and disclosure of your protected health information, including the right to:

• Request restrictions on certain uses and disclosures. However, Company is not obligated to agree to requested restrictions.
• Receive confidential communications (e.g., home phone, work phone, etc.) or protected health information. We will comply with reasonable requests.
• Request to see or receive an electronic or paper copy of your medical record and other health information we have about you.
• Inspect and copy your protected health information, with some limited exceptions.
• Request that we amend or correct your private health information. We may deny your request, but we will notify you of the reason why in writing.
• Receive an accounting of disclosures of your health information, for a period of six (7) years after your discharge, except for disclosures made at your request, or relative to your treatment, payment, or our company operations.
• Request that someone act on your behalf, for example, by giving someone medical power of attorney, or by appointing someone as your legal guardian.
• Obtain a copy of this notice. We will provide you with a paper copy of the notice promptly upon your request.

COMPANY’S DUTIES REGARDING THE PRIVACY OF YOUR HEALTH INFORMATION

Subject to limitations outlined by law, Company has certain duties related to your protected health information, including:

• Company is required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.
• Company is required to abide by the terms of the privacy notice that is currently in effect.
• Company reserves the right to change a privacy practice described in this notice and to make such change effective for all protected health information. Revised notices will be posted in our offices, on our website, and available upon request.
• Company is required by law to let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• Company will not use your information other than as described in this patient privacy policy unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

CONCERNS

If you believe your privacy rights have been violated, you may make a complaint by contacting:

Sana Behavioral Health Center
150 Sana Lake Recovery Way
Dittmer, MO 63023
(855) 745-3336