Notice Of Privacy Practices
Just like you, we care about how personal information is used and shared. With that in mind this notice tells you how we make use of your health information here at AZALEA HEALTH CARE, how we might disclose your health information to others, and how you can get access to the same information. It is being provided to you pursuant to the regulations of the Health Insurance Portability and Accountability Act (HIPAA).
The privacy of your health information is very to us and we want to do everything possible to protect that privacy.
We have a legal responsibility under the laws of the United States and the State of Alabama to keep you health information private.
Here are some examples of how we use and disclose information about your health information.
We may use or disclose your health information...
1. To anyone for whom you give us written authorization to have your health information, for any reason you wat. You may revoke this authorization in writing anytime you want. When you revoke an authorization it will only affect your health information from that point on.
2. To your physician or other healthcare provider who is also treating you, with appropriate authorization.
3. To anyone on our staff involved in your treatment program.
4. To any person required by federal, state, or local laws to have lawful access to your treatment program.
5. To receive payment from a third party payer for services we provide for you.
6. To staff of AZALEA HEALTH CARE, IN CONNECTION WITH OUR BUSINESS OPERATIONS. Examples of these include, but are not limited to the following: evaluating the effectiveness of our staff, supervising our staff, improving the quality of our services, meeting accreditation standards, and in connection with licensing, credentialing, or certification activities.
7. To a family member, a person responsible for your care, or your person representative in the event of an emergency. If you are present in such a care, we will give you an opportunity to object. If you object, or are not present, or are incapable of responding, we may use our professional judgement, in light of of the nature of the emergency, to go ahead and use or disclose your health information in your best interest at that time. In so doing, we will only use or disclose the aspects your health information that are necessary to respond to the emergency.
8. To law officers or child protection personnel, in accordance with such situations as are detailed in Alabama Statues. Counselors are required by law to report or cause to be reported the threat of homicide or suicide and threat of serious harm to self or others, as in care of child abuse or child neglect.
9. To officers of the court, when mandate by subpoena or other court order. We will not use your health information in any of our marketing, developing, public relations, or related activities without your written authorization. We cannot use or disclose your health information in any ways other than those described in this notice unless you give us written permission.
As a client of AZALEA HEALTH CARE, you have these important rights:
A. You have a right to a copy of this notice at no charge.
B. With limited exceptions, you can make a written request to inspect your health information that is maintained by us for our use. This inspection will occur in the presence of your clinician or with our Clinical Director, in the absence of your clinician. Information provided for inspection will be subject to the clinical judgment of your AZALEA HEALTH CARE clinician and/or our Clinical Director.
C. You have the right to a written summery of your clinical records.
D. You can make a written request to have us communicate with you about your health information by alternative means, at an alternative location. )An example would be if your primary language is not spoken at AZALEA HEALTH CARE, and we are treating a child of whom you have lawful custody.) Your written request must specify the alternative means and location.
E. You can make a written request that we place other restrictions on the ways we use or disclose your health information. We may deny any or all of your requested restriction. If we agree to these restrictions, we will abide by them in all situations except those which, in our professional judgment, constitutes an emergency.
F. You can make a written request that we amend the information in part "B" above.
G. If we approve your written amendment, we will change our records accordingly. We will also notify anyone else who may have received this information, and anyone else of your choosing.
H. If we deny your amendment, you can place a written statement in our records disagreeing with our denial of your request.
I. You may make a written request that we provide you with a list of those occasions where we or our business associates disclose your health information for purpose other than treatment, payment, or our operations. This can go back as far as six years, but not before April 14, 2003.
J. If you request the accounting in "I" above more than once in a 12 month period, we may charge you a fee based on our actual cost of tabulating these disclosures.
K. If you believe we may violate any of our privacy rights, or you disagree with a decision we have made about any of your rights in this notice you may file a complaint with us in writing to the following person:
HIPAA Compliance Officer: Dexter Julien, Owner, President
Telephone: 251.344.9443
Fax: 251.344.9880
Address: AZALEA HEALTH CARE, 805 Church Street, Suite B Mobile, AL 36602-1112
L. You may also submit a written complaint to the United States Department of Health and Human Service. We will provide you with that address upon written request.
AZALEA HEALTH CARE, 805 Church Street, Suite B Mobile, AL 36602-1112
Phone: 251.344.9443 Fax: 251.344.9880