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Privacy
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NOTICE
OF PRIVACY PRACTICES
How information about you may be used and disclosed: Please
review the information carefully.
A.Your confidential healthcare information may be released
to other healthcare professionals within the hospital for
the purpose of providing you with quality healthcare.
For example: All information obtained by a nurse, physician,
or other member of the healthcare team will be documented
in your record and used to communicate with other members
of the healthcare team involved in your care.
B.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.
For example: A bill may be sent to you or your health care
insurance company. Information on the bill includes identifying
information along with a diagnosis and procedures rendered.
C.Your confidential healthcare information may be released
for routine healthcare facility operations.
For example: Your health information will be reviewed by medical
staff and other professionals in an effort to continually
improve the quality of healthcare and services we provide.
Storing the information involves entering some of the data
into databases as well as filing and storing the paper documents
in your chart. These functions may be handled by a number
of different employees in the facility.
D.Your confidential healthcare information may be released
for any of the following reasons, without your prior authorization:
* Mandatory public health reporting of certain diseases, products,
and injuries;
* Required reporting about victims of abuse, neglect or domestic
violence;
* For health oversight activities, such as audits and investigations;
* For judicial and administrative proceedings in response
to a court order,
subpoena or discovery request;
* For certain law enforcement purposes, for example, to identify
or locate a
suspect, fugitive, material witness, or missing person;
* To coroners, medical examiners and funeral directors, for
purposes of
determining cause of death, or performing duties related to
the
departed;
* For organ, eye or tissue donation purposes;
* Under certain circumstances, for research;
* When necessary to prevent or lessen a serious threat to
the health or
safety of the individual or the public; AND
* Specialized government functions such as national security
activities and
medical suitability determinations.
* 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
for workers'
compensation or similar programs.
E.The hospital has an agreement with local physicians' groups
that allow them to do required committee work for the hospital.
Some of that committee work will require that doctors review
records on patients not under their care. Your records could
be included in those reviews. In accordance with the special
agreement between the hospital and the clinic, the doctors
are required to extend all privacy protections to these records
also.
F.When your physician, including but not limited to, anesthetists,
pathologists, radiologists or other non-Kanabec Hospital employed
health care providers such as advanced practice nurses, technicians
and physician assistants are treating you at Kanabec Hospital,
they will follow the terms of this notice. One group of providers
with whom we share information about you is the Allina Medical
Clinics in Mora, Pine city and Hinckley. We share health information
with these providers to help them provide treatment and for
payment and health care operations. Your physician or other
health car provider may have different policies or notices
about their use and disclosure of your health information
used in their office or clinic.
G.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.
H.You may be contacted by the hospital for the purposes of
raising funds to support the hospital's operations. If you
do not want the healthcare center to contact you for fundraising
efforts, you must notify the healthcare center at: Kanabec
Hospital, 301 S. Highway 65, Mora, MN 55051, (320) 679-1212.
I.Your confidential healthcare information may not be released
without your written authorization for any purpose other than
that stated above.
J.You may revoke your permission to release confidential healthcare
information at any time. If you wish to revoke your authorization,
please do so in writing and submit to: Kanabec Hospital, Attn:
Director of Health Information (HIM)/Privacy Officer, 301
S. Hwy. 65, Mora, MN 55051.
YOUR RIGHTS
You have specific rights regarding confidential information
about you created by us or kept here in either your medical
records or your billing records.
RIGHT TO REQUEST RESTRICTIONS
You have the right to request restrictions on the use of your
confidential healthcare information. However, the hospital
may choose to refuse your restriction if it is in conflict
with providing you with quality healthcare or in the event
you have an emergency situation.
To request restrictions, you must make your request in writing
to: Kanabec Hospital, Attn: Director of Health Information
(HIM)/Privacy Officer, 301 S. Hwy. 65, Mora, MN 55051.
In your request, you must tell us:
1. What information you want to limit;
2. Whether you want to limit the use, disclosure or both;
and
3. To whom you want the limits to apply.
RIGHT TO REQUEST CONFIDENTIAL
COMMUNICATIONS
You have the right to request that we communicate with you
about medical matters in a certain way or at a certain location
(for example, you can ask that we only contact you at work
or by mail).
We will not ask you the reason for your request. We will accommodate
all reasonable requests. Your request must specify how or
where you wish to be contacted.
RIGHT TO INSPECT AND COPY
You have the right to review, inspect, and receive a photocopy
of any/all portions of your healthcare information. This includes
medical and billing records.
To inspect and/or receive a photocopy of your healthcare information
you must submit your request in writing to: Kanabec Hospital,
Attn: Health Information Department (HIM), 301 S. Hwy. 65,
Mora, MN 55051.
If you request a copy of the information, we may charge a
fee for the costs of copying, mailing, or other supplies associated
with your request.
We may deny your request to inspect and copy in certain very
limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed.
Another licensed healthcare professional chosen by the hospital
will review your request and the denial. The person conducting
the review will not be the person who denied your request.
We will comply with the outcome of the review.
RIGHT TO AMEND
You have the right to request changes to your healthcare information.
If you feel that medical information we have about you is
incorrect or incomplete, you may ask us to amend the information.
To request an amendment, your request must be made in writing
and submitted to the following address. In addition, you must
provide a reason that supports your request.
Kanabec Hospital
Attn: Director of Health Information (HIM)/Privacy Officer
301 S. Hwy. 65, Mora, MN 55051
We may deny your request for an amendment if it is not in
writing or does not include a reason to support the request.
In addition, we may deny your request if you ask us to amend
information that:
* Was not created by us;
* Is not part of the medical information kept by or for the
healthcare
center;
* Is not part of the information which you would be permitted
to inspect
and copy; or
* Is accurate and complete.
RIGHT TO AN ACCOUNTING OF DISCLOSURES
You have the right to know who has accessed your confidential
healthcare information and for what purpose. To request an
accounting of disclosures, you must submit your request in
writing to: Kanabec Hospital, Attn: Director of Health Information
(HIM)/Privacy Officer, 301 S. Hwy. 65, Mora, MN 55051
Your request must state a time period which may not be longer
than six (6) years and may not include dates before April
15, 2003.
RIGHT TO A PAPER COPY OF THIS
NOTICE
You have the right to possess a copy of this Privacy Notice
upon request. You may ask us to give you a copy of this notice
at any time. You may obtain a copy of this notice online at
www.kanabechospital.org, or by calling
(320) 679-1212, or by writing to Kanabec Hospital, Attn: Health
Information Department (HIM), 301 Hwy 65, Mora, MN 55051.
CHANGES TO THIS NOTICE
We reserve the right to change this notice and make the new
terms effective for all confidential health information we
maintain. We will post a copy of the current notice in this
facility and online at www.kanabechospital.org. The effective
date of this notice is listed on the last page.
OUR PLEDGE REGARDING HEALTH
INFORMATION
We understand that health information about you is personal.
We are committed to protecting the privacy of your health
information by following all applicable federal and state
privacy and confidentiality requirements. As a result, we
have developed policies, improved the controls over our computers
and other systems which access and store health data, and
educated our employees about protecting your health information.
We are required by law to keep your health information private
and to give you this notice of our legal duties and privacy
practices. When required by Minnesota, federal or any other
law, we will get your consent before using or disclosing your
health information.
COMPLAINTS
You have the right to complain to the health care center or
with the Secretary of the Department of Health and Human Services
if you believe your rights to privacy have been violated.
All complaints must be submitted in writing.
* All complaints will be investigated.
* You will not be penalized for filing a complaint.
For further information about this Privacy Notice or to file
a complaint, please contact:
Kanabec Hospital
Director of Health Information (HIM)/Privacy Officer
301 S. Hwy. 65
Mora, MN 55051
Phone: (320) 679-1212 |
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