Updated: January 20, 2022.
The federal HIPAA Privacy Rule and other federal regulations found in 42 CFR Part 2 require health care providers such as the Dunes to develop and distribute a notice that provides a clear, user-friendly explanation of individual rights with respect to their personal health information and the privacy practices of health care providers.
We must make our notice available to any person who asks for it.
We must prominently post and make available our notice on any website we maintain that provides information about our services or benefits.
This policy will describe how Dunes may use and disclose protected health information about an individual. The policy will discuss an individual’s rights with respect to the information and how the individual may exercise these rights, including how the individual may complain to the Dunes or to the government. Such rights might include a client’s right to inspect, copy, change, or remove their protected health information.
The policy will discuss our legal duties with respect to the information, including a statement that we are required by law to maintain the privacy of protected health information.
It will also discuss whom individuals can contact for further information about our privacy policies.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
You have a right to get an electronic or paper copy of your medical record
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
You can ask us to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing within 60 days.
You have a right to request confidential communications
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.
You can ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
You can get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, whom we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
You can get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
You can choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action.
You can file a complaint if you feel your rights are violated
You can complain if you feel we have violated your rights by contacting us using the information below.
You may contact our privacy official, David G. Evans, Esq., Director of Legal and Regulatory Affairs at email: firstname.lastname@example.org, telephone 908-963-0254. You may call him seven days a week from 9 AM until 5 PM.
You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. You may also file a complaint with the New York Office of Addiction Services and Supports at https://oasas.ny.gov/
We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In the below cases we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fund-raising: We may contact you for fund-raising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information? We typically use or share your health information in the following ways.
To treat you
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition or if we have to take you for medical care at a hospital.
To run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share our information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
To help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services or the state Office of Addiction Services and Supports if they want to see that we’re complying with privacy laws. https://oasas.ny.gov/
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here 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.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Other Instructions for Notice
The Effective Date of this Notice is January 20, 2022
Our privacy official is David G. Evans, Esq. Director Legal and Regulatory Affairs Email: email@example.com. Telephone 908-963-0254. You may contact him seven days a week from 9 AM until 5 PM
We never market or sell personal information.
For more information about the HIPAA Privacy Rule and the Notice requirements, see: http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/notice.html
A COPY OF THIS POLICY IS PROVIDED UPON ADMISSION. A COPY CAN ALSO BE PROVIDED BY YOUR COUNSELOR. IT IS ALSO POSTED ON OUR WEBSITE AT: HTTPS://THEDUNESEASTHAMPTON.COM/