Now accepting new patients of all ages!
Skip to main content
907-455-4567 Patient Portal

Notice of Use of Private Health Care Information

Interior Community Health Center Contents Patient Information Notice of Use of PHI

 

This is a copy of our Notice of Use of Private Health Care Information. You may request a paper copy of this notice at any time. A copy is also posted in our lobby. 

NOTICE OF USE OF PRIVATE HEALTH CARE INFORMATION

For Your Protection

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.

Your Health Care Information Is Private

We understand that information we collect about you and your health is personal. Keeping your health care information private is one of our most important responsibilities. We are committed to protecting your health care information and following all laws about its use. You have the right to discuss with the privacy officer your concerns about how your health care information is shared. The law says:

  1. We must keep your health care information from others who do not need it.
  2. You may ask us not to share certain health care information. Sometimes we may not be able to agree to your request.

Who Sees And Shares My Health Care Information?

We are permitted to see, use, and share your health information for purposes of your treatment, ensuring payment for our services, and operating our healthcare business entity. For example:

Your health caregivers, such as nurses, doctors, physician assistants, nurse practitioners, behavioral health providers, and dentists may see, use, and share your health care information, including to your other providers outside this office, to determine your plan of care/treatment. This use may cover health care services you had before now or may have later.

We review your health care information and bills (claims) to make sure that you get quality care and that all laws about providing and getting paid for your health care are being followed. We release your information to your health plan or other appropriate entities to ensure that payment is made for the services you receive from us. If you choose to pay out-of-pocket and in full for services you receive, you may restrict disclosure of health information to your health plan with respect to those services upon written request to our practice.

We may also use your information to remind you about appointments, coordinate your care, obtain your feedback about your care and/or for quality improvement and health outcome reporting activities. Additionally, we participate in Health Information Exchange with some of your other healthcare providers and pharmacies via electronic communications, and we provide an online portal through which you can access your private health information.

May I See My Health Care Information?

In most cases, you may see your health care information. There may be legal reasons or safety concerns that may limit the amount of information you may see. You may ask in writing to receive a copy of your health care information. We will act upon your request within 30 days. We may charge a small amount for copying costs.

If you think some of your health care information is wrong, you may ask in writing within 60 days it was provided to you that we correct or add to it. You may ask that the corrected or new information be sent to others who have received your health care information from us. You may ask us for a list of where we sent your health care information.

What If My Health Care Information Needs To Go Somewhere Else?

You may ask to have your health care information sent to others. You will be asked to sign a separate form, called an authorization form, permitting your health care information to go to them.

The authorization form tells us what, where, and to whom the information must be sent. You can stop or limit the amount of information sent at any time by letting us know in writing.

Note: If you are younger than 18 years old and, by law, you are able to give consent for your own health care, then your health care information is kept private from others unless you sign an authorization form.

Could My Health Care Information Be Released Without My Authorization?

We follow laws that tell us when we have to share health care information, even if you do not sign an authorization form. We always report:

  1. contagious diseases, birth defects, and cancer;
  2. firearm injuries and other trauma events;
  3. reactions to problems with medicines or defective medical equipment;
  4. to the police when required by law;
  5. when the court orders us to;
  6. to the government to review how our programs are working;
  7. to a provider or insurance company who needs to know for purposes of payment on a health claim;
  8. to Workers Compensation for work related injuries;
  9. birth, death, and immunization information;
  10. to the federal government when they are investigating matters important to protect our country, the President, and other government workers;
  11. abuse, neglect, and domestic violence, if related to child protection or vulnerable adults

We may also share health information for permitted research purposes, for matters concerning organ donations, and for serious threats to public health or safety.

We are prohibited by law from selling your private health information without your express written authorization.
Except as permitted above, we are required to notify you in the event of an unauthorized disclosure of your health information, such as a breach in security which results in your private information becoming accessible to unauthorized individuals.

May I Have a Copy of this Notice?

You may ask for a copy at any time. If you received this notice electronically, you may ask for a paper copy. If there are important changes to this notice, you will get a new one.

We have the right to change the terms of this notice. Any changes that are made in future versions of this notice will be effective for all health information maintained by us.

Questions or Complaints?

If you have questions or feel your privacy rights have been violated, you can contact the Operations Officer by calling 907-455-4567, or by writing to ICHC Operations Officer, 1606 23rd Avenue, Fairbanks, AK 99701.

You can also complain to the federal government Secretary of Health and Human Services (HHS) or to the HHS Office of Civil Rights. Your health care services will not be affected by any complaint made to the Operations Officer, Secretary of Health and Human Services, or Office of Civil Rights.