Quality Care from People Who Care
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.
Tiffany Care Centers, Inc. use health information about you for treatment to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of Tiffany Care Centers, Inc. This Notice of Privacy practices was prepared to comply with the HIPAA Privacy Rule. State law, in certain circumstances, may be stricter than the Privacy Rule and will prevail in such circumstances.
How Tiffany Care Centers May Use or Disclose Your Health Information
For Treatment Tiffany Care Centers (TCC) may use and disclose your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a therapist, or other person providing health services to you, will record information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.
For Payment Tiffany Care Centers may use and disclose your health information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payer, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.
For Health Care Operations TCC may use and disclose health information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:
• Evaluate the performance of our staff
• Assess the quality of care and outcomes in your cases and similar cases
• Learn how to improve our facilities and services
• Determine how to continually improve the quality and effectiveness of the health care we provide
Appointments TCC may use your information to provide appointment reminders of information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Required by Law TCC may use and disclose information about you as required by law. For example, TCC may disclose information for the following purposes:
• For Judicial and administrative proceedings pursuant to legal authority
• To report information related to victims of abuse, neglect or domestic violence
• To assist law enforcement officials in their law enforcement duties
Public health Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability, or for other health oversight activities.
Descendants Health information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.
Organ/Tissue Donation Your health information may be used or disclosed for cadaver organ, eye or tissue donation purposes.
Health and Safety Your health information may be disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.
Government Functions Your health information may be disclosed for specialized government functions such as protection of public officials or reporting to various branches of the armed services.
Worker’s Compensation Your health information may be used or disclosed in order to comply with laws and regulations related to Worker’s Compensation.
Other Uses Other uses and disclosures will be made only with your written authorization and you may revoke the authorization except to the extent TCC has taken action in reliance on such.
Your Health Information Rights
You have the right to:
• Request a restriction on certain uses and disclosures or your information as provided by 45 C.F.R. S164.522; however, TCC is not required to agree to a requested restriction
• Obtain a paper copy of the notice of information practices upon request
• Inspect and obtain a copy of your health record as provided for in 45 C.F.R. S164.524
• Request that your health record be amended as provided in 45 C.F.R. S164.526
• Request communications of your health information by alternative means or at alternative locations using a designated form obtained from the TCC Privacy Office/Corporate
• Receive an accounting of disclosures made of your health information as provided by 45 C.F.R. S164.528
You may complain to TCC and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.
Obligations of Tiffany Care Centers
Required by Law:
• Maintain the privacy of protected health information
• Provide you with this notice of its legal duties and privacy practices with respect to your health information
• Abide by the terms of this notice
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed
• Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations
Tiffany Care Centers reserves the right to change its information practices and to make the new provisions effective for all protected health information it maintains. Revised notices will be made available to you by an appropriate means. TCC is required to abide by the terms of this Notice.
If you have any questions or complaints, please contact.
Tiffany Care Centers Corporate Office
1105 State Street
Mound City, MO 64470