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.
If you have any questions about this Notice please contact our office by calling 603-434-1577.
CHANGES TO THIS NOTICE
We are required to follow the privacy practices described in this Notice, although we reserve the right to change our privacy practices and the terms of this Notice at any time. If we do so, the revised privacy practices will apply to all protected health information we already have about you, as well as any we receive or create about you in the future. If we do change our privacy practices and the terms of this Notice, we will post a new Notice at each of our offices and on our website at www.clmnh.org
OUR DUTY TO SAFEGUARD YOUR HEALTH INFORMATION
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all of the records of your care generated by or held by the Center for Life Management.
We are required by law to maintain the privacy of your health information, to provide you a description of our privacy practices, and to abide by the terms of this notice.
We are required to extend certain protections to your personal and medical information, know as “protected health information”, and to give you this Notice about our privacy practices that explains how, when and why we may use or disclose your protected health information. Except in specified circumstances, we must use or disclose only the minimum necessary protected health information to accomplish the purpose of the use or disclosure.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
We use and disclose protected health information for a variety of reasons. Federal law provides that we are permitted to make some uses/disclosures without your consent or authorization, primarily for treatment, payment, or agency operations. There are many situations, however, where the Center for Life Management will continue to require written authorizations. The Center for Life Management will no longer release or request “entire records” unless it is specifically justified. Areas where we are permitted to disclose protected health information without written authorization are:
Some examples of instances where we may use and disclose certain protected health information:
If you do not wish to be on our mailing list, please fill out a Mailing List Exclusion Form at the site at which you are seen.
There are some services provided in our organization through contracts with business associates. Examples include our answering services, a transcription service, a records storage service, our legal advisors. When these services are contracted, we may disclose your protected health information to our business associates so that they can perform the job we have asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information. Whenever an arrangement between the Center for Life Management and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.
PERMITTED DISCLOSURES UNLESS YOU OBJECT
If you do not object, we may disclose some limited protected health information to family members or others involved in you care or payment for your care. For example, we may share information about your medications, appointments, diagnosis or potential for self-harm or information regarding services for payment purposes. We may also use or disclose your protected health information to notify or assist in notifying a family member or other person responsible for your care of your location and general conditions, or to an authorized entity assisting in a disaster relieve effort so you family can be notified of your location and general condition.
OTHER STATE AND FEDERAL LAW REQUIREMENTS
In situations where New Hampshire laws or other federal laws are more stringent or give you more rights than the federal privacy law, we will abide by the New Hampshire or other federal law. For example, HIV information is subject to greater protection under New Hampshire law and information about alcohol and drug abuse treatment is subject to more limited disclosure requirements under another federal law.
OTHER PERMITTED DISCLOSURES
For all other disclosures, we are required to have your written authorization, unless the use or disclosure fall within one of the exceptions described below.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have the following rights relating to your protected health information:
If you believe your privacy rights have been violated, you may file a complaint with the Center for Life Management by calling the Privacy Officer at 603-434-1577 or with the US Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. The Center for Life Management will take no retaliatory action against you if you make complaints.
Effective Date: This Notice is effective as of April 14, 2003.