Bridgeway Counseling Center llc Notice for Use and Sharing of Protected Health Information
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.
We at Bridgeway Counseling Center llc pledge to give you the highest quality healthcare and to have a relationship with you that is built on trust. This trust includes our commitment to respect the privacy and confidentiality of your health information.
The word "Bridgeway" in this Notice includes all of the organizations listed at the end of this notice.
This Notice is being given to you because federal law gives you the right to be told ahead of time about:
Please note that treatment at Bridgeway Counseling Center llc provides you with additional protections, as explained throughout this Notice.
This Internet communication is limited to the dissemination of general information about the services provided by Bridgeway Counseling Center llc. Information in this Internet communication (Web site) is for informational purposes only and should not be construed as medical advice. Please obtain relevant professional advice before making any healthcare decisions.
A. HOW WE MAY USE AND DISCLOSE (SHARE) YOUR PROTECTED HEALTH INFORMATION
When you need healthcare, you give information about yourself and your health to doctors, nurses, and other healthcare workers and staff. This information, along with the record of the care you receive, is "protected health information" (or "health information"). This information is kept in a paper form such as your medical record and in an electronic form on the computer.
Bridgeway uses your health information within its system, and shares your health information outside its system in order to give you excellent medical care. Bridgeway uses and shares your health information for other reasons that can include medical research and training new healthcare workers. For example, Bridgeway may share your health information with outside healthcare providers for purposes such as treatment or research; in some cases, these providers have a specific relationship with Bridgeway and physicians who have outside private practices but also occasionally work at a Bridgeway hospital. In addition, other outside parties who receive your information in order to perform services on Bridgeway's behalf ("business associates") must also take steps to keep your health information private.
This Notice will tell you how Bridgeway uses and shares your health information for these and other purposes. It will also tell you when we need to get your specific permission to do so.
1. Treatment, Payment, and Healthcare Operations
Except where prohibited by Idaho state or federal laws (see section 4), Bridgeway may legally use and share your health information for treatment, payment, and healthcare operations. We do not need to ask for your specific permission to do these things, as explained below:
Bridgeway healthcare providers will use and share your health information to provide and manage your healthcare and related services. For example, your primary care doctor may refer you to a specialist such as a radiologist or surgeon. The specialist may tell you that you need to be admitted to the hospital for treatment or surgery. All of the doctors in this example, whether they are in the Bridgeway system or not, will share medical information about you. This is to coordinate your care before, during and after you go into the hospital. Bridgeway will share information with other third parties, such as home health agencies, visiting nurses, rehabilitation hospitals, and ambulance companies. It will also share information with those who treated you before you went into the hospital and those who will treat you in the future. This helps to make sure that everyone caring for you has the information they need.
Bridgeway Counseling Center llc and/or its providers will not share information with other Bridgeway entities and/or healthcare providers without an authorization signed by you to release information.
Bridgeway will use and share your health information to bill and collect payment for the healthcare services it gives to you. For example, if you have health insurance, your healthcare provider will share your medical information with the insurance company or government agency. The insurance company uses the information to tell if you are eligible for benefits or if the services you received were medically needed.
Bridgeway may use and share your health information for activities that are known as healthcare operations. These are activities that are needed to operate its facilities and carry out its mission. Some of the information is shared with outside parties who perform these healthcare operations or other services on behalf of Bridgeway ("business associates"), such as lawyers, auditors, consultants, and transcription services. We require these business associates, by contract, to take steps to keep your health information private. Examples of activities that make up healthcare operations include:
Bridgeway may use your health information to contact you:
2. Uses and Disclosures (Sharing) of Your Health Information for Other Purposes
Bridgeway may legally use and/or share your health information with others in the following areas without your specific permission:
3. Uses and Disclosures (Sharing) You May Ask To Be Limited, or Request Not Be Made
If you are admitted to the hospital, your name, room location, general condition, and religion may be listed in that hospital's directory (information desk). This will be shared with members of your family, friends, members of the clergy, and others who ask for you by name. You may ask to have your name taken off the directory list. You may also ask to restrict the information that is given out about you. If you are in an emergency situation and are not able to make your wishes known, we will put this information in the directory if we think it is in your best interest. We will not put the information in the directory if you have been admitted to the hospital before and asked that it not be shared.
Bridgeway Counseling Center llc does not have a patient directory and will not give out any information regarding your care. Dedicated Substance Abuse Facilities also will not release any directory information without your specific authorization.
Disclosures to Family, Friends or Others
Bridgeway Counseling Center llc and dedicated Substance Abuse Facilities/Providers will not give out any information to family or friends without an authorization signed by you.
4. Uses and Disclosures (Sharing) of Information that Require Your Written Permission (Authorization)
Except as described in this Notice and as permitted by law, we cannot use or share your health information without your written permission.
Idaho state or federal laws require that we obtain your written permission before using or disclosing the information listed below:
Note: If you have given permission for your medical information in the above categories to be used or shared, you may withdraw your permission in writing at any time except to the extent that the providers have already acted on it.
B. YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION AND HOW TO EXERCISE THEM
The Right to Ask for Limits on the Use and Sharing of Your Health Information.
You have the right to ask for restrictions on the use and sharing of your health information for treatment, payment or healthcare operations. You can also ask for restrictions on using this information to notify you about appointments and sharing your information with family members and close friends.
Bridgeway is not required to agree to your request. If we do, we must put the restriction in writing and abide by it, except if you need to be treated in an emergency. You may not ask us to restrict uses and sharing of information that we are legally required to make.
The Right to Ask that Bridgeway Communicate Your Health Information to you in a Confidential Manner.
You have the right to ask for your health information to be sent to you in different ways. For example, you may ask that Bridgeway not contact you with appointment reminders by telephone, or only call at your work or cell telephone number rather than home. When we request an address and telephone numbers to contact you, it is your responsibility to give us telephone numbers and an address that will allow us to carry out our needs to reach you and care for you. We may request that the method and location where you wish to be contacted be in writing and that you contact us with any changes to this information. Bridgeway must agree to any reasonable request and cannot ask you to explain the reason for your request. Bridgeway can require you to give information as to how a payment will be handled, and what address a bill should be mailed to.
The Right to Look at and Get a Copy of Your Health Information.
You have the right to look at and get a copy of your health information that Bridgeway keeps of your medical treatment and bills. You must ask for this in writing. We will respond within thirty (30) days from receipt of your request. If you ask for a copy of your records, you will be charged a fee for them.
If your request is denied, we will explain the reasons in writing and tell you which rights you have, if any, to a review of the denial. We may offer to give you a summary or explanation of the information you requested, as long as you agree in advance to this and to any fees that it might cost. If you ask for information that we do not have, but we know where it is, we must tell you where to direct your request.
The Right to Change Your Health Information.
The Right to Receive An Accounting of Disclosures (Record of When Your Health Information was Shared without Your Written Permission or Authorization).
You have the right to get a record of the times that your health information has been shared. You must make your request in writing. You may request this information as far back as six years, but not for periods prior to April 14, 2003. The listing you get will include the date, name, and address (if known) of the person receiving your information. It will also include a brief description of the information given, and a brief statement of why the information was shared.
The following exceptions apply:
The Right to Ask for a Paper Copy of this Notice.
You may ask for a paper copy of this Notice from the contact listed below. You can ask for a paper copy even if you agreed to receive the Notice by email.
C. OUR DUTIES WITH RESPECT TO YOUR HEALTH INFORMATION
Bridgeway is required by law to keep your health information private. We are required to give people notice of our legal duties and privacy practices with respect to your health information.
Bridgeway must abide by the terms of the Notice currently in effect. Bridgeway reserves the right to change its privacy practices and the terms of this Notice at any time. Bridgeway reserves the right to make the new Notice provisions effective for all protected health information that it maintains. If Bridgeway makes a material change to this Notice, the updated Notice will be posted on the Bridgeway Web site and in all Bridgeway registration areas for public viewing. You may request a copy of the current Notice at any time by calling any of the people listed at the end of this Notice, or you may view it on our Web site at www.Bridgewaybehavioralcare.com.
D. HOW TO COMPLAIN IF YOU BELIEVE YOUR PRIVACY RIGHTS HAVE BEEN VIOLATED
If you think that we may have violated your privacy rights or you disagree with any action we have taken with regard to your health information, we want you, your family, or your guardian to speak with us. If you present a complaint, your care will not be affected in any way. It is the goal of Bridgeway Counseling Center llc to give you the best care while respecting your privacy.
E. PERSON TO CONTACT FOR INFORMATION OR WITH A COMPLAINT
If you have any questions about this Notice or any complaints, please contact a representative at any of the Bridgeway sites that are listed at the bottom of this notice.
F. EFFECTIVE DATE OF THIS NOTICE
This Notice is effective as of April 14, 2003.
Bridgeway Counseling Center llc MEMBER ORGANIZATIONS
This Notice applies to the following Bridgeway organizations:
Bridgeway Counseling Center, llc
324 5th St, #102
Lewiston, ID 83501