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Privacy Policy

 

LEE COUNTY COOPERATIVE CLINIC

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION.

We are Required by Law to:

  • Ensure that health information that identifies you is kept private and in accordance with federal and state laws.
  • Provide you with this notice as to our legal duties and privacy practices with respect to individually identifiable health information that we collect and maintain about you.
  • Allow you to obtain a copy of your health information in paper and electronic form
  • Correct any information in your health information that you prove to be inaccurate
  • Train our personnel concerning privacy and confidentiality
  • Implement a sanction policy to discipline those who breach privacy/Confidentiality or our policies with regard to Personal Health Information (PHI)
  • Mitigate (lessen the harm) any breach of privacy/ confidentiality
  • Abide by terms of this notice

Who We May Disclose Health Information to:

  • To a specialist in which our health center is sharing in the treatment
  • We may use your health information to collect payment for services from your insurance provider, Medicare, Medicaid and other health plan providers
  • Public Health, abuse or neglect and health oversight. Example: to alert a person who may have been exposed to a disease or may be at risk contracting or spreading a disease
  • Workers Compensation relating to a work-related injury that you were treated for at our health center
  • Authorization required by law including legal proceedings were a subpoena has been issued
  • In the event of a death that may be the result of criminal conduct
  • To identify or locate a suspect, fugitive, material witness or missing person
  • Information may be released or disclosed to a coroner, medical examiner, or funeral director to assist in the performance of their duties in accordance with applicable law
  • To prevent a treat to National Security
  • To a business associate who provides services through a contract and who has signed a HIPPA Business Agreement
  • If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
  • We may disclose your health information to the Department of Health and Human Services (HHS) as necessary to determine our compliance with those standards.

Disclosure for Which Authorization is Required:

  • Use for Psychotherapy
  • For marketing purposes including subsidized treatment communication
  • Disclosure that constitute a sale of Personal Health Information
  • Disclosure to health insurance providers where you paid the full amount of the services
  • Disclosure to any third party that is not listed in (Who We May Disclose Your Information to)
  • We will notify you in writing of all other disclosures that are not listed here and request your permission for such disclosure.

NOTE: The list above is not inclusive and there may be other instances in which your Authorization is required for release of your Personal Health Information

 

Notice of Intent:

  • We may contact you by mail or phone calls to remind you of your appointment
  • We may contact you to provide information regarding your treatment alternatives or other health-related benefits and services.
  • If we decide to contact you concerning fundraising, we will first ask your approval

Right to Restrict Disclosure: You have a right to request restrictions or limitation on certain uses and disclosures of your Personal Health Information.  Each individual request will be reviewed to determine in the restriction is within your rights.  you have a right to request and receive an accounting of all disclosures of your Personal Health Information.

Right to Inspect and Copy: You have a right to inspect and copy your Personal Health Information.  You have a right to receive the information electronically once we have such authorization in writing.  If you feel that this information is incorrect or incomplete, you may ask us to amend the information.

Instances Where Right to Copy or Inspect May be Refused:

  • Psychotherapy notes that are recorded in any medium by a health care provider who is a mental health professional documenting or analyzing a conversation during a private, group, joint, or family counseling session and that are separated from the rest of your medical record.
  • Information compiled in reasonable anticipation of or for use in civil, criminal, or administrative actions or proceedings
  • Protected Health Information that is subject to the Clinical Laboratory Improvement Amendments 1988 (CLIA), 42 USC 263a, to the extent that giving you access would be prohibited by law
  • Information that was obtained from someone other than a health care provider under a promise of confidentiality and the requested access would be reasonably likely to reveal the source of the information.
  • Information that is copyright protected, such as certain rad data obtained from testing

Note: In other situations, we may deny you access, but if we do, we must provide you a review of your decision denying access.  These reviewable grounds for denial include the following.

  • A licensed health care professional, such as your attending physician, has determined in the exercise of professional judgement, that the access is reasonably likely to endanger the life or physical safety of you or another person.
  • Protected Health Information makes reference to another person (other than a health care provider) and a licensed health car provider has determined in the exercise of professional judgement, that the access is reasonably likely to cause substantial harm to such other person.
  • The request is made by your personal representative and a licensed health care professional has determined, in the exercise of professional judgment that giving access to such personal representative is reasonably likely to cause substantial harm to you or another person.
  • For these reviewable grounds, another licensed professional must review the decision of the provider denying access within 60 days.  If we deny you access, we will explain why and what your rights are, including how to seek review.  If we grant access, we will tell you what, if anything, you have to do to get access.  We reserve the right to charge a reasonable cost-based fee for making copies.

If We Deny Your Request for Amendment/Correction: if we deny your request for amendment/correction, we will notify you why, how you can attach a statement of disagreement to your records (which we may rebut) and how you can complain.  If we grant the request, we will make the correction and distribute the correction to those who need it and those whom you identify to us that you want to receive the corrected information.

Changes to this Notice: We reserve the right to make changes to this notice.  If changes are made, we will make the changes readily available to you upon request on or after the effective date of the revisions to existing patients who request a copy and we will post the revised copy in our centers.  Copies may also be found on our website, http://leecountycooperativeclinc.com.

Breaches: If your Protected Health Information is breached, we will notify within sixty (60) days of the breach that your Protected Health Information has been breached. We will take every precaution and steps as required by federal and state law to circumvent any damages caused by the breach.

Complaints: If you believe that there has been a violation of your Privacy Rights, you may file a complaint with the Secretary of the Department of Health and Human Services.

Centralized Case Management Operations

U.S. Department of Health and Human Services

200 Independence Avenue, S.W.

Room 509F HHH Bldg.

Washington, D.C. 20201

You may email to OCRComplaint@HHS.gov. Complaints may be filed with our Privacy Officer by mail, email or fax:

Privacy Officer: Andrea Hope Howard

Andrea.hopehoward@lccc.us.com

530 Atkins Boulevard

Marianna, AR 72360

870-298-4258

FAX: 870-295-4073

Contact Us

530 W. Atkins Boulevard
Marianna, Arkansas 72360
Office Number (870) 295-5225

info@leecountycooperativeclinic.com

Locations & Office Hours

Marianna: M, Tu, Th 8AM-5:30PM | W 8AM-7PM | F 8AM-5PM
Lake View: Tu 9AM-4:30PM (DENTAL) | Th 9AM-4:30PM (DR)
Madison: Tu & F 9AM-4:30PM
Hughes: M, W, F 9AM-4:30PM

An FTCA Deemed Facility