Country Road Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review this notice carefully.
How We May Use and Disclose Health Information About You:
For Treatment. We may use medical and clinical information about you to provide you with treatment or services.
For Payment. With your authorization, we may use and disclose medical information about you so that we can receive payment for the treatment services provided to you.
For Health Care Operations. We may use and disclose your protected health information (“PHI”) for certain purposes in connection with the operation of our program and to make sure that all of our clients receive quality care.
We must obtain a written authorization from you for other uses and disclosures of your PHI unless the use or disclosure is required or permitted by law, as explained on the following Pages.
Your Rights Regarding Your PHI
You have the following rights regarding PHI we maintain about you:
- Right of Access to Inspect and Copy.
- You have the right, which may be restricted in certain circumstances, to inspect and copy PHI that may be used to make decisions about your care. We may charge a reasonable, cost based fee for copies.
- Right to Amend.
- If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information although we are not required to agree to the amendment.
- Right to an Accounting of Disclosures.
- You have the right to request an accounting of the disclosures that we make of your PHI.
- Right to Request Restrictions.
- You have the right to request a restriction or limitation on the use of your PHI for treatment, payment, or health care operations. We are not required to agree to your request.
- Right to Request Confidential Communication.
- You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
- Right to a Copy of this Notice.
- You have the right to a copy of this notice.
You have the right to file a complaint in writing to us or to the U. S. Secretary of Health and Human Services if you believe we have violated your privacy rights.
We will not retaliate against you for filing a complaint.
Confidentiality of Substance Use Disorder Patient Records
Federal law and regulations protect the confidentiality of substance use disorder patient records. Country Road Recovery Center is required to comply with these confidentiality protections.
Identifying you as having or having had a substance use disorder may only be provided if allowed under federal regulation. Release of information without your written permission may only be allowed under limited circumstance, such as in response to a court order or to medical personnel in the event of a medical emergency.
Violation of Federal laws or regulations by this program is a crime. Suspected violations of confidentiality should be reported to Country Road Recovery Center's Privacy Officer. If your concern is not resolved you may also file with your local U.S. Attorney’s Office.
If you commit a crime on program premises or against program personnel, we will disclose information identifying you to law enforcement.
We will make a report of suspected child abuse and neglect, as mandated under state law to appropriate state and local authorities.
The confidentiality of substance use disorder treatment records regulations are found at title 42 of the Code of Federal Regulations (CFR) part 2 (42 CFR part 2).
If you have any questions about this Notice of Privacy Practices, please contact the Country Road Recovery Center Privacy Officer:
24962 Okay Road
Tecumseh, Oklahoma, 74873
Your health record contains personal information about you and your health. State and federal law protects the confidentiality of this information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. As referenced in the Client Rights form, this Notice of Privacy Practices describes how we may use and disclose your protected health information (“PHI”) in accordance with applicable law, including the Health Insurance Portability and Accountability Act (“HIPAA”) and regulations promulgated under HIPAA including the HIPAA Privacy and Security Rules. It also describes your rights regarding how you may gain access to and control your PHI. We are required by law to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will make available a revised Notice of Privacy Practices by posting a copy on our website, sending a copy to you in the mail upon request, or providing one to you at your next appointment.
How We May Use and Disclose Health Information About You
Listed below are examples of the uses and disclosures that Country Road Recovery Center may make of your protected health information (“PHI”). These examples are not meant to be exhaustive. Rather, they describe types of uses and disclosures that may be made.
Uses and Disclosures of PHI for Treatment, Payment and Health Care Operations
Treatment. Your PHI may be used by your physician, counselor, program staff and others inside of our program that are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and any related services.
Payment. We will not use your PHI to obtain payment for your health care services without your written consent. Examples of payment related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review Activities.
Healthcare Operations. We may use or disclose, as authorized, your PHI in order to support the business activities of our program including, but not limited to, quality assessment activities, employee review activities, training of students, licensing, and conducting or arranging for other business activities. For example, we may use a sign in sheet at the registration desk where you will be asked to sign your name and indicate your physician or counselor. We may also call you by name in the waiting room when it is time to be seen. We may contact you to remind you about appointments or to provide information to you about treatment alternatives or other health related benefits and services that may be of interest to you. We may also contact you concerning Country Road Recovery Center's fundraising activities. We may share your PHI with third parties that perform various business activities (e.g., billing or typing services) for Country Road Recovery Center, provided we have a written contract with the business that prohibits it from redisclosing your PHI and requires it to safeguard the privacy of your protected health information.
Other Uses and Disclosures That Do Not Require Your Authorization
Required by Law. We may use or disclose your PHI to the extent that the use or disclosure is required by law, made in compliance with the law, and limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures. Under the law, we must make disclosures of your PHI to you upon your request. In addition, we must make disclosures to the U. S. Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule.
Health Oversight. We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third party payors) and peer review organizations performing utilization and quality control. If we disclose PHI to a health oversight agency, we will have an agreement in place that requires the agency to safeguard the privacy of your information.
Notification and Communication with Family
For organizations only subject to HIPAA:
- We may disclose to a family member, your personal representative or another person responsible for your care, the PHI directly relevant to that person’s involvement in your care or about your location, your general condition or death.
- In the event of an emergency, we may disclose information to public service organizations to facilitate your care.
- We may also disclose information to someone who is involved with your care or helps pay for your care.
- If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures, although we may disclose this information in an emergency even over your objection if we believe it is necessary to respond to the emergency circumstances. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.