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 are committed to preserving the privacy and confidentiality of your personal health information. While receiving care through MAGRUDER HOSPITAL AND AFFILIATES, we will create, receive, or maintain records that contain personal health information about you. Personal health information is information about you, including information about where you live, that can reasonably be used to identify you and that relates to your past, present, or future physical or mental condition, the provision of health care to you or the payment for that care.
MAGRUDER HOSPITAL AND AFFILIATES are required by certain state and federal regulations to safeguard the privacy of your personal health information. We are also required by the federal Health Insurance Portability and Accountability Act (or “HIPAA”) Privacy Rule to give you this Notice. This Notice informs you about the possible uses and disclosures of your personal health information and describes your rights and our obligations regarding your personal health information. This Notice applies to all information and records related to your care that MAGRUDER HOSPITAL AND AFFILIATES has received or created.
You have the right to:
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
Ask us to correct your medical record
Request confidential communications
Ask us to limit what we use or share
Get a list of those with whom we’ve shared information
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
File a complaint if you feel your rights are violated
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to:
How do we typically use or share your health information? We typically use or share your health information in the following ways.
Treat you - We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization - We can use and share your health information to run our hospital and office practices, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services - We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
Health Information Exchange- We participate, as allowed in Ohio Rev. Code 3798.06, in Ohio’s state HIE, Clinisync. You have the right to request that we do not disclose any protected health information or specific categories of protected health information to Clinisync in writing to Magruder Hospital Affiliated Privacy Group, Health Information Management- Privacy Officer 615 Fulton St. Port Clinton, Ohio 43452.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
We can use or share health information about you:
If you have any complaints or questions about our privacy policies, please contact: Privacy Officer,
MAGRUDER HOSPITAL Affiliated Privacy Group
Health Information Management- Privacy Officer 615 Fulton St.
Port Clinton, Ohio 43452
Telephone: 419-734-3131 Fax: 419-732-2678
This Notice of Privacy Practices is posted in all Magruder Hospital and affiliated services buildings and on our web-site(s): Magruder Hospital Privacy Group is an Affiliated Covered Entity.
Federal regulations require us to ask you for your signature indicating that you have received this Notice of Privacy Practices.
Magruder Hospital and affiliates comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. Magruder Hospital and affiliates does not exclude people or discriminate because of race, color, national origin, age, disability, or sex.
If you need these services, contact the Civil Rights Compliance Coordinator of Magruder Hospital and affiliates.
Compliance Officer/Director of Performance Improvement/Risk Management
615 Fulton St. Port Clinton, Ohio
Direct telephone: 419-732-4016; FAX 419-734-4101
If you believe that Magruder Hospital and affiliates has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the Civil Rights Compliance Coordinator of Magruder Hospital, using the above contact
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Compliance Coordinator, is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201; 1–800–868–1019, 800–537–7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Effective Date of this Notice: 04/1/2019
Please find a pdf of the above Notice of Privacy for your convenience.
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