Burton Creek Rural Clinic (“we,” “us,” or “our”) is committed to protecting the privacy of our patients’ health information in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This HIPAA Privacy Policy outlines how we handle your Protected Health Information (PHI) and your rights concerning your PHI.

1. Understanding Your Health Record and Information

Each time you visit Burton Creek Rural Clinic, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

• Basis for planning your care and treatment.
• Means of communication among the many health professionals who contribute to your care.
• Legal document describing the care you received.
• Means by which you or a third-party payer can verify that services billed were actually provided.
• A tool for routine healthcare operations such as assessing quality and reviewing the competence of healthcare professionals.

2. Your Health Information Rights

Although your health record is the physical property of Burton Creek Rural Clinic, the information belongs to you. You have the right to:

• Request a restriction on certain uses and disclosures of your information.
• Obtain a paper copy of this notice of information practices upon request.
• Inspect and copy your health record as provided for in 45 CFR 164.524.
• Amend your health record as provided in 45 CFR 164.526.
• Obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528.
• Request communications of your health information by alternative means or at alternative locations.
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

3. Our Responsibilities

Burton Creek Rural Clinic is required to:

• Maintain the privacy of your health information.
• Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
• Abide by the terms of this notice.
• Notify you if we are unable to agree to a requested restriction.
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We will not use or disclose your health information without your authorization, except as described in this notice. We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will post the revised notice on our website and provide a copy upon request.

4. Examples of Disclosures for Treatment, Payment, and Healthcare Operations

We will use your health information for treatment. For example: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you.

We will use your health information for payment. For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular healthcare operations. For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it.

5. Other Uses or Disclosures of Your Information

We may use or disclose your health information without your consent or authorization for the following reasons:

• As required by law.
• For public health activities.
• In cases of abuse, neglect, or domestic violence.
• For health oversight activities.
• For judicial and administrative proceedings.
• For law enforcement purposes.
• To coroners, medical examiners, and funeral directors.
• For organ donation purposes.
• For research purposes (under certain conditions).
• To avert a serious threat to health or safety.
• For specialized government functions.
• For workers’ compensation.