All of the facilities and health care practitioners affiliated with the Barix ClinicsTM program ("Barix Providers") believe that your health information is personal and private. Our website contains forms through which users may request information or supply feedback to us. In some cases, telephone numbers or return addresses are required so that we can supply requested information to you. Any personal information that you provide us is treated confidentially in accordance with our Notice of Privacy Practices and is used to help determine if our program is right for you. No information is disclosed to anyone outside of Barix Providers and companies that perform administrative or marketing services on our behalf. We require these outside companies to protect the confidentiality of your information and to use the information only for the purpose for which the disclosure is made.
We take significant precautions to protect personally identifiable information stored on the site's servers from unauthorized access using industry standard computer security products, such as firewalls, as well as carefully developed security procedures and practices. All employees must review and sign a written statement of these practices, which includes limiting access to sensitive information to only those employees who require the information and enforcing strict password protocols for all employees.
Once the information is sent to our site, it is kept in secure databases where it is not available to users on the Internet. We use both internal and external resources to review the adequacy of our security measures on a regular basis.
We provide various ways to contact us about our information practices and other privacy aspects.
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 READ THIS NOTICE CAREFULLY
All of the facilities and health care practitioners affiliated with the Barix ClinicsTM program ("Barix Providers") believe that your health information is personal and private. We keep records of the care and services that you receive at facilities that participate in the Barix ClinicsTM program ("Barix Facilities") and we are committed to keeping your health information private. In addition, we are required by law to respect your confidentiality. This Notice of Privacy Practices ("Notice") describes the privacy practices of all of the Barix Providers and applies to all of the health records that identify you and the care you receive at Barix Facilities. If you are under 18 years of age, your parents or guardian must sign for you and handle your privacy rights for you. We are legally required to give you this Notice and to follow the terms of our Notice of Privacy Practices that is currently in effect.
I. BARIX CLINICSTM PROVIDERS
All of the Barix Providers - our hospitals, employed physicians, allied health care practitioners, doctor's offices, entities, facilities, and other affiliated programs, services, and health care practitioners - follow the terms of this Notice. The doctors and caregivers at other facilities who are not employed by or affiliated with Barix Providers or the ClinicsTM program may exchange information about you as a patient with Barix Providers for reasons of treatment, payment, and health care operations as discussed below. These health care practitioners also may give you other privacy notices that describe their own privacy practices.
When you become a patient of a Barix Facility, we will use your health information within the facility and disclose your health information outside of the facility for the reasons described in this Notice. The following categories describe some of the ways that we will use and disclose your health information.
II. PERMITTED USE AND DISCLOSURE OF YOUR HEALTH INFORMATION
Treatment. We use your health information to provide you with health care services. We may disclose your health information to Barix Providers - doctors, nurses, technicians, medical or nursing students, or other persons at Barix Facilities - who need that information to take care of you. We also may disclose your health information to people outside Barix Facilities who may be involved in your health care, such as treating doctors, home care providers, pharmacies, drug or medical device experts, and family members. For example, a Barix Provider treating you at a Barix Facility may need to ask another doctor if you have diabetes because diabetes may complicate your treatment.
Payment. We may use and disclose your health information so that the health care you receive may be billed and paid for by you, your insurance company, or another third party. For example, we may give information about surgery you had at a Barix Facility to your health plan so it will pay us or reimburse you for the surgery. We also may tell your health plan about a treatment you are going to receive so we can get prior payment approval or learn if your plan will pay for the treatment.
Health Care Operations. We may use your health information and disclose it outside a Barix Facility for our health care operations. These uses and disclosures help us operate our facilities to maintain and improve patient care. For example, we may use your health information to review the care you received and to evaluate the performance of our staff in caring for you. We also may combine health information about many patients to identify new services to offer, what services are not needed, and whether certain therapies are effective. We also may disclose information to doctors, nurses, technicians, medical students, and other persons at Barix Facilities who are not directly involved in your care for learning and quality improvement purposes. We may remove information that identifies you so people outside Barix Facilities may study your health data without knowing who you are. Moreover, we may use and disclose your health information to our business associates to perform business functions on our behalf. Whenever an arrangement between a business associate and us involves the use or disclosure of your health information, that business associate is required to keep your information confidential.
More Stringent State and Federal Laws: The information in this Notice complies with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) regulations. In some cases, other state or federal laws may be more stringent than the HIPAA regulations. Barix Providers will continue to abide by these more stringent state and federal laws. State law is more stringent when the individual is entitled to greater access to records than under HIPAA and when under state law the records are more protected from disclosure than under HIPAA.
Contacting You. We may use and disclose your health information to reach you about appointments and other matters. We may contact you by mail, telephone or e-mail. We may leave voice messages at the telephone number with which you provide us, and we may respond to your e-mail messages to us. Health-Related Services. We may use and disclose health information about you to send you mailings about health-related products and services available at Barix Facilities.
III. PERMITTED USE AND DISCLOSURE WHERE YOU HAVE AN OPPORTUNITY TO AGREE OR OBJECT
Patient Information. Our facilities maintain limited information about you in their patient directories, such as your name and possibly your location in the hospital and your general condition (for example: good, fair, serious, critical, or undetermined). We usually give this information to people who ask for you by name. We also may include your religious affiliation in the directories and give your name to members of the clergy. Releasing directory information about you enables your family and others (such as friends, clergy, and delivery persons) to visit you in the hospital and generally know how you are doing. We will not release any of this information if you tell the hospital's admitting department or hospital administration not to do so.
Promotional Communications: We do not share or sell your health information to companies that market health care products or services directly to consumers for use by those companies to contact you, such as drug companies. We do maintain a list of individuals to whom we may have sent health improvement or health promotion materials and news about the ClinicsTM program. You may be included in this list. If you do not wish to be contacted for promotional communications, please notify us in writing addressed to the Barix Privacy Officer, Forest Health Services, LLC, 135 S. Prospect Street, Ypsilanti, Michigan 48198 or email@example.com.
Other Uses. As described above, we will use your health information and disclose it outside Barix Facilities for treatment, payment, health care operations, and when permitted or required by law. We will not use or disclose your health information for other reasons without your written authorization. For example, you may want us to release medical information to your employer. These kinds of uses and disclosures of your health information will be made only with your written authorization. You may revoke the authorization, in writing, at any time, but we cannot take back any uses or disclosures of your health information already made with your authorization.
IV. USES AND DISCLOSURES PERMITTED BY PUBLIC POLICY OR LAW WITHOUT YOUR AUTHORIZATION
Organ and Tissue Donation. We may release health information about organ, tissue, and eye donors and transplant recipients to organizations that manage organ, tissue, and eye donation and transplantation.
Coroners, Medical Examiners and Funeral Directors. We will disclose your health information to a coroner, medical examiner or funeral director if it becomes necessary to identify a deceased person, to determine a cause of death or as necessary to carry out their duties.
Public Health and Legal Matters. We will disclose health information about you outside Barix Facilities when required to do so by federal, state, or local law, or by a court. We may disclose health information about you for public health reasons, like reporting reactions to medications, problems with medical products or death. We may release health information to help control the spread of disease or to notify a person whose health or safety may be threatened. We may disclose health information to a health oversight agency for activities authorized by law, such as for audits, investigations, inspections, and licensure.
V. YOUR RIGHTS REGARDING HEALTH INFORMATION
Right to Inspect and Obtain Copy. You have the right to inspect and obtain a copy of your completed health records unless your doctor believes the disclosure of that information could harm you. You may not see or receive a copy of information that has been gathered for a legal proceeding or that otherwise may be protected or prohibited by law. Your request to inspect or obtain a copy of your medical records must be submitted in writing to the Medical Records Department of the Barix Facility that maintains your records and the request must be signed and dated. (Requests for billing records should be sent to the Billing Department.) We may charge a fee for processing your request. If we deny your request to inspect or obtain a copy of your records, you may appeal the denial to the Barix Privacy Officer, Forest Health Services, LLC, 135 S. Prospect Street, Ypsilanti, Michigan 48198 or by sending an email message to: firstname.lastname@example.org.
Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you have the right to ask us to amend your medical records. Your request for an amendment must be in writing, signed, and dated. It must specify the records you wish to amend, identify the Barix Facility that maintains those records, and provide the reason for your request. You must address your request to the Privacy Official of the Barix Facility that maintains the records you wish to amend or to the Barix Privacy Officer, Forest Health Services, LLC, 135 S. Prospect Street, Ypsilanti, Michigan 48198 or email to email@example.com. We will respond to you within 60 days. We may deny your request and if we do, we will tell you why and explain your options.
Right to Accounting. You may request an accounting, which is a listing of the entities or persons (other than yourself) to whom a Barix Provider or Barix Facility has disclosed your health information without your written authorization. The accounting would not include disclosures for treatment, payment, health care operations, and certain other disclosures exempted by law. Your request for an accounting of disclosures must be in writing, signed, and dated. It must identify the time period of the disclosures and the Barix Facility that maintains the records about which you want the accounting. We will not list disclosures made before the later of April 14, 2003, or those made earlier than 6 years before your request. Your request should indicate the form in which you want the list (for example, on paper or electronically). You must submit your written request to the Medical Records Department of the Barix Facility that maintains the records. We will respond to you within 60 days. We will give you the first listing you request within any 12-month period free, but we will charge you for all other accountings requested within the same 12 months.
Right to Request Restrictions. You have the right to ask us to restrict the uses or disclosures we make of your health information for treatment, payment, or health care operations, but we do not have to agree. You also may ask us to limit the health information that we use or disclose about you to someone who is involved in your care or the payment for your care, such as, a family member or friend. Again, we do not have to agree. A request for a restriction must be signed and dated, and must identify the Barix Facility that maintains the information. The request also should describe the information you want restricted, state whether you want to limit the use or the disclosure of the information or both, and tell us who it is you do not wish to receive the restricted information. You must submit your request in writing to the Medical Records Department of the Barix Facility that maintains the information you want restricted. We will tell you if we agree with your request or not. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
Right to Request Confidential Communications. You have the right to request that we communicate with you about your health in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. Your request for confidential communications must be in writing, signed, and dated. It must identify the Barix Facility making the confidential communications and specify how or where you wish to be contacted. You need not tell us the reason for your request, and we will not ask. You must send your written request to the Barix Privacy Officer, Forest Health Services, LLC, 135 S. Prospect Street, Ypsilanti, Michigan 48198 or send an email message to: firstname.lastname@example.org. We will accommodate all reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice. You may obtain a paper copy of this Notice at any Barix Facility.
If you believe your privacy rights have been violated, you may file a complaint with the Barix Privacy Officer or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with the Barix Privacy Officer, please submit your complaint in writing to the Privacy Official at the Barix Facility where you believe your rights have been violated. You will not be penalized for filing a complaint.
VII. CHANGES TO THIS NOTICE
We may change this Notice at any time. Any change in this Notice could apply to medical information we already have about you, as well as any information we receive in the future. We will post a copy of the current Notice at each Barix Facility and on our web site, www.barixclinics.com.
If you have questions about this Notice, you may contact the Barix Privacy Officer at the following address: email@example.com.
Effective April 14, 2003 (Updated 6/8/10)