Kansas Care, Inc./Kansas Care Health Services, Inc.
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 carefully.
Use and Disclosure of Health Information
Kansas Care, Inc/Kansas Care Health Services,
Inc. may use your health information, information that constitutes
protected health information is defined in the privacy rule
of the Administrative Simplification provisions of the Health
Insurance Portability and Accountability Act of 1996, for purposes
of providing you treatment, obtaining payment for your care
and conducting health care operations. Kansas Care, Inc./Kansas
Care Health Services, Inc. has established policies to guard
against unnecessary disclosure of your health information.
The following is a summary of the circumstances
under which and purposes for which your health information may
be used and disclosed:
1. To Provide Treatment
2. To Obtain Payment
3. To Conduct Health Care Operations. The Agency may
use and disclose health information for its own operations
in order to facilitate the function of the Agency and as necessary
to provide quality care to all of the Agency's patients.
4. For Appointments Reminders.
5. For Treatment Alternatives.
The following is a summary of the circumstances
under which and purposes for which your health information
may also be used and disclosed:
- When Legally Required.
- When There Are Risks to Public Health
- To Report Abuse, Neglect Or Domestic Violence.
- To Conduct Health Oversight Activities.
- In Connection With Judicial And Administrative Proceedings
- For Law Enforcement Purposes.
- To Coroners And Medical Examiners
- To Funeral Directors
- In the Event of A Serious Threat To Health Or Safety
- For Specified Government Functions.
- For Worker's Compensation
Authorization To Use Or Disclose Health Information
Other than is stated above, the Agency will not disclose
your health information other than with your written authorization.
If you or your representative authorizes the Agency to use
or disclose your health information, you may revoke that authorization
in writing at any time.
Your Rights With Respect To Your Health Information
You have the following rights regarding your
health information that the Agency maintains:
- Right to request restrictions
- Right to receive confidential communications
- Right to inspect a copy of your health information
- Right to amend your health care information
- Right to an accounting
- Right to a paper copy of this notice
Duties of the Agency
The Agency is required by law to maintain the privacy of
your health information and to provide to you and your representative
this Notice of its duties and privacy practices. The Agency
is required to abide by the terms of this Notice as may be
amended from time to time. The Agency reserves the right to
change the terms of its Notice and to make the new Notice
provisions effective for all health information that it maintains.
If the agency changes its Notice, the Agency will provide
a copy of the revised Notice to you or your appointed representative.
You or your personal representative have the right to express
complaints to the Agency and to the Secretary of Department
of Health and Human Services if you or your representative
believe that your privacy rights have been violated. Any complaints
to the Agency should be made in writing to the Privacy Officer
at 712 S. Ohio, Salina, KS 67401. The Agency encourages you
to express any concerns you may have regarding the privacy
of your information. You will not be retaliated against in
any way for filing a complaint.
The Agency has designated the Privacy Officer as contact
person for all issues regarding patient privacy and your rights
under the Federal privacy standards. You may contact this
person at 1-785-825-8500.
This Notice is effective April 14, 2003
If you have any questions regarding this notice, please
contact the Privacy Officer at 785-825-8500.
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