CALAIS REGIONAL HOSPITAL, CALAIS, MAINE
Notice of Privacy Practices
This notice describes how Calais Regional Hospital (“CRH”) may use and disclose medical Information about you and how you can get access to that information.
Please review it carefully.
- CRH is required by law to maintain the privacy of your protected medical information and to provide you with notice of the Hospital’s legal duties and privacy practices with respect to that information.
- CRH will abide by the terms of the notice currently in effect, but it reserves the right to change the notice and to make the change effective as to all information in its possession.
Revisions To This Notice
CRH will promptly post and make available at the hospital a revised notice whenever there is a change that affects uses or disclosures, your rights, CRH’s legal obligations, or other changes in privacy practices.
Use and Disclosures of Your Medical Information:
Treatment - CRH may use medical information about you to provide you with medical treatment or services, and CRH may disclose medical information about you for
treatment purposes to doctors, nurses, technicians, or other health care providers who are involved in your care.
Payment - CRH may use and disclose health information about you so that the treatment and services you receive from this Hospital or another provider may be billed and
payment may be collected from you and/or an insurance company or a third party.
Health Care Operations - CRH may use health information about you for its/the Hospital’s operations, and CRH may disclose health information to others of your treating health care providers for limited operations purposes such as quality assessment and protection from fraud.
Business Associates – CRH may disclose your health information to individuals and entities which perform business functions for CRH and who agree to safeguard the privacy of that information.
Compliance With Law – CRH may disclose your health information when required by law, and CRH will comply with state disclosure laws that are more restrictive than the federal privacy law.
Examples of Permitted Uses/Disclosures:
- To remind you of appointments
- For CRH fundraising activities
- To identify your treatment options
- To identify health related benefits & services available to you
- To inform organ procurement programs
- To comply with Worker Compensation laws
- To health oversight agencies
Individual Rights: With some limitations (as described in the federal privacy law), you have the right to:
- Obtain access to, inspect and request a copy of your health information, except in limited situations;
- Amend your health information;
- Obtain an accounting of the uses and disclosures of your information;
- Receive a paper Copy of this notice;
- Request restrictions on certain uses and disclosures of your health information (though CRH is not required to agree to the request);
- Request that CRH communicate with you confidentially about your information.
Who Must Comply with this Notice
All CRH health care professionals authorized to enter information on your chart, all CRH departments and units, all members of volunteer groups CRH allows to help
you while you are in the hospital, and all other CRH personnel are obliged to comply with the terms of this Notice.
If you believe your privacy rights have been violated, you may file a written complaint with the Secretary of the Department of Health and Human Services, or with the Hospital. To complain to CRH/the Hospital, mail your written complaint to: Health Information Director and Privacy Officer, Health Information Department, Calais
Regional Hospital, 24 Hospital Lane, Calais, ME 04619, telephone (207) 454-9211. You will not be retaliated against for filing a complaint.
If you have questions about this notice, want additional information, or want to exercise any of the rights described in the notice, mail a written request to:
Health Information Director and Privacy Officer,
Department, Calais Regional Hospital, 24 Hospital Lane,
Calais, ME 04619, telephone (207) 454-9211. There is a charge for copies.
Other Uses of Health Information
Other uses and disclosures of health information not covered by this notice or the laws that apply to CRH will be made only with your written authorization. If you authorize
CRH to use or disclose medical information in ways other than described in this notice, you may revoke that authorization, in writing, at any time. That revocation will
then be effective except to the extent that CRH has already relied on the authorization.
Effective Date of this Notice - April 14, 2003