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This notice describes how medical, dental, or other
health information about you may be used and disclosed, and how you
can get access to this information. Please review it carefully.
Lewis County Primary Care is required by law to maintain the privacy
of your health care information, and to provide you with a notice of
Lewis County Primary Cares’
privacy practices. While required to abide by the terms of the
notice that is currently in effect, Lewis County Primary Care reserves
the right to change Lewis County Primary Cares’ privacy practices
at any time. If Lewis County Primary Care’ privacy practices change,
Lewis County Primary Care will provide you with a revised notice at your
next visit following the change.
Lewis County Primary Care may use your information for treatment,
payment, and health care operations. For example: Your information
may be used to develop a diagnosis and treatment plan, or to coordinate
referrals to another health care provider. Portions of your information
may be submitted to your insurance carrier or other third-party
payor to secure payment on your behalf. Your information may be
used in the course of health care operations, such as for quality
assurance, evaluation, training, or audit activities.
Persons whom we contract with to perform services on Lewis County
Primary Cares' behalf related to treatment, payment, or health
care operations may also have access to your information solely
for the purpose of providing such services, provided that the business
associate has agreed in writing to maintain the confidentiality
of such information.
Lewis County Primary Care may disclose information without your
authorization as permitted or required by applicable law, including
any of the following: to comply with public health statutes and
rules; to make any required reports of abuse or neglect; to comply
with health oversight activities by government agencies (for example,
licensure); to comply with a court order, government subpoena,
or other lawful process; for research purposes; in the event of
your death, to a medical examiner; to avert a serious threat to
health or safety; or for Workers’ Compensation purposes.
Lewis County Primary Care may use your information to contact
you for appointment reminders, or confirm appointments by telephone
unless you give us restrictions in writing. Lewis County Primary
Care may disclose your health information to notify, or assist
in the notification of a family member, your personal representative
or another person responsible for your care.
Except as described above, Lewis County Primary Care will not
use or disclose your information, except with your written authorization.
You may revoke your authorization at any time by giving written
notice of revocation to Lewis County Primary Care.
You have the right to request restrictions on the use and disclosure
of your information. However, Lewis County Primary Care is not
required to agree to a requested restriction, and it is Lewis County
Primary Cares’ policy not to agree to such restrictions unless
Lewis County Primary Care determines, in Lewis County Primary Cares’ sole
discretion, that a compelling reason exists to do so.
You have the right to receive communications from Lewis County
Primary Care in a confidential manner. If you would like Lewis
County Primary Care to use another address or telephone number
to contact you, you must request so in writing.
You have the right to receive an accounting of disclosures of
your health care information that you have not authorized. To receive
such an accounting, please contact Lewis County Primary Care at
the address given below, allowing up to 30 days to process this
request.
You have the right to inspect and copy your information. If you
wish to do so, you will be provided an opportunity to inspect your
information within 30 days of receipt of your written request.
You may be charged reasonable costs of copying your information,
or of preparing any summaries that you request.
You have the right to amend your health care information. If you
wish to do so, please submit the proposed amendment in writing
to Lewis County Primary Care at the address given below.
You have the right to a copy of this Notice of Privacy Practices
upon request.
You have the right to complain to Lewis County Primary Care and
to the Secretary of the U.S. Department of Health and Human Services
if you believe your privacy rights have been violated. To file
a complaint, please contact Lewis County Primary Care as set forth
in this Notice. Nobody is permitted to retaliate against you for
filing a complaint.
For further information about Lewis County Primary Cares’ privacy
policies please contact:
Mr. Jerry Ugrin
Compliance Officer
Lewis County Primary Care
P.O. Box 550
Vanceburg , Ky 41179
606 -796-3029

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