THIS NOTICE DESCRIBES HOW SUBSTANCE ADDICTION AND/OR MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
To appropriately treat you and receive payment for the services we provide, we need to obtain information from you including your full name and address, insurance company, family medical history, current medical history, and current medical condition. We are required by law to maintain the privacy of our patients’ protected health information and to provide patients with notice of our legal duties and privacy practices with respect to your protected health information. Wyoming Recovery seeks to comply with all applicable confidentiality regulations including the confidentiality of Alcohol and Drug Abuse Patient records as established by the US Department of Health and Human Services.
Federal law and regulations protect the confidentiality of alcohol and drug use patient records maintained by this program. Generally, the program may not say to a person outside the program that the patient attends the program, or disclose any information identifying a patient as an alcohol or drug user.
- The patient consents in writing
- The disclosure is allowed by a court order
- The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation
Violations may be reported to appropriate authorities in accordance with Federal regulations.
Federal law and regulations do not protect any information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime.
Federal law and regulations do not protect any information about suspected child abuse or neglect including the elderly from being reported under State law to appropriate State or local authorities (See 42 USC 290 dd-3 and 42 USC 290 ee-3for Federal laws and CFR Part 2 for Federal Regulations).
Wyoming Recovery also seeks to respect the spirit of anonymity as expressed in the concept of Tradition #12 of Alcoholics Anonymous. We expect our patients to honor the rights of fellow participants in treatment to remain anonymous. This includes not communicating in any way “patient and/or participants identifying information” to people outside of Wyoming Recovery without written consent of that other person.
The remainder of this notice is a detailed description of
- How your medical and psychological information may be used and disclosed
- Disclosures requiring neither consent or authorization
- The uses and disclosures requiring authorization
- Your rights
- Our duties
To exercise the rights outlined below, contact Wyoming Recovery’s Privacy Officer, Lynn Thompson at 265-3791 ext 4193.
- Access to your protected health information. You have the right to inspect or obtain a copy (or both) of your medical record. To inspect and copy your protected health information, you must submit your request in writing to our privacy contact person, Carolyn Toews. We may charge a fee for the copying and mailing costs, and for any other costs associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If your request is denied, you may request that the denial be reviewed by a mutually agreed upon licensed health care professional. We will comply with the outcome of the review.
- Right to Request Restrictions. You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, we are not required to agree to a restriction you request.
- Right to Request Communications by Alternative Means or at Alternative Locations. For example, you may not want a family member to know that you are a patient at Wyoming Recovery. Upon your request, your bills may be sent to another address.
- Right to amend. You have the right to request an amendment of your medical record. Your request may be denied if Wyoming Recovery did not create the information or if the information is accurate and complete in our judgment.
- Right to an accounting. You have the right to receive an accounting of disclosures made for up to six years. This right does not apply to disclosures made pursuant to an authorization and those made for treatment, payment, and health care operations. Nor does it apply to disclosures made before April 14, 2003.
- Right to paper copy. You have the right to receive a paper copy of this notice upon request, even if you have agreed to receive the notice electronically.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
We may use and disclose your protected health information for the following:
Treatment. We may use and disclose your information to provide you with medical treatment and services. An example of treatment would be when I consult with another health care provider, such as your family physician, call in prescriptions or lab tests. We may also disclose your information to individuals outside of Wyoming Recovery to other health care providers that may be involved in your care after you leave.
Payment. We will use and disclose your information to receive payment for the services and treatment provided to you. We use your information to create a bill and disclose your information when we send the bill to your insurance company, you, or a third party. The individual or entity paying the bill may request more information to determine whether the bill is covered by your insurance. Your health plan may request information about a treatment you are going to receive to get approval for payment or to determine whether your health plan will cover the treatment. We may also disclose information about you for payment activities of another health care facility.
Health Care Operations. We may use and disclose your information for health care operation purposes of our health care facility or to another health care facility that had or has a relationship with you. Health care operations includes review of the care you receive for quality assessment, educational, business planning, and compliance plan purposes.
Appointment Reminders. We may use and disclose health information about you to contact you as a reminder that you have an appointment at Wyoming Recovery.
Follow-up Questionnaires/Surveys. We may use and disclose health information about you to contact you for surveys regarding the quality of care you received and your disposition, to improve the quality of care.
DISCLOSURES REQUIRING NEITHER CONSENT OR AUTHORIZATION
Federal law and regulations do not protect information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such crime. Wyoming Recovery may disclose information about you when required to do so by federal, state or local law including the following circumstances:
- Serious threat to health or safety. We may use and disclose heath information about you when necessary to prevent a serous threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to respond to the threat.
- As ordered by the court
- Child/elder abuse. Federal law and regulations do not protect any information about suspected child abuse or neglect including the elderly from being reported under State law to appropriate State or local authorities.
- Health Oversight. Your information maybe disclosed to governmental agencies and boards for investigations, audits, licensing, and compliance purposed.
- Worker’s Compensation. If you file a worker’s compensation claim, that is a release of information for the duration of the benefit period, and upon request and upon notice to you, We must release substance abuse records pertaining to your injury to the Wyoming Worker’s Compensation Division or your employer.
USES AND DISCLOSURES REQUIRING AUTHORIZATION
To use or disclose your information for any other uses or disclosures, we will request an authorization from you. If we do obtain an authorization from you, you may revoke it at any time .
- We are required by law to maintain the privacy of protected health information and to provide individuals with Notice of our legal duties and privacy practice regarding health information
- We are required to follow the terms of the current Notice.
- We may change the terms of this Notice and the revised Notice will apply to all health information in our possession. If we revise this Notice, a copy of the revised Notice will be posted at the reception desk at 231 S. Wilson and may be requested from Lynn Thompson.
If you believe your privacy rights have been violated you may notify Wyoming Recovery’s Privacy Officer, Lynn Thompson at 307-215-3242. You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services to Healthcare Licensing and Surveys, Hathaway Building, Suite 510, 2300 Capital Avenue, Cheyenne WY 82002 or The Joint Commission, One Renaissance Blvd., Oakbrook Terrace, IL 60181.