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Notice of Privacy Practices
This Notice Describes How Medical Information about You May be Disclosed & How You Can Get Access to This Information.
If you have any questions about this notice, please contact the Health Information Management Department at (207) 794-3321
Types of Uses and Disclosures of Medical Information
- Appointment Reminders
- Birth Announcements
- Fund-raising Activities
- Inmates
- Law Enforcement
- News Media
- Public Health Risks
- Public Record
- As Required By Law
- Coroner / Medical Examiner
- Funeral Directors
- Laws and Disputes
- Military & Veterans
- Organ & Tissue Donation
- Public Interest
- Research
- Workers Compensation
- Health Oversight Activities as Required by Law
- Health-Related Benefits & Services
- Individuals Involved in Your Care or Payment of Care
- National Security & Intelligence Activities
- To Alert Serious Threat to Health or Public Safety
Other Uses of Medical Information
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing at any time. If you revoke permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.
Your Rights Regarding Information
All written inquiries or complaints are to be directed to:
Privacy Officer
c/o Penobscot Valley Hospital
P.O. Box 368
7 Transalpine Road
Lincoln, Maine 04457
Fax: (207) 794-8704
E-Mail: HIPAAprivacy@pvhhealthcare.org
You have the following rights regarding medical information we maintain about you:
Right to Amend
If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the hospital. Your request to amend your medical information must be in writing.
Right to Inspect & Copy
You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing. Your request may be denied in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by the hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to an Accounting of Disclosures
You have the right to an “accounting of disclosures”. This is a list of the disclosures we made of medical information about you. To request this list or accounting of disclosures, you must submit your request in writing.
Right to Request Restrictions
You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. (We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency care).
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
Right to a Paper Copy of this Notice
You have a right to a paper copy of this notice in its entirety. You may ask us to give you a copy of the full notice including specific disclosure examples at any time. You may also obtain a copy of this notice on our website: www.pvhhealthcare.org.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the Department of Health & Human Services. To file a complaint with the hospital, contact the privacy officer. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Who Will Follow This Notice
This notice describes our hospital’s practices and that of:
- Any healthcare professional authorized to enter information into your hospital chart
- All departments and units of the hospital
- Any member of a volunteer group we allow to help you while you are in the hospital
- All employees, hospital-based physician practices, staff, and other hospital personnel
- All owned subsidiary practices of Penobscot Valley Hospital will follow this privacy notice. All these entities, sites, and locations may share medial information with each other for treatment, payment or healthcare operations purposes described in this notice.
Our Pledge Regarding Information
We understand that medical information about you and your health is personal. We are committed to protecting your information. We create a record of care and services you receive at the hospital. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records your care generated by the hospital, whether made by hospital personnel or your personal physician. Your personal physician may have different policies and notices regarding the use and disclosure of your medical information created in his/her office or clinic.
We are Required by Law
- To make sure that medical information that identifies you is kept private;
- To give you this notice of our legal duties and privacy practices with respect to medical information about you
- To follow the terms of the notice that is currently in effect.
How We May Use or Disclose Medical Information About You
The following categories describe different ways we may use and disclose medical information. Not every use or disclosure in category will be listed. However, all the ways we are permitted to use or disclose information will fall into one of these categories:
For Treatment:
We may use medical information about you with medical treatment or services. We may disclose medical information about you to physicians, mid-level providers, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you in the hospital.
For Payment:
We may use and disclose medical information about you so that the treatment and services you receive at the hospital may be billed and payment may be collected from you, an insurance company, or a third party.
For Health Care Operations:
We may use and disclose medical information about you for hospital operations. These uses and disclosures are necessary to run the hospital and make sure that all our patients receive quality care.
Changes to this Notice
We reserve the right to change this notice. We also reserve the right to make the revised or changed notice effective for 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 in the hospital with the current effective dates.
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