你Infor-ma-tion. 你的权利. 我们的责任

This notice describes how med­ical infor­ma­tion about you may be used and dis­closed and how you can get access to this infor­ma­tion. 请仔细审阅.

你的权利

当涉及到你的健康信息时，你有一定的权利. This sec­tion explains your rights and some of our respon­si­bil­i­ties to help you.

拿一份电子版或纸质的病历

• You can ask to see or get an elec­tron­ic or paper copy of your med­ical record and oth­er health infor­ma­tion we have about you. 问我们该怎么做.
• 我们将提供您的健康信息的副本或摘要, 通常是在你提出要求后的30天内. 我们可能收取合理的、以成本为基础的费用.

• You can ask us to cor­rect health infor­ma­tion about you that you think is incor­rect or incom­plete. 问我们该怎么做.
• 我们可能会说 ​“不同意你的要求，但我们会在60天内书面告诉你原因.

请求保密通信

• 您可以要求我们以特定的方式与您联系(例如, 家庭或办公室电话)或发送邮件到不同的地址.
• 我们会说 ​“对所有合理的要求都是“是”.

要求我们限制我们使用或分享的东西

• You can ask us not to use or share cer­tain health infor­ma­tion for treat­ment, pay-ment, 或者我们的操作. 我们不需要同意你的要求，我们可以说 ​“如果会影响你的护理，就不要.
• 如果你自费购买服务或医疗项目，请全额支付, you can ask us not to share that infor­ma­tion for the pur­pose of pay-ment 或者我们的操作 with your health insur­er. 我们会说 ​“是的，除非法律要求我们分享这些信息.
• As part of our ongo­ing efforts to pro­vide qual­i­ty care to our patients, The South Bend Clin­ic par­tic­i­pates in var­i­ous elec­tron­ic health infor­ma­tion exchanges (HIE). This activ­i­ty allows your med­ical infor­ma­tion to be read­i­ly avail­able to oth­er com­mu­ni­ty health­care providers for coor­di­na­tion of care and may avoid dupli­cate testing.
  

找一份与我们共享信息的人的名单

• You can ask for a list (account­ing) of the times we’ve shared your health infor­ma­tion for six years pri­or to the date you ask, 我们和谁分享, 为什么.
• 我们将包括所有的披露，除了那些关于治疗, pay-ment, 还有医疗保健业务, 以及某些其他披露(例如您要求我们做出的任何披露). We’ll pro­vide one account­ing a year for free but will charge a rea­son­able, 如果您在12个月内要求另一个，则按成本收费.

把这份私人通知复印一份

• 你可以随时索取这份通知的纸质副本, 即使你已经同意以电子方式收到通知. 我们会及时为您提供纸质复印件.

选择一个人来代表你

• If you have giv­en some­one med­ical pow­er of attor­ney or if some­one is your legal guardian, that per­son can exer­cise your rights and make choic­es about your health information.
• We will make sure the per­son has this author­i­ty and can act for you before we take any action.

如果你觉得自己的权利受到侵犯，就提出申诉

• You can com­plain if you feel we have vio­lat­ed your rights by con­tact­ing us using the infor­ma­tion at the bot­tom of this poster.
• 你可以向美国海关投诉.S. Depart­ment of Health and Human Ser­vices Office for Civ­il Rights by send­ing a let­ter to 200 Inde­pen­dence Avenue, S.W.华盛顿特区.C. 20101，拨打1−877−696−6775，或亲自访问 www.美国卫生和公众服务部.gov / o c / p r i v c y / h i p a / c o m p l int /
• 我们不会因为你提出投诉而对你提出异议.

你Choic-es

For cer­tain health infor­ma­tion, you can tell us your choic­es about what we share. If you have a clear pref­er­ence for how we share your infor­ma­tion in the sit­u­a­tions described below, 跟我们谈谈. 告诉我们你想让我们做什么，我们会按照你的指示去做.

在这些情况下，您有权利和选择告诉我们:

• Share infor­ma­tion with your fam­i­ly, close friends, or oth­ers involved in your care
• 在灾后救济情况下分享信息
• 将您的信息包含在hos -关键目录中
• 为筹款活动联系您

如果你不能告诉我们你的偏好, 例如，如果你是无意识的, we may go ahead and share your infor­ma­tion if we believe it is in your best inter­est. We may also share your infor­ma­tion when need­ed to lessen a seri­ous and immi­nent threat to health or safe­ty.

In these cas­es, we nev­er share your infor­ma­tion unless you give us writ­ten permission:

• Mar-ket-ing目的
• 个人信息的销售
• 大多数分享心理选择的笔记

在筹款方面:

• We may con­tact you for fundrais­ing efforts, but you can tell us not to con­tact you again.

我们的使用和披露

我们如何使用或共享您的健康信息? We typ­i­cal­ly use or share your health infor­ma­tion in the fol­low­ing ways.

对待你

• We can use your health infor­ma­tion and share it with oth­er pro­fes­sion­als who are treat­ing you.
  Exam­ple: A doc­tor treat­ing you for an injury asks anoth­er doc­tor about your over­all health condition.

管理我们的组织

• 我们可以使用和分享你的健康信息来经营我们的诊所, 改善你的护理, 我需要的时候会联系你.
  Exam­ple: We use health infor­ma­tion about you to man­age your treat­ment and services.
  

服务帐单

• We can use and share your health infor­ma­tion to bill and get pay-ment from health plans or oth­er enti­ties.
  Exam­ple: We give infor­ma­tion about you to your health insur­ance plan so it will pay for your services.

我们还可以如何使用或共享您的健康信息? We are allowed or required to share your infor­ma­tion in oth­er ways — usu­al­ly in ways that con­tribute to the pub­lic good, 比如公共卫生和研究. We have to meet many con­di­tions in the law before we can share your infor­ma­tion for these pur­pos­es. 有关更多信息，请参阅: www.美国卫生和公众服务部.gov/​o​c​r​/​p​r​i​v​a​c​y​/​h​i​p​a​a​/​u​n​d​e​r​s​t​a​n​d​i​n​g​/​c​o​n​s​u​m​e​r​s​/​i​n​d​e​x​.html

帮助解决公共卫生和安全问题

We can share health infor­ma­tion about you for cer­tain sit­u­a­tions such as:

• Pre-vent-ing疾病
• 协助产品召回
• 报告药物的不良反应
• 举报疑似虐待、忽视或家庭暴力
• 预防或减少对任何人健康或安全的严重威胁

做研究

• 我们可以使用或分享您的信息用于健康研究.

遵守法律

• We will share infor­ma­tion about you if state or fed­er­al laws require it, includ­ing with the Depart­ment of Health and Human Ser­vices if it wants to see that we’re com­ply­ing with fed­er­al pri­va­cy law.

回应器官和组织捐赠请求

• We can share health infor­ma­tion about you with organ pro­cure­ment organizations.

与医学检查主任或葬礼主任合作

• 我们可以和同事分享健康信息, med-ical exam-in-er, 或者当一个人去世时，担任葬礼主管.

Address work­ers’ com­pen­sa­tion, law enforce­ment, and oth­er gov­ern­ment requests
我们可以使用或分享您的健康信息:

• 对于工人的赔偿索赔
• 为执法目的，或与执法人员
• 与卫生监督机构一起进行法律授权的活动
• 用于特殊的政府职能，如军事, 中国secu-ri-ty, 以及牙医保护服务
  
  

回应法律诉讼和法律行动

• We can share health infor­ma­tion about you in response to a court or admin­is­tra­tive order, 或者是回应传票.

我们Respon-si-bil-i-ties

• We are required by law to main­tain the pri­va­cy and secu­ri­ty of your pro­tect­ed health information.
• We will let you know prompt­ly if a breach occurs that may have com­pro­mised the pri­va­cy or secu­ri­ty of your information.
• We must fol­low the duties and pri­va­cy prac­tices described in this notice and give you a copy of it.
• We will not use or share your infor­ma­tion oth­er than as described here unless you tell us we can in writ­ing. 如果你告诉我们可以，你可以随时改变主意. 如果你改变主意，请书面告诉我们.

有关更多信息，请参阅: www.美国卫生和公众服务部.gov/​o​c​r​/​p​r​i​v​a​c​y​/​h​i​p​a​a​/​u​n​d​e​r​s​t​a​n​d​i​n​g​/​c​o​n​s​u​m​e​r​s​/​n​o​t​i​c​e​p​p​.html

本通知条款之变更
我们可以更改这份通知的条款, 这些变化将适用于我们掌握的关于你的所有信息. The new notice will be avail­able upon request, in our office, and on our web site. 本通知适用于十大正规赌博平台大全及所有科室, 单位, 网站, 以及十大正规赌博平台大全的位置.