Men's Center

(701) 586-3300

Women's Center

(701) 838-3300

Privacy Policy

Providence House Privacy Practices

Providence House 2126 Vista Avenue, Arnegard, ND 58835 providencehouse.net

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

Your Rights

  • Get an electronic or paper copy of your medical record: You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

  • Ask us to correct your medical record: You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

  • Request confidential communications: You can ask us to contact you in a specific way, such as by home or office phone, or to send mail to a different address. We will say “yes” to all reasonable requests.

  • Ask us to limit what we use or share: You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

  • Get a list of those with whom we’ve shared information: You can ask for an accounting of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, health care operations, and certain other disclosures. We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

  • Get a copy of this privacy notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

  • Choose someone to act for you: 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.

  • File a complaint: You can complain if you feel we have violated your rights by contacting us using the information on page 1. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Your Choices

  • Both the right and choice to tell us to: Share information with your family, close friends, or others involved in your care. Share information in a disaster relief situation. Include your information in a hospital directory.

  • Unable to state preference: If you are unconscious or otherwise unable to tell us your preference, we may 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.

  • Require written permission: We never share your information without written permission for marketing purposes, the sale of your information, or for most sharing of psychotherapy notes.

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

Our Uses and Disclosures

  • Treat you: We can use your health information and share it with other professionals who are treating you.

  • Run our organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.

  • Bill for your services: We can use and share your health information to bill and get payment from health plans or other entities.

  • Help with public health and safety issues: We can share information to prevent disease, help with product recalls, report adverse reactions to medications, report suspected abuse or neglect, and prevent or reduce a serious threat to anyone’s health or safety.

  • Do research: We can use or share your information for health research.

  • Comply with the law: We will share information if state or federal laws require it, including with the Department of Health and Human Services.

  • Respond to organ and tissue donation requests: We can share health information about you with organ procurement organizations.

  • Work with a medical examiner or funeral director: We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

     

  • Address government requests: We can share information for workers’ compensation claims, law enforcement purposes, health oversight agencies, and special government functions such as military or national security.

     

  • Respond to lawsuits and legal actions: We can share health information in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • Privacy and security: We are required by law to maintain the privacy and security of your protected health information.

  • Breach notification: We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • Policy adherence: We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • Written permission: We will not use or share your information other than as described here unless you tell us we can in writing. You may change your mind at any time by letting us know in writing.

Changes and Contact Information

 

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.