Dr. Arenia C. Mallory Community Health Center

Dr. Arenia C. Mallory Community Health Center, Inc. (Mallory CHC)

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAYBE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Dr. Arenia C. Mallory Community Health Centers are not-for-profit healthcare providers in the state of Mississippi. As a leader in our community we strive to provide high quality, customer oriented and cost effective health care services in a safe and accessible environment to all person of Holmes County, Carroll County, and surrounding communities regardless of their ability to pay, while striving to ensure patient safety and improve the quality of life for the whole community.

Mallory CHC uses health information about you for treatment, to obtain payment for treatment, for administrative purposed, and to evaluate the quality of care that yon receive. Your health information is contained in a medical record that is physical property of Mallory CHC.

How Mallory CHC May Use or Disclose Your Health Information

For Treatment. Mallory CHC may use your information to provide you with medical treatment or services.

For example, information obtained by a health care provider, such as a physician, nurse, or other person providing health services to you, will record information in you record that is related to your treatment This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.

For Payment. Mallory CHC may use and disclose your health information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payer, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.

For Health Care Operations. Mallory CHC may use or disclose health information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:
• Evaluate the performance of our staff
• Access the quality of care and outcomes in your cases and similar cases
• Learn how to improve our facilities and services
• Determine how to continually improve the quality and effectiveness of the health care provider

Appointments. Mallory CHC may use your information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fundraising. Mallory CHC may use your information to contact you to raise funds for Mallory CHC.

Required by Law. Mallory CHC may use and disclose information about you as required by law for example, Mallory CHC may disclose information for the following purposes:
• For judicial and administrative proceedings pursuant to legal authority
• To report information related to victims of abuse, neglect, or domestic violence
• To assist law enforcement officials in their new law enforcement duties

Public Health. Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability, or for other health oversight activities.

Decedents. Health information may be disc1ose to funeral directors or coroners to enable them to carry out their lawful purposes.

Organ / Tissue Donation. Your health information may be used or disclosed for cadaveric organ(s), eye or tissue donation purposes.

Research. Mallory CHC may use your information for research purposes, with an institutional review board or privacy board that has reviewed the research proposal and established protocols, to ensure the privacy of your health information as approved for research.

Health and Safety. Your health information may be disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.

Government Functions. Your health information may be disclosed for specialized government functions such as protection of public officials or reporting to various branches of the armed services.

Worker's Compensation. Your health information may be used or disclosed in order to comply with laws and regulations related to Worker's Compensation.

Other Uses. Other uses and disclosures win be made with your written authorization and you may revoke the authorization except to the extent Mallory CHC has taken action in reliance on the authorization.

YOUR HEALTH INFORMATION RIGHTS

You have the right to:
• Request a restriction on certain uses and disclosures of your information as provided by 45 C.F.R. §164 ..522; however, Mallory CHC is not required to agree to requested restriction
• Obtain a paper copy of the notice of information practices upon request
• Inspect and obtain a copy of your health record as provided for in 45 C.F.R. §164.524
• Request that your health record be amended as provided in 45 C.F.R. §164.526
• Request communications of your health information by alternative means or at alternative locations
• Receive an accounting of disclosures made of your health information as provided by 45 C.F.R. §164.528

COMPLAINTS

You may complain to Mallory CHC and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.

OBLIGATIONS OF MALLORY CHC

Mallory CHC is required by law to:
• Maintain the privacy of protected health information
• Provide you with this notice of the legal duties and privacy practices with respect to your health information
• Abide by the terms of this notice
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed
• Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations

Mallory CHC reserves the right to change the information practices and to make the new provisions effective for all protected health information it maintains. Revised notices will be made available to you by posting a copy of his notice in a prominent place on our premises.

Internet Privacy

Dr. Arenia C. Mallory Community Health Center respects the privacy of all individuals who use our web site. Dr. Arenia C. Mallory Community Health Centers are committed to maintaining a secure computing environment. As a result we maintain various layers of security, which employ firewalls, encryption, IP filtering, VPN's, specialized software, antivirus software, and internal logging. All data collected by the server run by the company hosting our website (USNX). Dr. Arenia C. Mallory Community Health Centers, Inc. would never intentionally present any personal information on this website unless written authorization was given. If information is presented on this website without proper authorization, we encourage you to contact us directly by phone.

EFFECTIVE DATE - This notice is effective as of April 14, 2003

CONTACT INFORMATION

If you have any questions or complaints, please feel free to contact - Mallory CHC Privacy Contact

Carrie Williams
P.O. Box 479/17280 Hwy 17 South
Lexington, Mississippi 39095
Phone #: (662) 834-1857