Notice of Privacy and Confidentiality Practices

IMPORTANT: THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS YOUR INFORMATION. PLEASE REVIEW THIS INFORMATION CAREFULLY.

1. Your confidential healthcare information may be released to other healthcare professionals for the purpose of providing you with quality healthcare.

2. Your confidential healthcare information may be released to your insurers, pharmacy benefit manager or other third party payers for the purpose of the Health Center receiving payment for providing you with needed healthcare services.

3. Your healthcare information may be reviewed by students, or for quality assurance and other healthcare operations.

4. Your confidential healthcare information may be released to public officials or law enforcement authorities in the event of an investigation in which you are a victim of abuse, a crime, domestic violence or motor vehicle crash.

5. Your confidential healthcare information may be released to other healthcare providers in the event you need emergency care.

6. Your confidential healthcare information may be released to a public health organization or federal organization in the event of a communicable disease or to report a defective device or untoward event to a biological product (food or medication).

7. Your confidential healthcare information may not be released for any other purpose than that which is identified in this notice.

8. Your confidential healthcare information may be released only after receiving written authorization from you. You may revoke your permission to release confidential healthcare information at any time.

9. You may be contacted by the Health Center to remind you of any appointments, healthcare treatment option or other health services that may be of interest to you.

10. You may be contacted by the Health Center for the purposes of raising funds to support the Center’s operations.

11. You have the right to restrict the use of your confidential healthcare information. However, the Health Center may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of an emergency.

12. You have the right to receive confidential communication about your health status.

13. You have the right to review and receive photocopies of your healthcare information.

14. You have the right to amend your healthcare information.

15. You have the right to know who has accessed your confidential healthcare information and for what purpose.

16. You have the right to possess a copy of this Notice of Privacy Practices upon request. This copy can be in the form of an electronic transmission or on paper.

17. The Health Center is required by law to protect the privacy of its patients. It will keep confidential all patient healthcare information and will provide patients with a list of duties or practices that protect confidential healthcare information.

18. The Health Center will abide by the terms of this notice. The Center reserves the right to make changes to this notice and continue to maintain the confidentiality of all healthcare information. Patients will receive a mailed copy of any changes to this notice within 60 days of making the changes.

You have a right to complain to the Health Center if you believe your rights to privacy have been violated. If you feel your privacy rights have been violated, please mail your complaint to the Health Center: Waianae Coast Comprehensive Health Center milo d. huempfner, RN, MS,CHC Chief Compliance & Ethics Officer 86-260 Farrington Hwy Waianae, HI 96792 (808)697-3585 Email: milo@wcchc.com   All complaints will be investigated. No personal issue will be raised for filing a complaint with the Health Center.   This notice is effective as of April 14, 2003 Reprinted & Rev.  (May 22, 2003; 7/11/06, 11.2009)