Your protected health information (PHI) is maintained in a written and/or electronic medical record of your contacts or visits for healthcare services. Your PHI includes information such as name, address, phone, etc. that identifies you. It also includes information that relates to your past, present or future physical or mental health condition and related healthcare services.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities. Please feel free to discuss any questions with our staff.
- Obtain a copy of your medical record. You can ask to see or get a copy of your medical record. If your health record is stored electronically, you can request a copy in electronic format. We have the right to charge a reasonable fee for paper or electronic copies as established by professional, state, or federal guidelines.
- Request an amendment to your protected health information. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we will tell you why in writing within 60 days.
- Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
- Request a restriction (to limit the use) of your PHI.
- You can ask us, in writing, 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 purposes of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
- Request an accounting of disclosure.
- You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).
- We will provide one accounting a year for free. We may charge a reasonable fee for paper or electronic copies as established by professional, state, or federal guidelines.
- Receive a copy of this Notice of Privacy Practices. You can ask for a copy of this privacy notice at any time, even if you have agreed to receive this notice electronically. We will provide you with a paper copy promptly. We will give you a copy of the revised privacy notice at your request. A revised copy can be mailed to you or you can ask for one at your next appointment.
- Choose a personal representative. If you have given someone your health care power of attorney or if someone is your legal guardian, that person can exercise your privacy rights and make choices about your health information. We will make sure that the person has this authority and can act for you before we take any action or follow his/her directions regarding your health information.
- File a complaint if you feel your rights are violated.
- You can file a complaint if you feel we have violated your privacy rights by contacting us by: 1) sending us a letter to CommUnityCare, Attention: Privacy Officer, P. O. Box 17366, Austin, TX 78760-7366; or 2) by calling the complaint line at (512) 978-9918.
- You can file a complaint with the U. S. Department of Health and Human Services for Civil Rights by: sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201; or calling 1-877-696-6775; or visiting hhs.gov/ocr/privacy/hipaa/complaints/.
- You can file a complaint with the Office for Civil Rights U.S. Department of Health and Human Services by: 1) sending a letter to 1301 Young Street, Suite 1169, Dallas, TX 75202; or 2) calling (214) 767-4056.
- We will not retaliate against you for filing a complaint.