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GTBHC PRIVACY POLICY - Notice Of Privacy
Practices - Effective April 14, 2003 |
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THIS NOTICE DESCRIBES HOW PERSONAL AND MEDICAL INFORMATION ABOUT YOU
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Understanding the Type of Information: We have we get
information about you when you enroll in services. It includes information
such as date of birth, sex, social security number and other personal
information. We also may get reports from your other health care providers
and other data about your medical care in order to provide the best
possible care.
Our Privacy Commitment To You We Care About Your Privacy: The
information we collect about you is private. We are required to give you
this notice of our privacy practices. Only people who have both the need
and the legal right may see your information. Unless you give us
permission in writing, we will only disclose your information for purposes
of treatment, payment, business operations, or when we are required by law
to do so.
Treatment: We may disclose medical information about you to
coordinate your health care. For example, we may notify other service
providers involved in your care to better coordinate services.
Payment: We may use and disclose information so the care you
get can be properly billed and paid for. For example, we may contact your
insurance company to obtain authorization for treatment.
Business Operations: We may need to use and disclose
information for our business operations. For example, we may use
information to review the quality of care you get.
Exceptions: For certain kinds of records, your permission
may be needed even for release for treatment, payment, and business
operations. For example, here in New Jersey, we are required to get your
permission to release information regarding drug and alcohol use.
As Required By Law: We will release information when we are
required by law to do so. Examples of such releases would be for court
orders, communicable disease reporting, and to avert a serious threat to
health or safety.
With Your Permission: If you give us permission in writing,
we may use and disclose your personal information. If you give us
permission, you have the right to change your mind and revoke it. This
must be in writing, too. We cannot take back any uses or disclosures
already made with your permission.
Your Privacy Rights:
You have the following rights regarding the health information that we
have about you. Your requests must be made in writing to Greater Trenton
Behavioral HealthCare at the address below.
Your Right to Inspect and Copy: In most cases, you have the
right to look at or get copies of your records. You will be charged a fee
for the cost of copying your records.
Your Right to Amend: You may ask us to change your records
if you feel that there is a mistake. We can deny your request for certain
reasons, but we must give you a written reason for our denial.
Your Right to a List Of Disclosures: You have the right to
ask for a list of disclosures made after April 14, 2003. This list will
not include the times that information was disclosed for treatment,
payment, or health care operations.
Your Right to Request Restrictions on Our Use or Disclosure of
Information: You have the right to ask for limits on how your
information is used or disclosed. We are not required to agree to such
requests.
Your Right to Request Confidential Communications: You have
the right to ask that we share information with you in a certain way or in
a certain place. For example, you may ask us to send information to your
work address instead of your home address. You do not have to explain the
basis for your request.
Greater Trenton Behavioral HealthCare is required to respond to your
requests to inspect or copy, amend, or to obtain an accounting of
disclosures within a 60 day period.
Changes to this Notice: We reserve the right to revise this
notice. A revised notice will be effective for medical information we
already have about you as well as any information we may receive in the
future. We are required by law to comply with whatever notice is currently
in effect. Any changes to our notice will be published on our web site. Go
to www.gtbhc.org. If
the changes are material, a new notice will be mailed to you before it
takes effect.
How to Use Your Rights Under This Notice: Your requests
regarding your privacy rights must be in writing. If you need assistance,
we will help you to prepare this request.
Complaints to the Federal Government: If you believe that your
privacy rights have been violated, you have the right to file a complaint
with the federal government. You may write to:
Region II, Office of Civil Rights
U.S. Dept. of Health and Human Services
Jacob Javits Federal Building
26 Federal Plaza – Suite 3312 - New York, NY 10278
212-264-3313 - 212-264-3039 (fax) - 212-264-2355 (TDD)
Email: OCRcomplaint@hhs.gov
You will not be penalized for filing a complaint with the federal
government.
Complaints and Communications to Us: If you want to exercise
your rights under this notice or if you wish to communicate with us about
privacy issues or if you wish to file a complaint, you can write to:
Privacy Officer
Greater Trenton Behavioral HealthCare
P.O. Box 1393 - Trenton, NJ 08607
609-396-6788
You will not be penalized for filing a complaint.
Copies of this Notice: You have the right to receive an additional
copy of this notice at any time. Please call or write to us to request a
copy. |
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