Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Effective date November 1, 2019

Introduction

Foundation Health Partners (FHP) is committed to protecting the confidentiality of information about you, and is required by law to do so. This notice describes how we may use information about you within FHP and how we may disclose it to others outside FHP. We will notify you if there is a breach of your unsecured protected health information. This notice also describes the rights you have concerning your own health information. FHP includes Tanana Valley Clinic, Fairbanks Memorial Hospital, and Denali Center.

How Will We Use & Disclose Information About You?

Treatment: FHP may use information about you to provide you with medical services and supplies. We may also disclose information about you to others that need the information to treat you, such as doctors, physician assistants, nurses, medical and nursing students, technicians, therapists, emergency service and medical transportation providers, medical equipment providers, and others involved in your care. For example, we will allow your physician to have access to your medical record to assist in your treatment and for follow up care.

We may make your medical information available electronically through an electronic health information exchange to other health care providers and health plans that request your information for their treatment and payment purposes. Foundation Health Partners works with healtheConnect Alaska, which is the non-profit organization, entrusted by the Alaska Department of Health & Social Services to exchange health information electronically.  To learn more about healtheConnect Alaska and other health information exchanges that we participate in, you may contact the FHP Privacy Office at (907) 458-6986.  

Exchange of electronic health information can provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions about your care. You may choose to opt out from healtheConnect Alaska or any other exchange we participate in by contacting the FHP Privacy Office at (907) 458-6986 and requesting an Opt Out form.   Completed forms can be returned by email to privacy@foundationhealth.org or mailed to Fairbanks Memorial Hospital Attn: Privacy Department 1650 Cowles Street, Fairbanks AK 99701. Opt-out forms are also available at any FHP registration or reception desk or can be downloaded at www.foundationhealth.org.

We may also use and disclose information about you to contact you to remind you of an upcoming appointment, to inform you about possible treatment options or alternatives, or to tell you about health-related services available to you.

Facility Directory: Unless you object, FHP will include your name, location in our facility, your general condition (e.g., fair, stable, critical) and your religious affiliation in our facility directory. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Information in the facility directory may be shared with clergy.

Family Members and Others Involved in Your Care: FHP may disclose information about you to a family member or friend who is involved in your medical care. If you do not want the facility to disclose information about you to family members or others, you must notify the registration and nursing staff at the facility. In the event of a disaster, we may disclose information to help a family member or friend locate you. In the unlikely event you are unable to make decisions about your own care, treatment and services, we may involve a surrogate decision maker to help plan your care and treatment.

Payment: FHP may use and disclose information about you to get paid for the medical services and supplies we provide to you. For example, your health plan or health insurance company may request to see parts of your medical record before they will pay us for your treatment.

Health Care Operations: FHP may use and disclose information about you if it is necessary to improve the quality of care we provide to patients or for health care operations. We may use information about you to conduct quality improvement activities, to obtain audit, accounting or legal services, or to conduct business management and planning. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.

Fundraising: Many of our patients like to make contributions to support the care provided by FHP. FHP or its institutionally related foundations may contact you in the future to raise funds for this purpose. You will be provided the option of not receiving these communications. Your medical information is not shared for the purpose of fundraising.

Research: FHP may use or disclose information about you for research projects, such as studying the effectiveness of a treatment you received. These research projects must go through a special process that protects the confidentiality of your information.

Required by Law: Federal, state, or local laws do not require patient consent to disclose information which is required to be reported. For instance, we are required to report child abuse and neglect, gunshot wounds, etc. Public policy has determined that these types of needs outweigh the patient’s right to privacy. FHP is also required to give information to the state workers’ compensation program for work- related injuries.

Public Health: FHP may report certain medical information for public health purposes. For instance, we are required by law to report births, deaths, and communicable diseases to the state. We may also need to report patient problems with medications or medical products to the manufacturer and to the Food and Drug Administration.

Public Safety: FHP may disclose medical information for public safety purposes in limited circumstances. We may disclose medical information to law enforcement officers or to the court in response to a search warrant or other court order. We may also disclose medical information to assist law enforcement in identifying or locating a person, to prosecute a crime of violence or to report deaths that may have resulted from criminal conduct at the facility. We may also disclose information about you to law enforcement and others to prevent a serious threat to health or safety.

Health Oversight Activities: FHP may disclose medical information to a government or oversight agency that oversees FHP facilities or its personnel, such as the state’s department of health services, or other federal agencies that oversee Medicare, or licensing agencies who govern physicians and other health care professionals.

Coroners, Medical Examiners and Funeral Directors: FHP may disclose medical information concerning deceased patients to coroners, medical examiners and funeral directors to assist them in carrying out their duties.

Organ and Tissue Donation: FHP may disclose medical information to organizations that handle organ or tissue donation or transplantation.

Military Veterans, National Security and Other Government Purposes: If you are a member of the armed forces, we may release information about you as required by military command authorities or to the Department of Veterans Affairs. We may also disclose medical information to federal or state officials for intelligence and national security purposes.

Judicial Proceedings: FHP may disclose medical information in a lawsuit where your health status is an issue. For example, FHP may be ordered to do so by court order or search warrant.

Information with Additional Protection: Certain types of medical information may have additional protection under state or federal law. For instance, medical information about communicable disease, HIV/ AIDS, drug and alcohol abuse treatment, psychotherapy notes, genetic testing, or a court-ordered mental evaluation. FHP may obtain your authorization to release this information except as required by law.

Other Uses and Disclosures: Other uses and disclosures not described in this Notice will be made only with your written authorization such as sale of medical information. You may revoke such an authorization by sending us a written request.

What Are Your Rights?

Right to Request Information About You: You or your legally authorized representative are entitled to online access of documents available, review or receive paper copies, or request an electronic delivery of your health information. This includes your medical and billing information.

If you request a copy of your information, we may charge you for our costs. We will tell you in advance what this cost will be.

Right to Request to Amend or Supplement Information About You That You Believe is Incorrect or Incomplete: If you see information about you and believe that some of the information is incorrect or incomplete, you may ask us to amend your record. You may submit a request to amend your medical information by contacting Health Information Management at fmhrecords@foundationhealth.org or (907) 458-5450. Find our Request to Amend or Supplement Records form at www.foundationhealth.org. Or to amend your billing information, contact the Patient Financial Services/ Business Office at
 (907) 458-5510.

Right to Get a List of Certain Disclosures of Information About You: You have the right to request a list of certain disclosures we made of information about you. If you would like to receive such a list, contact Health Information Management at fmhrecords@foundationhealth. org or (907) 458-5450. We will provide the first list to you at no charge, but we may charge you for any additional lists you request during a twelve-month period. We will tell you in advance what this list will cost.  

Right to Request Restrictions on How FHP Will Use or Disclose Information About You for Treatment, Payment, or Health Care Operations: You have the right to request us not to use or disclose information about you to treat you, to seek payment for care, or to operate the health care system. We are not required to agree to your request, but if we do agree, we will comply with that agreement unless that information is necessary to provide you emergency treatment.

You may request that we withhold information from your health plan for the purpose of payment or health care operations provided it is not otherwise required by law. If you want to request a restriction to your medical information, you may contact Health Information Management or for billing information, you may contact the Business Office.

You have the right to pay for an item or service and elect not to have this information about you submitted to your health plan. We are not required to accept your request until you have paid for this service or item. We are not required to notify other health care providers of these types of restrictions, this is your responsibility.

If you want to request a restriction to your medical information, contact Health Information Management at (907) 458-5450. To request a restriction to your billing information, contact the Patient Financial Services/ Business Office at (907) 458-5510.

Right to Request Confidential Communications: You have the right to request us to communicate with you in a way that you feel is more confidential. You can ask to speak with your health care providers in private, outside the presence of other patients. We will accommodate reasonable requests including alternative addresses or alternative means. For example, you can ask us not to call your home, but to communicate only by mail. To do this, submit your request in writing to Health Information Management at fmhrecords@foundationhealth.org or (907) 458-5450.

Right to a Copy of FHP’s Notice of Privacy Practices:
You have the right to a paper copy of the Notice at any time. You may obtain a copy of the Notice from our web site at www.foundationhealth.org or you may obtain a paper copy of the Notice at patient registration sites.

Changes to this Notice

We may amend or revise our practices concerning how we will use or disclose patient medical information, or how we will implement patient rights concerning their information. We reserve the right to change this Notice and to make the provisions in our new notice effective for all your information. If we change these practices, we will publish a revised Notice of Privacy Practices.

Which Health Care Providers Does this Notice Cover?

This Notice of Privacy Practices applies to FHP facilities and its personnel, volunteers, students and trainees. The Notice also applies to other health care providers that come to the facility to care for patients, such as physicians, physician assistants, therapists, emergency services providers, medical transportation companies, medical equipment suppliers and other health care providers not employed by FHP unless these health care providers give you their own Notice of Privacy Practices. FHP may share your medical information with other health care providers for their treatment, payment and health care operations.

Do You Have Concerns or Complaints?

Please tell us about any problems or concerns you have with your privacy rights or how FHP uses or discloses information about you. If you have a concern, you may contact the FHP Privacy Officer by calling (907) 458-6986 or emailing privacy@foundationhealth.org. You may also file a complaint with the U.S. Department of Health & Human Services Office for Civil Rights (OCR). Complaints can be sent by electronic mail to OCRComplaint@hhs.gov or by mail to:  

Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Avenue, S. W.
Room 509F, HHH Bldg.
Washington, DC 20201

We will not penalize you or take any retaliatory action against you in any way for filing a complaint with the federal government. 

Do You Have Questions?

FHP is required by law to give you this Notice and to follow terms of the Notice that is currently in effect. If you have any questions about this Notice, or have further questions about how we may use and disclose information about you, please contact the Health Information Management Department or the FHP Privacy Officer.


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