The
Resource Exchange, Inc
Health Insurance portability and accountability act of 1996
Privacy Notice
This notice describes how medical information about you may be used and disclosed an how you can get access to this information. Please review it carefully.
ACKNOWLEDGEMENT
OF RECEIPT OF THIS NOTICE:
You will be asked to sign acknowledgement of receipt. If you decline to sign,
we will continue to use and disclose your protected health information for treatement,
payment and health care operations when applicable.
OUR DUTIES REGARDING
PROTECTED HEALTH INFORMATION:
"Protected Health Information"(PHI) is individually identifiable health
information. We are required by law to make sure that your PHI is kept private,
provide you this notice, follow the terms of the notice currently in effect
and communicate any changes in the notice to you.
HOW WE MAY USE OR
DISCLOSE YOUR PROTECTED HEALTH INFORMATION:
Examples are not exhaustive:
| Required by law | Treatment | healthcare Operations | Legal Proceedings | Coroners |
| Criminal Activity | Payment | Workers Compensation | Disclosures by Health Plans | Parental Access |
| Public Health |
USES AND DISCLOSURES
OF PROTECTED HEALTH INFORMATION REQUIRING YOUR PERMISSION:
Examples in which your agreement or objection is required:
use and disclosure in inpaticnt directoreis
Disclosure of Individuals involved in your health care (family, close friend,
etc.)
YOUR RIGHTS REGARDING
YOUR HEALTH INFORMATION:
You may exercise the following rights by submitting a written request or electronic
message to the Privacy Officer.
Right to Inspect and Copy
Right to Request Restrictions
Right to Request Confidential Communications
Right to Request Amendment
Right to Accounting Disclosures
Right to Obtain a copy of this notice.
FEDERAL PRIVACY
LAWS:
This Notice of Privacy Practices is provided as a requirement of the Health
Insurance Portablility and Accountability Act(HIPAA). there are several other
privacy haws that also apply including the Freedom of Information Act, the Privacy
Act and the Alcohol, Drug Abuse and Mental Health Administration Reorganization
Act. These laws have not been superceded.
COMPLAINTS:
If you believe these privacy rights have been violated, you may file a written
complaint with the Commnunity Centerd Boards privacy officer, your agency privacy
officer or the Department of Health and Human Services privacy Officer. No retaliation
will occur against you for filing a complaint.
CONTACT INFORMATION:
The Resource Exchange Privacy Officer
418 S. Weber St.
Colorado Springs, CO 80903
(719)784-6447
E-mail : jhill@tre-x.org
For additional information regarding your privacy rights, contact your agency
contract administrator.
The
Resource Exchange, Inc
Statement of Rights Notice