Notice of Privacy Practices
1. Protecting your Privacy
- It is your right as a patient to be informed of the privacy practices of the Cudahy Health Department, as well as to be informed of your privacy rights with respect to your personal health information. This notice of privacy practices is intended to provide you with this information.
- The Cudahy Health Department will respond to any questions regarding this policy or the use of your personal health information as it relates to obtaining insurance payment or other health care operations.
- The Cudahy Health Department is required to:
- Maintain the Privacy of your health information;
- Provide you with a notice of the legal duties and privacy practices regarding protected health information collected and maintained about you;
- Abide by the terms of this notice
- The Cudahy Health Department reserves the right to change the terms of the notice of privacy practices and make the new notice provisions effective for all protected health information that it maintains. The Cudahy Health Department also reserves the right to change the terms of its notice with respect to any applicable uses and disclosures. The Cudahy Health Department will promptly revise and distribute its privacy practices policy whenever a substantial change is made to any of its privacy practices. The Cudahy Health Department will not use or disclosure your health information without your authorization, except as described in this policy.
3. Your Health Information Rights
You have the right to:
- Request restrictions on certain uses and disclosures of protected health information, even if the restriction affects your treatment or the Cudahy Health Department payment or health operations activities. However, the Cudahy Health Department is not required to agree to your requested restrictions.
- Request that the Cudahy Health Department communicates your health information to you. The Cudahy Health Department will accommodate any reasonable request. You may inspect and obtain a copy of your health record. This request for access to your
health care record must be submitted to the Cudahy Health Department, in writing, to the compliance officer, with a consent signed by the patient or the patient’s parents or legal guardian. The Cudahy Health Department may charge a reasonable fee for additional copies of your health care record.
- Request an amendment to your health care record if you believe that the health information is incorrect or incomplete as documented by the Cudahy Health Department. You must make this request in writing, to the compliance officer of the Cudahy Health Department. You need to state the reason why your health record should be changed. If the Cudahy Health Department did not create the record or disagrees with your request changes, your request may be denied.
- Obtain a paper copy of the Cudahy Health Department’s Privacy Practices Policy, at no charge, by contacting the Cudahy Health Department Compliance Officer.
4. Uses and Disclosures for Treatment, Payment and Health Care Operations
The city of Cudahy Health Department is permitted by federal privacy rule to use or disclosure your protected health information for treatment, payment or health care operations.
The Cudahy Health Department may use or disclosure your health information:
- In the provision, coordination or management of your health care
- To obtain reimbursement for the provision of health care services provided. The bill may include information that identifies you, your diagnosis and your treatment.
- For evaluation of patient care services, evaluation the performance of the public health nursing, business budgeting projection and activities such as internal audit that relate to compliance with the laws that regulate our operations.
5. Uses or Disclosures of your Projected Health information permitted without Your Authorization
Without your written authorization, the Cudahy Health Department may use or disclose your health information as required by law. This includes:
- Information pertaining to a worker’s compensation claim
- To injury for victims of abuse, neglect or domestic violence
- For judicial proceedings
- For statutory reporting to the State of Wisconsin for public health safety
- In response to a request by a state or federal agency for activities related to death or tissue donation
- To avert a serious threat to health or safety