Revised January 1, 2018
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.
Ebenezer Notice of Privacy Practices – Entities Covered
The Notice of Privacy Practices tells you about your rights under a federal law called the Health Insurance Portability and Accountability Act – or HIPAA for short. This law protects your health information and sets rules about who can see and get your health information. (“Health information” includes any information about your mental or physical health, your health care, payment for your health care, and any demographic information.) The notice also tells you about Ebenezer’s policies for protecting, using, and sharing your health information.
Your privacy is important to us. The law requires that you be given a copy of this notice so that you can:
Ebenezer works hard to protect your health information. We use computer systems to store your health information. We have protections in place to keep your information from being seen by anyone that should not see it. While our computer systems are protected from access by unauthorized people, e-mails sent through the Internet are not.
We will not communicate with you using e-mail unless you want us to.
We may share your health information with public health or authorized government authorities
We may share health information for health oversight activities as authorized by law. Examples of oversight activities include audits, investigations, inspections, and licensing. These activities are needed for the government to oversee the health care system.
If you are involved in a dispute or lawsuit, we may share your health information if required by court order. We may also share your health information in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but usually only if you give us permission.
We may give health information to a coroner or medical examiner. We may need to do this, for example, to identify someone who has died or to determine the cause of death. We may also give health information to funeral directors with your permission as needed to carry out their duties.
We may give health information to authorized federal officials for activities authorized by law. We may share health information with authorized federal officials so they can protect the President and other authorized persons or foreign heads of state or conduct special investigations.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your health information:
Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. For example, we will ask for your permission to disclose your information for re- search or marketing purposes or to sell any of your information. We will also ask for your permission to disclose any psychotherapy notes we maintain related to services you have received. If you have given us written permission to use or share your health information, you may take back that permission in writing at any time. If you take back your permission, we will no longer use or share your health information for the reasons listed on your written permission. Of course, we cannot take back any information we have already shared with your permission.
If you think your privacy rights may have been violated, you may file a complaint with us. You may call the Ebenezer Privacy Office at 612-672-5647 to talk about your complaint. Or you may email or write to the Ebenezer Privacy Of- fice at firstname.lastname@example.org or 400 Stinson Blvd, Minneapolis, MN 55413. You may also file a complaint with the US Department of Health and Human Services Office for Civil Rights at: www.hhs.gov/ocr/privacy/hipaa/complaints. We will not penalize you or act against you in any way for filing a complaint.
This notice applies to Ebenezer Society and Ebenezer Management Services. Ebenezer provides a wide variety of health care services in conjunction with a number of hospitals, clinics, and other entities. In order to provide quality care, we share health information within Ebenezer as appropriate. All of Ebenezer’s entities, employees, volunteers, and agents will follow this notice. The notice applies to all records of the care you received at Ebenezer.
When doctors and other health care providers not employed by Ebenezer are treating you at Ebenezer, they must follow the terms of this notice. However, they may use a different privacy notice in their office or clinic.
We must follow the terms of this Notice of Privacy Practices. We can change this Notice however, and reserve the right to make the new notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in this facility. The effective date of this notice is listed on the first page.
If you have any questions about this notice, please call the Ebenezer Privacy Office at 612-672-5647 or toll free at 1-866-356-7410 or write to Ebenezer Privacy Office at 400 Stinson Blvd, Minneapolis, MN 55413.