Short Notice of Privacy Practices
PLEASE READ CAREFULLY
SEPTEMBER 23, 2013
THIS SHORT NOTICE TELLS YOU HOW WE USE AND SHARE YOUR MEDICAL INFORMATION AS WELL AS HOW YOU MAY ACCESS THIS INFORMATION.
THIS IS NOT OUR FULL NOTICE OF PRIVACY PRACTICES. A COPY OF OUR FULL NOTICE OF PRIVACY PRACTICE IS AVAILABLE UPON REQUEST AND ON OUR WEBSITE AT: www.stmarysmaine.com.
YOUR RIGHTS You have the right to:
- Get a copy of your paper or electronic record
- Correct your paper or electronic record
- Request confidential communication
- Ask us to limit the information we share
- Get a list of those with whom we have shared your information
- Get a copy of the St. Mary’s Notice of Privacy Practices
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
YOUR CHOICES You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Include you in a hospital directory
- Provide mental health care
- Market our services and sell your information
- Raise funds
- We participate in HealthInfoNet, the statewide health information exchange (HIE) designated by the State of Maine. You do not have to participate in the HIE to receive care. For more information about HealthInfoNet and your choices regarding participation, visit www.hinfonet.org or call toll-free 1-866-592-4352.
OUR USES AND DISCLOSURES We may use and share your information as we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Respond to organ and tissue donation requests
- Work with a medical examiner or funeral director
- Address workers’ compensation, law enforcement, and other government requests
- Respond to lawsuits and legal actions
COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint in writing, with our Privacy Officer at:
PO Box 291,
Lewiston, Me. 04243.
You may also file a complaint with the U.S. Department of Health and Human Services (“HHS”) at
200 Independence Avenue, S.W.,
Washington, D.C. 20201 .
Call (202)619-0257 or toll free (877-696-6775 or go to the website of the Office for Civil rights, for more information.