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Effective November 18, 2016THIS 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.1. Our Legal Duty. Federal and state laws require us to maintain the privacy of your health information, to give you this Notice. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We are bound to follow these privacy practices from the effective date, until we replace this Notice. We will not use or share your information other than as described here unless you tell us in writing, in which case, you may change your mind by writing us. We are unable to take back any disclosures that we may have already made. We are required to retain our records of the care we provided to you.2. HOW WE USE AND DISCLOSE YOUR HEALTH INFORMATION. We store it in a chart and electronically. By law, we may use and disclose your health information for:A. Treatment. To share it with professionals who are treating you. Example: We share your health information with your doctor or your optician to verify your prescription or to contact you for education about treatments or product recalls.B. Payment. To bill and collect payment for our services to you. Example: We may use or disclose your information so that a bill may be sent to you or a family member, or to another health plan that requires the information before paying us.C. Running Our Organization and Contacting You When Necessary. For certain administrative, financial, legal, and quality improvement activities necessary for us to run our business and make sure that you receive quality customer service; these activities include (office) operations, quality assessment/improvement activities, business planning/development, and business management and general administrative activities, including the sale, transfer, merger, or consolidation of all or part of our business with another covered entity, or an entity that following such activity will become a covered entity, and due diligence related to such activity. We are not allowed to use genetic information to decide whether you can be a member or the price of the membership.Example: We use health information about you to evaluate and to improve quality of care of the service we provide to you.D. Ask Us to Limit What We Use or Share. You can ask us not to use or share certain health information for treatment, payment or our operations. If you paid out-of-pocket for a specific item or service, you have the right to request that we not disclose health information about that item or service to a health plan for purposes of payment or health care operations, and we must honor that request. We are not required to agree to your request and we may say "no" if it would affect your care.E. Request Confidential Communications. You can ask us to contact you in a specific way (for example, at home or by office phone) or to send mail to a different address. We will consider all reasonable requests and must say "yes" if you tell us you would be in danger if we do not.F. Ask Us to Correct Health and Claims Records That You Believe Are Inaccurate or Incomplete. Ask us how to do this. We may say "no" to your request but we will tell you why in writing within 60 days.G. Get a List of Those with Whom We've Shared Information. You can ask for a list (accounting) of the times we've shared your health information for 6 years prior to the date you ask, who we shared it with, and why. We will include all disclosures except for those about treatment, payment and health care operations, and certain other disclosures (such as any you asked us to make). If an electronic health record is used, you have the right to an accounting of protected health information disclosures for treatment, payment or healthcare operations for a 3-year period, including business associate disclosures. We'll provide one account a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
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