Page ContentNotice of Privacy Practices (English) Your Information.Your Rights.Our Responsibilities.This notice describes how medical/treatment information about you may be used and disclosed and how you can get access to this information. Please review it carefully.Your RightsWhen it comes to your health/treatment information, you have certain rights. This section explains your rights and some of our responsibilities to help you.Get an electronic or paper copy of your medical/ service recipient recordYou can ask to see or get an electronic or paper copy of your medical/service recipient record and other health/treatment information we have about you. Ask us how to do this.We will provide a copy or a summary of your health/treatment information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.Get an electronic or paper copy of your medical/ service recipient recordYou can ask to see or get an electronic or paper copy of your medical/service recipient record and other health/treatment information we have about you. Ask us how to do this.We will provide a copy or a summary of your health/treatment information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.Ask us to correct your medical/service recipient recordYou can ask us to correct health/treatment information about you that you think is incorrect or incomplete. Ask us how to do this.We may say “no" to your request, but we'll tell you why in writing within 60 days.Request confidential communicationsYou can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.We will say “yes" to all reasonable requests.Ask us to limit what we use or shareYou can ask us not to use or share certain health/treatment information for treatment, payment, or our operations.We are not required to agree to your request, and we may say “no" if it would affect your care.If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.We will say “yes" unless a law requires us to share that information.Get a list of those with whom we've shared informationYou can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why.We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.Get a copy of this privacy noticeYou can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.Choose someone to act for youIf you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.We will make sure the person has this authority and can act for you before we take any action.File a complaint if you feel your rights are violatedYou can complain if you feel we have violated your rights by contacting us using the information on page 1.You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visitingwww.hhs.gov/ocr/privacy/hipaa/complaints/.We will not retaliate against you for filing a complaint.Your Choices For certain health/treatment information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.In these cases, you have both the right and choice to tell us to:Share information with your family, close friends, or others involved in your careShare information in a disaster relief situationInclude your information in a hospital directoryContact you for fundraising efforts If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.In these cases, we never share your information unless you give us written permission:Marketing purposesSale of your informationMost sharing of psychotherapy notesIn the case of fundraising:We may contact you for fundraising efforts, but you can tell us not to contact you again.Our Uses and DisclosuresHow do we typically use or share your health information? We typically use or share your health information in the following ways.Treat youWe can use your health/treatment information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.Run our organizationWe can use and share your health/treatment information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.Bill for your servicesWe can use and share your health/treatment information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services. How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.Help with public health and safety issuesWe can share health/treatment information about you for certain situations such as:Preventing diseaseHelping with product recallsReporting adverse reactions to medicationsReporting suspected abuse, neglect, or domestic violencePreventing or reducing a serious threat to anyone's health or safetyDo researchWe can use or share your information for health research.Comply with the lawWe will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.Respond to organ and tissue donation requestsWe can share health information about you with organ procurement organizations.Work with a medical examiner or funeral directorWe can share health information with a coroner, medical examiner, or funeral director when an individual dies.Address workers' compensation, law enforcement, and other government requestsWe can use or share health/treatment information about you:For workers' compensation claimsFor law enforcement purposes or with a law enforcement officialWith health oversight agencies for activities authorized by lawFor special government functions such as military, national security, and presidential protective servicesRespond to lawsuits and legal actionsWe can share health/treatment information about you in response to a court or administrative order, or in response to a subpoena.Our ResponsibilitiesWe are required by law to maintain the privacy and security of your protected health information.We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.We must follow the duties and privacy practices described in this notice and give you a copy of it.We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html. Changes to the Terms of This NoticeWe can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site. Effective Date 09/01/2021This Notice also describes the privacy practices of an organized health care arrangement or "OHCA" between Boys Town National Research Hospital (BTNRH) and its Medical Staff in which BTNRH and its Medical Staff share medical information from inpatient and outpatient hospital visits for treatment, payment and health care operations. All Members of the BTNRH Medical Staff will follow this Notice when providing services at BTNRH facilities including outpatient clinics. This Notice does not cover the information practices of practitioners in their private offices or at other locations when such practitioners are not employed by BTNRH.