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. If you are looking for information about how we protect your privacy in electronic communications (email or online), please view our website privacy policy.

Your medical information may be used and disclosed by Glencoe Regional Health Services for the following purposes:

• Treatment: To determine the best approach to meeting your healthcare needs (i.e., administering medications; performing tests, therapies and treatments) confidential consultation with other health care professionals may be necessary.
• Payment: Information may be released to your insurance companies and their affiliates for the purpose of payment of claims to Glencoe Regional Health Services.
• Health Care Operations: Including but not limited to payment, collection, legal proceedings, and peer-review.

Other uses and disclosures may be made only with your written authorization, which may be revoked upon request.

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. Additionally, we may contact you for fundraising purposes.

Your rights

• You have the right to request restrictions on certain uses and disclosures of protected health information, although Glencoe Regional Health Services is not required to agree to a requested restriction.
• You have the right to receive confidential communications of protected health information.
• You have the right to inspect and copy protected health information.
• You have the right to amend protected health information.
• You have the right to receive an accounting of disclosures of your protected health information.
• You have the right to obtain a paper copy of this notice from Glencoe Regional Health Services upon request.

Duties of Glencoe Regional Health Services

• Glencoe Regional Health Services is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information.
• Glencoe Regional Health Services is required to abide by the terms of the notice currently in effect.
• Glencoe Regional Health Services reserves the right to change the terms of this notice and to make new provisions effective for all protected health information that it maintains. In that event, revised notice will be provided to you upon presentation for your first visit after the notice has been revised.

If you believe your privacy rights have been violated, you may submit a complaint to the Glencoe Regional Health Services, Director Health Information Management, Glencoe, MN 55336 at 320-864- 7774 or to the Secretary of the Department of Health and Human Services, Office for Civil Rights.

A copy of this document is available upon request.