To Our Patients...
This notice describes how health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
If you have any questions about this notice, please contact Ara Chakrabarti, CEO at 707-884-4005 during normal business hours.
Notice of Privacy Practices for Protected Health Information Redwood Coast Medical Services (RCMS) is permitted by federal privacy laws to make use of and disclosure your health information for purposes of treatment, payment, and health care operations. Protected health information is the information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and rest results, diagnoses, treatment, and applying for future care of treatment. It also includes billing documents for these services.
Examples of uses of your health information for treatment purposes are:
This notice describes how health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
If you have any questions about this notice, please contact Ara Chakrabarti, CEO at 707-884-4005 during normal business hours.
Notice of Privacy Practices for Protected Health Information Redwood Coast Medical Services (RCMS) is permitted by federal privacy laws to make use of and disclosure your health information for purposes of treatment, payment, and health care operations. Protected health information is the information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and rest results, diagnoses, treatment, and applying for future care of treatment. It also includes billing documents for these services.
Examples of uses of your health information for treatment purposes are:
- A nurse obtains treatment information about you and records it in your health record.
- During the course of your treatment, the physician determines he/she will need to consult with another specialist in the area. He / she will share the information with the specialist and obtain his/her input.
- We submit requests for payment to your health insurance company. The health insurance company, or business associate helping us obtain payment, requests information from us regarding the medical care given to you. We will provide information to them about you and the care given.
- We may obtain services from business associates such as quality assessment, quality improvement, outcome evaluation, protocol and clinical guidelines development, training programs, credentialing, medical review, legal services and insurance. We will share information about you with such business associates as necessary to obtain these services.
Your Health Information Rights
The health and billing records we maintain are the physical property of Redwood Coast Medical Services (RCMS). You have the following rights with respect to your Protected Health Information:
Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request but we will comply with any request granted.
Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information ("Notice") by making a request at our office.
You have the right to inspect and copy your health record and billing record. You may exercise this right by delivering the request in writing to our office using the form we provide to you upon request. You may appeal a denial of access to your protected health information except in certain circumstances.
You have the right to request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office using the form we provide to you upon request. (The doctor or other health care provider is not required to make such amendments.) You may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached to all future disclosures of your protected health information.
You have the right to receive an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office using the form we provide to you upon request. An accounting will not include internal uses of information for treatment, payment or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care.
You have the right to confidential communication by requesting that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office using the form we give you upon request. If you want to exercise any of the above rights, please contact the receptionist in person or in writing, during normal working hours. The receptionist will provide you with assistance on the steps to take to exercise your rights.
Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request but we will comply with any request granted.
Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information ("Notice") by making a request at our office.
You have the right to inspect and copy your health record and billing record. You may exercise this right by delivering the request in writing to our office using the form we provide to you upon request. You may appeal a denial of access to your protected health information except in certain circumstances.
You have the right to request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office using the form we provide to you upon request. (The doctor or other health care provider is not required to make such amendments.) You may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached to all future disclosures of your protected health information.
You have the right to receive an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office using the form we provide to you upon request. An accounting will not include internal uses of information for treatment, payment or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care.
You have the right to confidential communication by requesting that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office using the form we give you upon request. If you want to exercise any of the above rights, please contact the receptionist in person or in writing, during normal working hours. The receptionist will provide you with assistance on the steps to take to exercise your rights.
Our Responsibility
Redwood Coast Medical Services (RCMS) is required to:
- Maintain the privacy of your health information as required by law.
- Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain about you.
- Abide by the terms of this Notice.
- Notify you that we cannot accommodate a requested restriction or request.
- Accommodate your reasonable requests regarding methods to communicate health information with you.
- Accommodate your request for accounting of disclosures.
Request Information or File a Complaint
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If you have questions, would like additional information, or want to report a problem regarding handling of your information, or report and incident, please contact:
Deborah Lane, Corporate Compliance and Safety Officer RCMS P.O. Box 1100 Gualala, CA 95445 707-884-9215 or file your complaint online. Your message will be delivered to the RCMS CEO and the RCMS Corporate Compliance Officer. |
Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to Deborah Lane, Corporate Compliance and Safety Officer at the address above. A written complaint, online or mailed, is best. You may also email a complaint directly to OCRComplaint@hhs.gov.
RCMS cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the office. RCMS cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Resources.
For more information, please pick up a printed copy of Notice of Privacy Practices for Protected Health Information. Copies are available at all RCMS clinic locations.
RCMS cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the office. RCMS cannot, and will not, retaliate against you for filing a complaint with the Secretary of Health and Human Resources.
For more information, please pick up a printed copy of Notice of Privacy Practices for Protected Health Information. Copies are available at all RCMS clinic locations.
