Please note that this notice does not affect your eligibility or benefits or your existing rights to view information in your case record.
“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.” Thank you.
Our Privacy Commitment
We care about your privacy. The information we collect about you is private. Only people who have both the need and the legal right may see your information. Only with your written permission will we release your medical information. However, we do not need your permission for the following purposes:
- Treatment. To coordinate your health care. For example, we may notify your doctor about care you get in an emergency room.
- Payment. To bill and pay for services that you receive. For example, we may ask an emergency room for details before we pay the bill for your care.
- Business Operations. For medical review, legal services, and auditing including fraud and abuse detection. For example, the managed care program may use information to review the quality of care you get.
- Abuse Reporting. To report child or dependent adult abuse to proper authorities.
- Law Enforcement. To report crimes on our premises or in relation to the Medicaid program.
- Health Oversight. To monitor, investigate, discipline, or license those who work in the health care system.
- Judicial and Administrative Proceedings. In response to a court order or subpoena.
- Public Health. To help public health authorities prevent or control disease, injury, or disability.
- Serious Threat to Health or Safety. If we believe, in good faith, that it is necessary to prevent or minimize a serious threat to you and/or others’ health or safety.
- Business Associates – We may share your health information with others called “business associates,” who perform services on our behalf. The Business Associate must agree in writing to protect the confidentiality of the information
- Required by Law. We will release information when we are required by law to do so.If you give us your written permission to use or share your information for the purposes listed above and decide to cancel it, you must notify us in writing. We cannot take back any uses or disclosures already made with your permission.If you give us your written permission to use or share your information for the purposes listed above and decide to cancel it, you must notify us in writing. We cannot take back any uses or disclosures already made with your permission.If you give us your written permission to use or share your information for the purposes listed above and decide to cancel it, you must notify us in writing. We cannot take back any uses or disclosures already made with your permission.If you give us your written permission to use or share your information for the purposes listed above and decide to cancel it, you must notify us in writing. We cannot take back any uses or disclosures already made with your permission.
Your Rights to Privacy
Your rights to privacy regarding certain health information that we have about you are important. You have the following rights:
- Notice of Privacy Practices. This notice is your written notice of Village Enterprises policies and procedures on protected health information.
- Inspect and Copy. You have the right to look at or get copies of your records unless other laws say you can’t. You may be charged a fee for the cost of copying your records.
- Change Information. You may ask us to change your health records if you feel that there is a mistake. We can deny your request for certain reasons, but we must give you a written reason for our denial.
- List of Disclosures. You have the right to ask for a list of the time when we released your protected health information without your written permission. This list will not include times when information was released for purposes of your medical treatment, payment for your health care, or our business operations.
- Request Restrictions on Our Use or Disclosure of Information. You can ask us to limit how your information is used or disclosed. We may not be able to agree to all your requests.
- Request Confidential Communications. You have the right to ask that we share information with you in a certain manner or at a certain place. For example, you may ask us to send information to your work address instead of your home address. Your requests must be made in writing to the address below under “Communications to Us.”
Federal law places certain requirements on Village Enterprises with respect to your protected health information:
- Inform About Legal Duties. We will provide you with a notice of the Department’s legal duties and our policies regarding the use and disclosure of your protected health information.
- Maintain Privacy. We will maintain the privacy of your protected health information in accordance with state and federal law.
- Abide by the Notice. We will abide by the terms of this privacy notice.
Copies of this Notice
You have the right to receive an additional copy of this notice at any time. Please call or write to us to request a copy to the above address or phone number.
Changes to the Notice
We may update this notice as necessary. A revised notice will apply to your past, current, and future health information. If the changes affect your rights and responsibilities, we will provide a new notice to you before the changes takes effect.
Revocation of Permission
If you provide us with permission to use or disclose your health information, you may revoke that permission at any time. Please make your request in writing to Release of Information at the contact information listed at the end of this Notice.
If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written revocation. We are unable to take back any disclosures previously made with your permission. Also, we are required to keep all records of the care that we provided to you.
How to Use Your Rights Under this Notice
If you want to use your rights described in this notice, you may call or write to Village Enterprises office listed below. Village Enterprises office has forms that you can use. Your request to us must be in writing. If you wish, we will help you prepare your written request.
Communications to Us. Contact us at the address or phone number below if you want to:
- Questions about this privacy notice, or
- Exercise your rights under this notice, or
- File a complaint about how Village Enterprises has handled your health information.
Village Enterprises, Inc. Office
1208 Clark Avenue
Ames, IA 50010
Complaints to the Federal Government.
If you would like to file a complaint with the Secretary of the U.S. Department of Health and Human Services, please contact:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(You will not be penalized for filing a complaint.)
Policy on Non discrimination
No person shall be discriminated against because of race, color, national origin, sex, sexual orientation, age, mental or physical disability, creed, religion, or political belief when applying for or receiving benefits or services from Village Enterprises, Inc., or any of its vendors, Purchase of Service providers, or contractors.