Privacy & HIPAA
Dear Patient,
Enclosed is a document that provides the
details of a new regulation that is intended
to protect the privacy of patients. It describes
how medical information about patients may
be used and the kind of permission that patients
must provide to us in order to allow certain
information to be used for various purposes.
This document, The Notice of Privacy Practices,
provides details on a range of issues. The
notice is summarized on pages 1-4, and further
specific information is provided on pages
5-15. Please keep this document with your
medical records or other important papers
so you will have it for future reference.
The law requires us to provide you with this
notice of privacy, and therefore, we need
you to acknowledge that you have received
it. In addition, in order for us to continue
to treat you, get paid for that treatment,
and run our hospital business, we need you
to provide us with a “general written consent.”
This provides us with your permission to share
your medical information with the doctors
and nurses involved in caring for you, and
with your health insurance company and other
business associates of the hospital. Generally,
in order for us to disclose your health information
to those outside the hospital, we will ask
you for a separate written authorization.
Please review the document and sign the Acknowledgement
and Consent form, returning it to us in the
enclosed, self-addressed stamped envelope.
Our policies and procedures have been designed
and refined to show respect for patient privacy
and we hope that you feel that your privacy
is being respected in all aspects of our relationship
with you. If you have any questions about
this notice or the practices of our staff,
please feel free to contact our Privacy Officer
at 315.823.5362. In the meantime, we appreciate
your consideration in timely signing and mailing
the enclosed letter.
Sincerely,
Little Falls Hospital
Little Falls Hospital Consent and
Release Forms
1. Little Falls Acknowledgment and
Consent Form
2. Little Falls Notice of Privacy Practices
3. View Consent Form
& Practices in one download
4. Patient Autorization
for Release of Health Information
..............................................................
Additional Information
Information regarding HIPAA Government Sites
& Private Organization links have been
derived from The U.S. Department of Health
and Human Services. Please click on a link
to view details.
HIPAA
Procedure Codes and Background Information
GOVERNMENT
SITES
PRIVATE
ORGANIZATIONS
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