Privacy & Confidentiality of Your Records
Our agency respects client confidentiality and only releases confidential information about you in accordance with the Illinois Confidentiality Act (704 ILCS 110) and the Federal Privacy law, the Health Insurance Portability and Accountability Act (HIPAA). If you have any questions about this policy or your rights contact our Privacy Officer at (217) 525-1064.
In order to effectively provide you care, there are times when we will need to share your confidential information with others outside our Agency. This includes for:
Treatment. We may use or disclose treatment information about you to provide, coordinate, or manage your care or any related services, including sharing information with others outside our Agency that we are consulting with or referring you to.
Payment. With your written consent, information will be used to obtain payment for treatment and services provided to you. This includes contacting your health insurance company for prior approval of planned treatment or for billing purposes.
Healthcare Operations. We may use information about you to coordinate our business activities. This may include setting up your appointments, reviewing your care, and training staff.
Under Illinois and Federal law, information about you may be disclosed without your consent in the following circumstances:
Emergencies. Sufficient information may be shared to address the immediate emergency you are facing.
Follow Up Appointments/Care. We may be contacting you to remind you of future appointments or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We will leave appointment information on your answering machine unless you tell us not to.
As Required by Law. This would include situations where we have a subpoena, court order, or are mandated to provide public health information, such as communicable diseases or suspected abuse and neglect such as child abuse, elder abuse, or institutional abuse.
Coroners. We are required to disclose information about the circumstances of client death to a coroner who is investigating it.
Governmental Requirements. We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations inspections and licensure. We are also required to share information, if requested with the U.S. Department of Health and Human Services to determine our compliance with federal laws related to health care and to Illinois state agencies that fund our services.
Criminal Activity or Danger to Others. If a crime is committed on our premises or against our personnel we may share information with law enforcement to apprehend the criminal. We also have the right to involve law enforcement when we believe an immediate danger may occur to someone.
Disaster Relief. We may disclose information about you for disaster relief efforts.
Fundraising. As a not for profit provider of health care services we need assistance in raising money to carry out our mission. We may contact you to seek a donation.
You have the following privacy and confidentiality rights under Illinois and Federal law:
Copy of Record. You are entitled to inspect your client record that our agency has generated about you. We may charge you a fee for copying and mailing your record.
Release of Records. You may consent in writing to release of your records to others, for any purpose you choose. This could include your attorney, employer, or others who you wish to have knowledge of your care. You may revoke this consent at any time, but only if we have not already released information based on your prior authorization.
Restriction on Record. You may ask us not to use or disclose part of the clinical information. The MHCCI is not required to agree to your request if we believe it is in your best interest to permit use and disclosure of the information. The request should be made in writing to our Privacy Officer.
Contacting You. You may request that we send information to another address or by other means; however, we will not provide you information by email. We will honor your request as long as it is reasonable and we are assured it is correct. We have a right to verify that the payment information you are providing is correct.
Amending Record. If you believe that something in your record is incorrect or incomplete, you may request we amend it. To do this contact your therapists or case manager, or the site Administrator and ask for the Request to Amend Health Information form. In certain cases, we may deny your request. If we deny your request for an amendment, you have a right to file a statement that you disagree with us. We will then file our response, and your statement and our response will be added to your record.
Accounting for Disclosures. You may request an accounting of any disclosures we have made related to your confidential information, except for information used for treatment, payment, or health care operations purposes or that we shared with you, or information that you gave us specific consent to release. It also excludes information we were required to release. To receive information regarding disclosure made for a specific time period, no longer than 6 years and after April 14, 2003, please submit your request in writing to our Privacy Officer. We will notify you of the cost involved in preparing this list.
Questions and Complaints. If you have any questions, or wish a copy of this Policy or have any complaints you may contact our Privacy Officer in writing at 710 N. 8th St., Springfield, IL 62702 for further information. You also may complain to the Secretary of U.S. Department of Health and Human Services if you believe the MHCCI has violated your privacy rights. We will not retaliate against you for filing a complaint.
Changes in Policy. We reserve the right to change this Privacy Policy based on the needs of the MHCCI and changes in Illinois and Federal law.