If you have any questions about this notice, please contact the Madison
Valley Medical Center
by dialing 406-682-6862
Each time you visit a hospital, physician, or other healthcare provider,
a record of your visit is made. Typically, this record contains your symptoms,
examination and test results, diagnoses, treatment, and plan for future
care or treatment, and billing related information. This notice applies
to all the records of your care generated by the Madison Valley Medical
Center whether made by hospital personnel, agents of the hospital, or
your personal doctor.
We are required by law to maintain the privacy of your health information
and provide you a description of our privacy practices.
Uses and Disclosures
How we may use and disclose medical information about you?
The following categories describe examples of the way we use and disclose
For treatment: We may use medical information about you to provide you treatment or
services. We may disclose medical information about you to doctors, nurses,
technicians, medical students, or other hospital or long term care personnel
who are involved in taking care of you at Madison Valley Medical Center
For Payment: We may use and disclose medical information about your treatment and
services to bill and collect payment from you, your insurance company
or a third party payer.
For Health Care Operations: Members of the medical staff and quality improvement team may use information
in your health record to assess the care and outcomes in your case and
others like it.
We may also use and disclose medical information:
To remind you of an appointment you have for medical care;
To assess your satisfaction with our services;
To tell you about possible treatment alternatives;
To tell you about health-related benefits or services;
For Population based activities relating to improving care or reducing
health care costs;
For conducting training programs and reviewing competence of health care
Business Associates: There are some services provided in our organization through contracts
with business associates. We may disclose your health information to our
business associate so they can perform the job we've asked them to
do. To protect your health information, however, we require the business
associate to appropriately safeguard your information.
Individuals Involved in Your Care or Payment for Your Care: We may release medical information about you to a friend or family member
who is involved in your medical care or who helps pay for your care. In
addition, we may disclose medical information about you to an entity assisting
in a disaster relief effort so your family can be notified about your
condition, status, and location.
Fundraising activities: We may use limited information about you so the foundation can contact
you in an effort to raise money for the hospital/clinic and its operation.
Directory of information: Unless you notify us that you object, we will use your name, location
in the facility, general condition and religious affiliation for directory
purposes. This information may be provided to members of the clergy and
except for religious affiliation to other people who ask for you by name.
We must release information as Required by Law to:
Organ Procurement Organizations
Food and Drug Administration (FDA)
Your Health Information Rights
Although your health record is the physical property of the healthcare
practitioner or facility that compiled it, you have the right to:
To inspect and copy medical information that may be used to make decisions
about your care. Request an amendment for as long as the information is
kept by our
Request an accounting of disclosures
Request a restriction or limitations on the medical information we use
or disclose about you for treatment, payment, or health care operations
Have a paper copy of this notice.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this
notice or the laws that apply to us will be made only with your written
permission. If you provide us permission to use or disclose medical information
about you, you may revoke that permission, in writing, at any time. If
you revoke your permission, we will no longer use or disclose medical
information about you for the reasons covered by your written authorization.
You understand we are unable to take back any disclosures we have already
made with your permission. We are required to retain our records of the
care that we provided you according to the Laws of the State of Montana.
Privacy Officer: Vurnie Barnett