Effective: April 14, 2003
HEALTH PLAN PRIVACY NOTICE
Information We Have About You:
THIS NOTICE DESCRIBES HOW PERSONAL MEDICAL INFORMATION ABOUT YOU MAY BE USED ANDDISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We receive enrollment information about you that includes your date of birth, gender, identification
number and other personal information. We may also receive bills, physician reports and other information about your medical care.
We care about your privacy and we guard your information carefully. We are required by law to maintain the privacy of that information and to provide you with this Notice of our legal duties and our privacy practices. We will not sell any information about you. Only people who have both the need and the legal right may see your information. Unless you give us a written authorization, we will only disclose your information for purposes of treatment, payment or business operations or when we are otherwise required by law to do so.
Currently we do not use or disclose medical information for the purpose of coordinating your healthcare.
We may use and disclose medical information about you so that the medical services you receive can be properly billed and paid for. For example, we may disclose details about your treatment before we pay the bill for your care.
We may need to use and disclose medical information about you for our business operations. For example, we may use medical information about you to review the health benefit plans we provide.
As Required By Law:
We will disclose information about you when we are required by law to do so. For example, disclosures may be made for the purpose of: law enforcement, national security, court orders, reporting of communicable diseases, review of our activities by government agencies, to avert a serious threat to health or safety or in other kinds of emergencies.
If you give us a written authorization to do so, we may use and disclose your information. If you give us a written authorization, you have the right to change your mind and revoke that authorization.
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. You may obtain a copy of this Notice at our website www.genesys.org
Changes to this Notice:
We reserve the right to revise this Privacy Notice. A revised Notice will be effective for medical information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever Notice is currently in effect. Any changes to our Notice will be mailed to the enrollee.
Right to Inspect and Copy:
Upon written request, you have the right to inspect the information we have about you and to get copies of that information. We may charge a fee for the costs of copying, mailing, or other supplies related to your request.
Right to Amend:
If you feel that the information about you that we have is incorrect or incomplete, you can make a written request to us to amend that information. We can deny your request for certain limited reasons, but we must give you a written reason for our denial.
Right to a List of Disclosures:
Upon written request, you have the right to receive a list of our disclosures of your information, except when you have authorized those disclosures or if the disclosures are made for treatment, payment or operations. We are not required to give you a list of disclosures made before April 14, 2003.
Right to Request Restrictions on Our Use or Disclosure of Information:
If you do so in writing, you have the right to request restrictions on the information we may use or disclose about you. We are not required to agree to such requests.
Right to Request Confidential Communications:
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. Your request must be in writing. For example, you can ask that we contact you at home or at a certain address or by mail.
How to Use Your Rights Under This Notice:
If you want to use your rights under this Notice, you may call us or write to us. If your request to us must be in writing, we will help you prepare your written request, if you wish.
Complaints to the Federal Government:
If you believe that your privacy rights have been violated, you have the right to file a complaint with the federal government. You may write to: Office of the Secretary, Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201. You will not be penalized for filing a complaint with the federal government.
Complaints and Communications to GHS:
If you want to exercise your rights under this Notice or if you wish to communicate with us
about privacy issues or if you wish to file a complaint, you can write to:
HIPAA Privacy Officer
Genesys Health System
One Genesys Parkway
Grand Blanc, MI 48439-8066
You can also call us at 810-606-6551.
You will not be penalized for filing a complaint.
Genesys Acorn Gift and Floral Shop:
The Genesys Acorn Gift and Floral Shop specializes in unique specialty gifts, jewelry, handbags, accessories, boutique clothing as well as floral arrangements, cards, candy, magazines, sundries, baby items and soft toys. A Genesys volunteer will personally deliver your gift ordered online!
About Genesys: Genesys is a regionally integrated health care delivery
system comprised of a complete continuum of care primarily servicing Genesee,
Shiawassee, Lapeer, Oakland, Livingston and Tuscola counties.
Genesys Hospital Grand Blanc Michigan proudly serves these communities
within our six county Southeast Michigan service area:
Genesee County: Burton, Clio, Davison, Fenton, Flint, Flushing, Gaines,
Goodrich, Grand Blanc, Lennon, Linden, Montrose, Mount Morris, Otisville, Otter
Lake and Swartz Creek.
Shiawassee County: Bancroft, Byron, Corunna, Durand, Laingsburg, Lennon, Morrice, New Lothrop, Owosso, Perry and Vernon.
Lapeer County: Almont, Barnes Lake, Millers Lake, Brown City, Clifford,
Columbiaville, Deerfield, Dryden, Elba, Goodland, Hadley, Imlay City, Imlay,
Lapeer, Marathon, Mayfield, Metamora, North Branch, Oregon Township, Otter Lake
North Oakland County: Auburn Hills, Clarkston, Holly, Lake Angelus, Lake Orion, Leonard, Milford, Ortonville, Oxford, Pontiac, Waterford.
Livingston County: Brighton, Howell, Pinckney and Fowlerville.
Tuscola County: Akron, Caro, Cass City, Fairgrove, Gagetown, Kingston,
Mayville, Millington, Reese, Unionville and Vassar.