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Privacy Practices




Your Rights

Bacon County Hospital and Health System works hard to protect your privacy. Federal laws outlining the ways that healthcare providers can use and share medical information about patients is enforced at Bacon County Hospital and Health System. The law states that we need your permission (authorization) for certain uses, but not for others.

Your personal medical ( health ) information is called Protected Health Information or "PHI"

Bacon County Hospital and Health System and medical staff can use your PHI and share it with each other only in certain ways. We must also follow rules about sharing your PHI outside our hospital.

Using Your PHI Without Your Permission

The law allows us to use your PHI without your permission in these ways.

For your treatment -
Any of our medical staff involved in treating you can use your PHI. They can also share it with others involved in your care.

For payment -
We may use and share your PHI to collect payment for services. For example, we may give your PHI to other health plans or providers for billing purposes.

For our business operations -
We check on the quality of care we give. We train our staff. We manage budget. We raise funds for our programs, and much more. We may use your PHI to help them learn how to do their jobs better. We can also share PHI with lawyers. They help us follow the laws. We may also share PHI with other health care providers and health plans where you've been a patient in the past. We would do this only to help them with things such as giving better care or watching for fraud and abuse.

To follow the Law -
We may share PHI to follow the law, to report or solve crimes, or to help law enforcement.

To protect Public Health -
We can give PHI to people who work to stop the spread of diseases. We are mandated by law to report abuse and neglect.

To oversee health care systems-
We can give your PHI to government agencies that inspect health care systems.

To help Coroners or Medical Examiners -
We may need to give PHI to help identify a body or the cause of death.

For Organ or Tissue Donation -
We may give PHI to help agencies who match organ donors with people on waiting lists.

For Research -
We may use PHI for medical research.

To Avoid a Serious Threat to others-
We may share PHI with federal officials for national security reasons.

Workers' Compensation -
We can release PHI to comply with laws that protect you if you are hurt or get sick on the job.

For Fundraising -
We may use your PHI to contact you for our fundraising. You may opt out of this fundraising activities by simply calling Bacon County Hospital and Health System, 912-632-8961 extension 1087 or 1092

Appointment Reminders and other items of interest -
We can use your PHI to contact you about an appointment. We can also contact you about other treatments, services, and programs that may interest you.

Your Access to your own PHI -
We may share your PHI with you or someone you choose to represent you.

Government Offices -
We must give your PHI to certain federal workers when they are checking on how we follow the privacy laws.

You can ask that we not share the following PHI-
Normally, we can use your PHI in the two ways below, but if you object, you can ask us to keep your PHI private. In that case, we cannot give out this information.

Lists of patients and their status -
We keep lists of all patients who are in our facilities. We keep track of names, room numbers, their condition (e.g., stable, fair, etc.). We can share some of this information with people who ask about you by name.

People involved in your care or paying for your care -
We can give your PHI to a family member, a friend, another person you say is involved in your care, or another person who is involved in paying for your care.

We must have your permission to use your PHI in the following ways-
Before we can use or share your PHI in other ways, we must ask for your written permission. This Notice tells you our rules for using PHI. We have to follow what we say in this Notice. The law says we must keep your PHI private. It also says that we must tell you in writing what the law says we can and cannot do with your PHI and our privacy policies regarding PHI.

We have to let you know if a breach of unsecured PHI has occurred-
You have the right for us to notify you immediately after we are made aware that a breach has occurred with your unsecured PHI.

We have to allow you to restrict certain disclosures of PHI-
When you are paying for certain health care services or items in full ( out of pocket ) , you may restrict certain disclosures to a health plan .

We have to let you know if we make a change -
We have the right to change information in this notice. We can change how we use PHI and make new rules. Before we make any big changes, we will give you a new notice. We will post the new notice in all registration areas.

These Are Your Rights


You can ask us not to share your PHI with a person or group -
We don't have to do what you ask. But we must do what we say we will do. No matter what, we can always share your PHI in an emergency.

You can ask us to contact you in certain ways or at certain places -
For example, you may want us to call you at work instead of at home. Or you may want us to use regular mail. You must ask in writing. Send your requests to Patient Financial Services at Bacon County Hospital and Health System.

Usually, you can read and copy your PHI -
You must ask for it by writing to the Health Information Management Department at Bacon County Hospital and Health System. We will try to get back to you within thirty (30) days after we get your letter. We will tell you if we can let you see and/or get a copy of your PHI. Sometimes we will give you a summary of the information you ask for, but only if you agree to that. If we make a copy or summary of your PHI, we may charge you for copying, mailing, and other costs. If we decide not to let you see your PHI, we will explain why. We will also explain that you can get another health care professional to look at your request. Sometimes we don't have the PHI you want.

You can ask that we fix mistakes or add new facts to your PHI-
You must ask us in writing. Write to the Health Information Management Department at Bacon County Hospital and Health System. In your letter, explain why you are asking us to add to or change your PHI. We will try to get back to you within sixty (60) days after we get your letter. We will tell you whether we agree to make a change. We will tell you what changes we will make, if any. We can usually turn you down if the information wasn't written by us; is not part of our records; is not something you are allowed to see; is not correct and complete. If we turn you down, we will tell you why in writing. We will also explain what other steps you can take, such as saying in writing that you don't agree with us; or asking in writing that we include a copy of your letter and our answer with your PHI from now on; and complaining about being turned down.

You can ask for a list of people and groups who have seen your PHI in the past six (6) years-
(But we can only give information about what has happened since April 14, 2003.) The list will not include times when you gave your written permission. And it won't include things already covered in this Notice. These include giving out your PHI for treatment, payment, and health care operations; to you; for lists of patients; people involved in your care; government functions; or to law enforcement. You must ask for the list by writing to the Health Information Management at Bacon County Hospital and Health System. We will try to get back to you within sixty (60) days after we get your letter. We will give you one list each year at no charge. But we will charge you a fee of for the next list in one year.

You may complain to us if you believe your privacy rights have been violated-
Contact Bacon County Hospital and Health System Compliance Department and put your complaint in writing. We will not punish you or do anything against you for complaining. You also have the right to complain to the Secretary of the Department of Health and Human Services.

Contact Information


Quality Management
912-632-8961 extension 1039

Patient Financial Services
912-632-8961 extension 1059

Health Information Management
912-632-8961 extension 1087
Revised Copy

5-15-13