Right to Amend Your Health Information. If you believe that your health information records are inaccurate or incomplete, you may request that the Health Plan amend the records. That request may be made as long as the information is maintained by the Health Plan. A request for an amendment of records must be made in writing to: the Division of Risk Management, 805 Central Avenue, Centennial Plaza Two – Suite 100, Cincinnati, OH. 45202 fax (513) 352-3761. The Health Plan may deny the request if it does not include a reason to support the amendment. The request also may be denied if your health information records were not created by the Health Plan, if the health information you are requesting to amend is not part of the Health Plan’s records, if the health information you wish to amend falls within an exception to the health information you are permitted to inspect and copy, or if the Health Plan determines the records containing your health information are accurate and complete. You have the right to request a list of certain disclosures of your health information that the Health Plan is required to keep a record of under the Privacy Rule, such as disclosures for public purposes authorized by law or disclosures that are not in accordance with the Plan’s privacy policies and applicable law. The request must be made in writing to the Division of Risk Management, 805 Central Avenue, Centennial Plaza Two – Suite 100, Cincinnati, OH. 45202 fax (513) 352-3761. The request should specify the time period for which you are requesting the information, but may not start earlier than April 14, 2003. Accounting requests may not be made for periods of time going back more than six (6) years. The Health Plan will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee. The Health Plan will inform you in advance of the fee, if applicable. Right to an Accounting. Right to a Paper Copy of this Notice. You have a right to request and receive a paper copy of this Notice at any time, even if you have received this Notice previously or agreed to receive the Notice electronically. To obtain a paper copy, please contact Risk Management at (513) 352-2418 . You may also obtain a copy of the current version of the Health Plan’s Notice at the City’s Web site at http://citymatters.rcc.org/finance/riskmgt/.
DUTIES OF THE HEALTH PLAN
The Health Plan is required by law to maintain the privacy of your health plan information as set forth in this Notice and to provide to you this Notice of its duties and privacy practices. The Health Plan is required to abide by the terms of this notice, which may be amended from time to time. The Health Plan reserves the right to change the terms of this Notice and to make the new Notice provisions effective for all health information that it maintains. If the Health Plan changes its policies and procedures, the Health Plan will revise the Notice and will provide a copy of the revised Notice to you within 60 days of the change. You have the right to express complaints to the Health Plan and to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. Any complaints to the Health Plan should be made in writing to: Ms. Deborah Allison, Privacy Official, Division of Risk Management, 805 Central Avenue, Centennial Plaza Two – Suite 100, Cincinnati, OH. 45202. The Health Plan encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.
CONTACT PERSON
The Health Plan has designated the Privacy Official as its contact person for all issues regarding patient privacy and your privacy rights. You may contact this person at: Ms. Deborah Allison, Privacy Official, Division of Risk Management, 805 Central Avenue, Centennial Plaza Two – Suite 100, Cincinnati, OH. 45202, phone number (513) 352-2418.
EFFECTIVE DATE
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE PRIVACY OFFICIAL AT THE DIVISION OF RISK MANAGEMENT, 805 CENTRAL AVENUE, CENTENNIAL PLAZA TWO – SUITE 100, CINCINNATI, OH. 45202 PHONE (513) 352-2418.
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