I. Understanding Your Health Record/Information
Each time you visit an Tuba City Regional Health Care Corporation facility for services, a record of your visit is made. If you are referred by the Tuba City Regional Health Care Corporation through the Contract Health Service (CHS) program, TCRHCC also keeps a record of your CHS visit. Typically, this record contains your symptoms, examination, test results, diagnoses, treatment, and a plan for future care. This information, often referred to as your health record, serves as a:

• Plan for your care and treatment
• Communication source between health care professionals
• Tool with which we can check results and continually work to improve the care we provide
• Means by which Medicare, Medicaid or private insurance payers can verify the services billed
• Tool for education of health care professionals
• Source of information for public health authorities charged with improving the health of the people
• Source of data for medical research, facility planning and marketing
• Legal document that describes the care you receive

Understanding what is in your health record and how the information is used helps you to:

• Ensure its accuracy
• Better understand why others may review your health information
• Make an informed decision when authorizing disclosures

II. Your Health Information Rights
Although your health record is the physical property of Tuba City Regional Health Care Corporation, the information belongs to you.
You have the right to:

• Inspect and receive a copy of your health record
• Request a restriction on certain uses and disclosures of your health information. For example, you may ask that we not disclose your health information and or treatment to a family member. TCRHCC is not required to agree to your request; but if we do, we will comply with your request unless the information is needed to provide you with emergency services.
• Request a correction/amendment to your health record if you believe the health information we have about you is incorrect or incomplete, we may amend your record or include your statement of disagreement.
• Request confidential communications about your health information. You may ask that we communicate with you at a location other than your home or by a different means of communications such as telephone or mail.
• Receive a listing of certain disclosures TCRHCC has made of your health information upon request. This information is maintained for six years or the life of the record, whichever is longer.
• Revoke your written authorization to use or disclose health information. This does not apply to health information already disclosed or used or in circumstances where we have taken action on your authorization or the authorization was obtained as a condition of obtaining insurance coverage and the insurer has a legal right to contest a claim under the policy or the policy itself.
• Obtain a paper copy of the TCRHCC Notice of Privacy Practices upon request.
• Obtain a paper copy of the TCRHCC Health and Medical Records; System Notice # 09-17-0001 upon request.

III. TCRHCC' Responsibilities
The Tuba City Regional Health Care Corporation is required by law to:

• Maintain the privacy of your health information
• Inform you about our privacy practices regarding health information we collect and maintain about you
• Notify you if we are unable to agree to a requested restriction
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations
• Honor the terms of this notice or any subsequent revisions of this notice

TCRHCC reserves the right to change its privacy practices and to make the new provisions effective for all protected health information it maintains. If TCRHCC makes any significant changes to this Notice, it will send you a copy within 60 days. TCRHCC also will post any revised Notice of Privacy Practices at public places in its health care facilities and on its web site at www.tcrhcc.org and you may also request a copy of the notice.

TCRHCC understands that health information about you is personal and is committed to protecting your health information. TCRHCC will not use or disclose your health information without your permission, except as described in this notice and as permitted by the Privacy Act and the TCRHCC Health and Medical Records; System Notice 09-17-0001.

IV. How TCRHCC may use and disclose health information about you.
The following categories describe how we may use and disclose health information about you.
We will use and disclose your health information to provide your treatment.

For example: Your personal information will be recorded in your health record and used to determine the course of treatment for you. Your health care provider will document in your health record her/his instructions to members of your healthcare team. The actions taken and the observations made by the members of your healthcare team will be recorded in your health record so your health care provider will know how you are responding to treatment.

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