Ask us to restrict how we use or disclose your health information. The request must be in writing. We may not be able to comply with your request if we have already used your authorization, if the information is needed to pay for your care or if we are required by law to disclose it.
Ask us to communicate with you at a special address or by a special means.
Look at or get a copy of your Medicaid information. A personal representative who has the legal right to act for you may look at and get it for you. We have information about your Medicaid eligibility, your health care bills, and some medical records. To get a copy of your records, ask us to send you a form to fill out. We may charge a fee to copy and mail the records. We may keep you from seeing parts of your records when allowed by law.
Ask to change information in your records if it is not correct or complete. We may refuse to change the information if Medicaid did not create or keep it, or if it is already correct and complete. You may request a review of the denial or send a letter to disagree with the denial. This letter will be kept with your Medicaid records.
Ask us for a report of information shared about you for reasons other than treatment, payment, or Medicaid operations. You may ask for a list of those with whom we shared your information, when, why, and what information was shared. The list will start on April 14, 2003.
Ask us to send your information somewhere. You will be asked to sign an authorization form to tell us what information to send and where it is to go. The authorization can be used for up to one year, but you may tell us a specific time. You may write to stop the authorization at any time.
Ask for a paper copy of this Notice of Privacy Practices.