Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.

CareConnect Health Inc. and its medical providers respect your privacy. We understand that your health information is very sensitive. Your health information includes, for example, your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information relating to these services.

The law protects the privacy of the health information we create and obtain in providing our care and services to you. We will not disclose your information to others unless you tell us to do so or unless the law authorizes or requires us to do so.

The following general categories describe ways we use and disclose your health information. Not every use and disclosure in a category will be listed.

Uses and Disclosures of Your Health Information For Treatment, Payment, and Health Care Operations

For treatment. We may use and disclose your health information to coordinate and manage your treatment and other services. For example, information obtained by a nurse, physician or member of our healthcare team will be recorded in your medical record and used to help decide what care may be right for you. We also may provide information to others providing you care, such as your primary care physician.

For payment. We may use and disclose your health information to bill and collect payment from you.

For health care operations. We may use and disclose your health information for our operations, such as to assess quality and improve services. We may contact you to remind you about appointments and give you information about treatment alternatives or other health-related benefits and services.

Uses and Disclosures of Your Health Information Without Authorization

CareConnect Health Inc. will disclose your health information without your authorization only in specific situations which are legally required or allowed. These include:

As Required by Law

For Public Health purposes to public health or legal authorities:

To protect public health and safety.

To prevent or control disease, injury, or disability.

To report vital statistics such as births or deaths.

To Report Suspected Abuse, Neglect, or Domestic Violence to public authorities.

For Law Enforcement Purposes such as when we receive a warrant, subpoena, court order, or other legal process, or you are the victim of a crime.

For Health Oversight Activities. For example, we may share health information with the Department of Health for audits, investigations, inspections, and licensure.

For Disaster Relief Purposes. For example, we may share health information with disaster relief agencies to assist in notification of your condition to family or others.

With Medical Researchers in certain limited circumstances.

To Funeral Directors or Coroners consistent with applicable law to allow them to carry out their duties.

To Organ Procurement Organizations (tissue donation and transplant) or persons who obtain, store, or transplant organs.

To the Food and Drug Administration relating to problems with food, supplements, and products.

To Comply with Workers’ Compensation Laws if you make a workers’ compensation claim.

To Correctional Institutions, if you are in jail or prison, as necessary for your health and the health and safety of others.

To the Military Authorities of U.S. and Foreign Military Personnel if you are a member of the armed forces.

In the Course of Judicial/Administrative Proceedings at your request or as directed by a subpoena or court order.

To Avert a Serious Threat to Health or Safety to you or someone else. The disclosure would be only to someone who is likely to help prevent the threat.

For Specialized Government Functions. For example, we may share information for national security purposes.

To Our Business Associates who have agreed to protect your health information.

Incidental Disclosures which may occur as a by-product of permitted uses and disclosures.

De-identified Information and Limited Data Sets, which is health information that has had certain identifiers (such as name and address) removed, making it unlikely that you could be identified.

Uses and Disclosures with Authorization

Other uses and disclosures of your health information, not covered by this Notice or permitted by law, will be made only with your written authorization, including the use or disclosure of your health information for marketing or for the sale of your health information. You may revoke your authorization, in writing, at any time (unless you are told otherwise at the time you sign the authorization). If you revoke your authorization, then we will no longer use or disclose your health information for the reasons covered by your authorization, except to the extent that we already have relied on your authorization. We cannot take back any disclosures we already have made in reliance on your authorization, and we are required to retain our records of the care that we provided to you.

Your Health Information Rights

The health and billing information we create and store are our property. The protected health information in it, however, generally belongs to you. You have a right to:

Receive this Notice. You have the right to receive, read, and ask questions about this Notice. If you have received an electronic version, you also have the right to receive a paper copy of this Notice.

Request Additional Privacy Protections. You have the right to ask us to restrict certain uses and disclosures. For example, you may request that we restrict disclosure of your protected health information to a health plan when your services are paid in full out of pocket. You must deliver this request in writing to us. We are not required to grant the request, but we will comply with any request granted.

Access Your Health Information. You have the right to request that you be allowed to see and get a copy of your health information kept in a designated record set. You must make this request in writing. We have a form available for this type of request. We may deny this request in certain limited situations, and we will inform you of any denial.

Request an Amendment. You have the right to ask us to change your health information that is inaccurate or incomplete. You must give us this request in writing. You may write a statement of disagreement if your request is denied. It will be stored in your medical record, and included with any release of your records.

Accounting of Disclosures. You have the right to request a list of certain disclosures of your health information. The list will not include disclosures for treatment, payment, health care operations, and certain other types of disclosures. You may receive this information without charge once every 12 months. We will notify you of the cost involved if you request this information more than once in 12 months.

Request Alternative Communications. You have the right to ask that your health information be given to you by another means or at another location. You must make this request in writing. For help with these rights during normal business hours, please contact the Privacy Officer at 229-273-8881.

Our Responsibilities

We are required to:

Keep your protected health information private.

Provide you notice of a breach of unsecured protected health information.

Give you this Notice.

Follow the terms of this Notice.

To Ask for Help or File a Complaint

If you have questions, want more information, or want to report a problem about the handling of your health information, you may contact the Privacy Officer at 229-273-8881.

You also may deliver a written complaint to Privacy Officer at PO Box 5610, Cordele, GA 31010. You also may file a complaint with the U.S. Secretary of Health and Human Services.

We respect your right to file a complaint with us or with the U.S. Secretary of Health and Human Services. If you file a complaint, we will not retaliate against you.

Changes to This Notice

We reserve the right to change this Notice. The revised Notice will be effective for information we already have about you as well as any information we receive in the future. Unless required by law, the revised Notice will be effective on the new effective date of the Notice. The current Notice will be available from any of our staff areas or on our website. The Notice will state an effective date.


Standard e-mail is not secure. Transmissions could be read by third parties or stored on intermediary computers. If you choose to communicate with your health care providers by standard e-mail, CareConnect Health Inc. cannot guarantee the privacy of your communication or of our return response.