Patient Rights & Privacy Practices
Patient Rights
You have the right to privacy and confidentiality of both your office visits and medical records, within the limits of the law.
You have the right to view your medical records and have them explained to you.
You have the right to adequate education and counseling regarding your medical condition.
You have the right to have all procedures, risks, benefits and alternatives explained and your questions answered in plain language.
You have the right to have medication benefits and possible side effects explained to you.
You have the right to see your test results and have them explained to you.
You have the right to get the names, qualifications and titles of the professionals providing your care.
You have the right to participate in decisions made about treatments, medications, procedures and surgery.
You have the right to refuse treatment to the extent permitted by law and the right to receive information on options and results of refusing treatment.
You have the right to have fees explained to you.
You have the right to decide whether or not to participate in clinical research studies.
Notice of Privacy Practices
When it comes to your health information, you have certain rights. You have the right to:
Get a copy of your medical record
Correct your medical record
Request confidential communication
Ask us to limit the information we share
Get a list of those with whom we’ve shared your information
Get a copy of this complete detailed privacy notice
Choose someone to act for you in your medical care
File a complaint if you believe your privacy rights have been violated
For certain health information, you have choices in the way we use and share your information:
In these cases, you have both the right and choice to tell us who to share with
In certain cases we never share your information unless you give us written information
We can contact you for fundraising but you can tell us not to contact you again
We may use and share your information as we:
Treat you
Improve our care and contact you
Bill for your services
Help with public health and safety issues
Comply with all laws
Work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
Respond to lawsuits and legal actions
Our responsibilities:
We are required by law to maintain the privacy and security of your protected health information.
We will tell you promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing.
Privacy Officer:
Denise Highfill
HR & Compliance Officer
(530) 474-3390 ext. 318
Privacy Contact:
Tami Fraser
CEO
(530) 474-3390 ext. 307
Privacy Contact:
Tammy Rizzi
Business Office Manager
(530) 474-3390 ext. 322
Patients’ Responsibility
Patients have the responsibility to give honest, accurate and complete medical history information.
Patients have the responsibility to make sure they understand what the health care provider is saying and if not, ask questions for clarification.
Patients have the responsibility to follow their provider’s medical advice and instructions.
Patients should report any significant changes in their health to their health care provider.
Patient must respect Shingletown Medical Center office policies, procedures, and staff.
Patient should keep their appointment or cancel in advance. Patients arriving more than 15 minutes late will be rescheduled or treated as a walk-in.
Disability and Injury Verifications
Information can be obtained at the front desk
Specific questions should be directed to your health care provider
Anti-Discrimination Policy
Shingletown Medical Canter complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SMC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Shingletown Medical Center provides free aids and services to people with disabilities to communicate effectively with us, such as: qualified sign language interpreters, written information in other formats (large print, audio, accessible electronic formats, other formats), and provides free language services to people whose primary language is not English, such as: qualified interpreters or information written in other languages. If you need these services, please contact Denise Highfill, Civil Rights Coordinator at (530) 474-3390 ext. 318.
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If you believe that Shingletown Medical Center has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
Denise Highfill, Chief Operations Officer
31292 Alpine Meadows Rd
Shingletown, CA 96088Direct: (530) 474-3390 ext. 318
Toll Free: 1-800-855-7100 or 711 from a Frontier Communications numberYou can also fax to (530) 474-4899 or email to dhighfill@shingletownmedcenter.org. If you need help filing a grievance, Denise Highfill is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW Room
509F, HHH Building Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)Complaint forms are available online.
Shingletown Medical Center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health related claims including medical malpractice claims for itself and its covered individuals.a
