HIPAA & Your Privacy Rights

Neither ACMC nor its Affiliated Providers will use or disclose your medical information unless you allow us to do so in writing. If you do give us permission to use or disclose your medical information for another purpose, you have the right to change your mind and revoke the permission at any time.

Access to Your Health Information

You may request that ACMC and its Affiliated Providers not use your medical information in certain ways or for certain purposes. You may also request that ACMC and its Affiliated Providers not provide your medical information to certain people. However, ACMC and its Affiliated Providers have the right to refuse your request, and ACMC and its Affiliated Providers may use or disclose your medical information in situations requiring emergency treatment, in which case we will ask the person(s) who receive the information not to further use or disclose the information.

You may request that ACMC and its Affiliated Providers provide you with your medical information in a confidential manner. For example, you can request that we send your appointment reminders, bills, and other mailings to a different address or that we notify you of this kind of information in another way, such as by a phone call. You must make this request in writing and specify another address or means of communication. We may also ask you to give us information on how you will pay your bills.

You may ask to see and copy your medical records, unless that information is protected by law. You must make these requests in writing. If your request to look at or copy your medical records is denied, you have the right to have the denial reviewed by a health care professional. We will act upon your request within 30 days, and we may charge you a legally acceptable amount for copying costs.

You may ask ACMC and its Affiliated Providers to change information in your medical records. If your request is denied, you can write a statement of disagreement with the denial that we will keep with your medical information.

You may ask ACMC and its Affiliated Providers to provide you with information about certain disclosures of your medical information in the past.

If you have received this notice of your medical information privacy rights electronically, you may ask ACMC and its Affiliated Providers to provide you with a paper copy.

Patient Recourse if Privacy Protections are Violated

If you feel your medical information privacy rights have been violated, you may file a complaint with the Secretary of Health and Human Services, and/or with ACMC and its Affiliated Providers contact person listed below. Filing a complaint will not affect the quality of the services you receive from ACMC and physicians on its staff and you will not be retaliated against for filing a complaint.

You can contact the designated privacy official:
Name: Terry Tone
Title: Administrator
Phone Number: 320-231-5000
Address: ACMC-Willmar, 101 Willmar Avenue SW, Willmar MN 56201

You also have the right to report any violation to the Department of Health and Human Services, Office of Civil Rights, 200 Independence Avenue, S.W. Washington, D.C. 20201.

ACMC and its Affiliated Providers are required by law to maintain the privacy of protected health information and to provide individuals with this notice of its legal duties and privacy practices with respect to health information. ACMC and its Affiliated Providers are required to abide by the terms of the notice currently in effect. ACMC and its Affiliated Providers reserve the right to change the terms of this notice and to make a new notice provisions effective for all protected health information maintained by ACMC and/or its Affiliated Providers. If the terms of this notice are changed, ACMC and/or its Affiliated Providers will provide individuals with a revised notice upon request and by posting the revised notice in designated locations at ACMC.

There are situations where healthcare providers may not have to follow these privacy rules. They include: emergency circumstances, identification of a body or the cause of death, public health needs, judicial and administrative proceedings, limited law enforcement activities, and activities related to national defense and security. We understand your right to have your medical information kept confidential. Our compliance with the Health Information Portability and Accountability Act is one example of our advocacy and leadership on issues of patient's rights and privacy of information. We encourage you to ask questions and look forward to working together to improve the quality of your healthcare experience.