We understand that medical information about you and your health is personal and we are committed to protecting privacy while providing quality services. This Notice of Privacy Practice applies to all records generated by Northern Plains Laboratory.

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

We are legally required to protect the privacy of your health information. We call this information “protected health information,” or (PHI) and it includes information that can be used to identify you regarding your past, present or future health condition, the provision of health care to you, or the payment of health care services. We must provide you with this notice about our privacy practices that explains how, when and why we use and disclose your PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure.

We reserve the right to change the terms of this notice and our privacy policies. Any changes will apply to the current PHI in our possession. Before we make a change to our policies, we will promptly change this notice and post a new notice in our main reception area. You can request a copy of this notice from our Privacy Officer by calling 701-222-2480.

How we may use and disclose your protected health information

We use and disclose PHI for many different reasons. For some of these uses and disclosures, we need your written authorization. Within this notice we describe the different categories of our uses and disclosures.

Effective Date of this Notice
July 1, 2005

Uses and Disclosures Which Do Not Require Your Authorization

We may use and disclose your PHI without your authorization for the following reasons.

For Treatment. We may disclose your PHI to physicians, nurses, medical students and other health care personnel who provide you with health care services or are involved in your care.

For Payment. We may use and disclose your PHI in order to bill and collect payment for the services provided to you.

For Health Care Operations. We may disclose your PHI in order to evaluate the quality of services you received or to evaluate the performance of the health care professionals who provided health care services to you. We may also provide your PHI to our accountants, attorneys, consultants, and others in order to make sure we are complying with the laws that affect us.

For Disclosure. We will make disclosures when a law requires that we report information to government agencies, law enforcement, judicial or administrative proceedings.

For Public Health Activities. We report information about various diseases to government officials in charge of collecting that information.

For Health Oversight Activities. We will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.

To Avoid Harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

For Specific Government Functions. We may disclose PHI of military personnel and veterans in certain circumstances.

For Workers’ Compensation Purposes. We may provide PHI in order to comply with Workers' compensation laws.

Uses and Disclosures Require You to Have the Opportunity to Object.

Disclosures to Family, Friends, or Others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment of your health care, unless you object in whole or in part.

Other Uses of Health Information. In any other situation, not described in this notice, we will ask your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization in writing to stop any future uses and disclosures.

What Rights You Have Regarding Your PHI

You have the following rights with respect to your PHI.

The Right to Request Limits on Uses and Disclosures of your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.

The Right to Choose How We Send PHI to You. You have the right to ask that we send information to an alternate address (to your work address rather than your home) or by alternate means (e-mail instead of regular mail). We must agree to your request as long as we can easily provide it in the format you request.

The Right to Inspect and Copy Your PHI. In most cases, you have the right to look at or to get copies of your PHI that we have, but you must make the request in writing. If we do not have your PHI but we know who does, we will tell you how to get it. We will respond to you within 30 days after receiving your request.

If You Request Copies of Your PHI. There will be no charge for the first 10 pages. Beginning with page 11, we will charge a $5.00 handling fee plus .50 per page.

The Right to Get a List of the Disclosures We Have Made. You have the right to get a list of the instances in which we have disclosed your PHI. The list will not include uses or disclosures for treatment, payment, or healthcare operations; information which you have authorized us to disclose; national security; law enforcement as required by state or federal law; information released prior to April 1, 2003.

The Right to Correct or Update Your PHI. If you believe there is a mistake in your PHI or that a piece of information is missing, you have the right to request that we correct the existing information or add the missing information. You must provide the request and your reason in writing. We will respond within 30 days of receiving your request. We may deny your request in writing if the PHI is (1) correct and complete, (2) not created by us, (3) not allowed to be disclosed, or (4) not part of our records. If we approve your request, we will make the change to your PHI, tell you that we have done so and tell others that need to know about the change to your PHI.

The Right to Get this Notice by E-Mail. You have the right to get a copy of this notice by e-mail. You also have the right to request a paper copy of this notice even if you have agreed to receive this notice by e-mail.

For More Information or to Report a Problem.

If you have questions and/or would like additional information regarding any rights included in this Notice of Privacy Practices, you may contact Northern Plains Laboratory Privacy Officer at 701-222-2480 or write to:

Northern Plains Laboratory
Privacy Officer
3502 Franklin Avenue
Bismarck ND 58503

You may also contact the United States Secretary of Health and Human Services at 1-877-696-6775 (toll free), or e-mail hhsmail@os.dhhs.gov. There will be no retaliation for filing a complaint.