Privacy Officer:

The designated Privacy Officer for Valued Relationships Inc. is Dale Torrence. Telephone = 1-888-526-1456. Address = 355 N. Main St. Springboro, Oh 45066

Privacy Notice:

Each member is to receive and sign a Privacy Notice. The original shall be retained in the files of VRI and the member will be provided a copy of the notice. If the member can not sign the Privacy Notice the documented efforts to obtain the signature will be placed in the member's file.

Uses of health information:

Health care information shall be provided to organizations that are involved in treatment and/or safety of the member. Example: (health care information is provided to a monitoring center that in turn may provide the information to Responders that are responding to an emergency situation). (The outcome of an emergency situation is in turn reported the member’s Case Manager to enhance health care outcomes).

Minimal health care information shall be provided to our Business Associates in order to invoice Governmental Agencies for services rendered to members on behalf of the Agencies.

Disclosures of Health care information:

In certain situations it may be necessary to disclose health care information under State legal regulations such as Adult Protective Services. In each such disclosure the member will be notified of said disclosure.

Permission to Disclose Health care information:

In situations not covered by the above the members permission to disclose the information will be obtained in advance in writing.

Patient Rights:

To access your health care information, contact the Privacy Officer. An access request form may be obtained at 355 N. Main St. Springboro, Oh. 45066.

Access shall mean: the right to see data, the right to request amendments to the data, the right to an accounting of disclosures made by the provider, the right to place restrictions on uses and disclosures and the right for the communications to be confidential.

The Privacy Officer will respond to your request in writing within (60) sixty days. If your request is denied you may request an independent review of your request. This independent review form may be obtained at 355 N. Main St. Springboro, Oh. 45066. It is to be submitted to the Privacy Officer. The independent review will take place and be responded to within (60) sixty days.

Employee Responsibility:

It is each employee responsibility to safeguard each member health information. Each of us must be familiar with the Privacy policies to protect our members. The policy breaks down into four elements (see above) (Uses, Minimal, Disclosures & Permission). Disclosures and Permission are to be handled by the Privacy Officer. An inadvertent disclosure must be reported to the Privacy Officer. Failure to comply with the Privacy policy shall result in progressive disciplinary actions as outlined in our employee manual. Employees shall attend a training session conducted by the Privacy Officer to insure their understanding of the Privacy policy.

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