Notice of Privacy Practices

The following Notice of Privacy Practices describes how you health information may be used and disclosed, and how you can get access to this information. Please review this information carefully.
Effective: November 1, 2015
  1. Your personal health information may be released to other healthcare professionals within CommWell Health (“CWH”) for the purposes of providing you with quality, comprehensive care.
  2. Your personal health information may be released to your insurance provider for the purpose of CWH receiving payment for providing you with needed healthcare services.
  3. Your personal health information may be released to public or law enforcement officials in the event of an investigation in which you are a victim or abuse, a crime or domestic violence.
  4. Your personal health information may be release to other healthcare providers in the event you need emergency care. 
  5. Your personal health information may be released to a pubic health organization or federal organization in the event of a communicable disease or to report a defective device or an adverse event to food or medication.
  6. Your personal health information may not be released for any other purpose than that which is identified in this notice.
  7. Your personal health information may be released only after receiving written authorization from you. You may revoke your permission to release personal healthcare information at any time.
  8. You may be contact by CWH to remind you of any appointments, healthc are treatment options or other health services that may be of interest to you.
  9. You have the right to restrict the use of your personal health informational. However, CWH may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of an emergency situation.
  10. You have the right to receive confidential communication about your health status.
  11. You have the right to review and receive a copy of any/all portions of your healthcare information. 2,3
Notice of Privacy Practices, continued
  1. You have the right make changes regarding the healthcare information that you have provided.
  2. You have the right to know who has accessed your personal healthcare information and for what purpose.
  3. You have the right to possess a copy of our Notice of Privacy Practices upon request.
  4. CWH is required by law to protect the privacy of its patients and clients including all applicable State and Federal laws (42CFR4 Part2; 45 CFR; NC General Statute 122C-53). We will keep confidential any and all healthcare information and will provide patients with a list of duties or practices that protect confidential healthcare information.
  5. CWH will abide by the terms of this notice. CWH reserves the right to make changes to the notice and continue to maintain confidentiality of all healthcare information. We will post a copy of our current notice in all our sites. Our notice will indicate the effective date on the first page. We will also give you a copy of our current notice upon request. You have the right to complain to CWH or the Secretary of the Department of Health and Human Services if you believe your rights to privacy have been violated. All complaints will be investigated. No personal issue will be ra ised for filing a complaint with CWH. If you feel your privacy rights have been violated or you want further information about our Notice of Privacy Practices, please write or call CWH privacy contact person at:
Attn: Privacy Officer
CommWell Health
PO Box 227
Newton Grove, NC 28366
Tel. (910)567-6194
1-Tri-County Community Health Council, Inc. doing business as CommWell Health of Newton Grove,
Salemburg, Harrells, Smithfield, Four Oaks, Dublin, Tar Heel, Shallotte, Ocean Isle Beach, McGees
CrossRoads, Bolivia/Supply, Building Bridges, Harvest House, Angelic House.
2-A copy fee may apply under NC General Statute 90-411.
3-Release of behavioral health records may be limited under NC General Statute 122c.
4-CFR—Code of Federal Regulations.

CommWell Health

1-877-935-5255 | Contact Us

3331 Easy Street Dunn, NC 28366

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