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Privacy Practices

Privacy Practices

The following is a summary of our Notice of Privacy Practices. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

We are required by law to maintain the privacy of your medical information, and as a patient we must provide you with a copy of this notice and follow the terms of this notice. If the notice is changed in any material way, a revised notice will be available upon request.

Medical Information

  • We will use your medical information for your Treatment. For example, a nurse who is providing your care will report any  changes in your condition to your doctor.
  • We will use your medical information for Payment. For example, we may need to give your insurance plan information about your diagnosis, treatment and supplies used.
  • We will use your medical information for Health Care Operations. For example, we may use your medical information to evaluate our services. We may contact you at any phone number or address you have provided to us to remind you of an appointment or other health care matters or to obtain payment for our services.
  • We may use and disclose your medical information to inform you of treatment alternatives or other health-related benefits and services.
  • We may use your name and address for fund-raising activities.
  • We may include you in our patient directory. You must notify Our Designee in writing if you do not want us to communicate your information in any of these ways.
  • We may use your medical information for any uses that are required or permitted by law. Other uses and disclosures will be made only with your written authorization. You may cancel an authorization at any time by notifying Our Designee in writing.

You have the following rights:

  • To receive a copy of the Culbertson Memorial Hospital Privacy Notice
  • To request restrictions on uses and disclosures of your medical information
  • To receive confidential communications
  • To inspect and copy your medical information
  • To request an amendment to your medical information
  • To have an accounting of disclosures of your medical information.

Contact Information. If you feel that your privacy rights have been violated, please contact our Privacy Officer at 217-322-4321 or the U.S. Secretary of Health and Human Services.

Culbertson Memorial Hospital | 238 S. Congress, Rushville, IL 62681 |Telephone: (217) 322-4321 | Fax: (217) 322-2608 | Contact Us
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