Policy effective: January 1, 2026
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.
Who will follow this notice
Health-care practitioners who treat you at any of our locations, including employees, volunteers, and members of our workforce; all departments and operating units of our organization, and all medical practices operated by us; and our business associates.
Your medical information
This Notice refers to your “medical information”. This means all information that identifies you and relates to your past, present or future physical or mental health or condition, including information about payment and billing for the health-care services you receive.
Our pledge regarding medical information
We understand that your medical information is personal and we are committed to its protection. We create a record of the care and services you receive to ensure that we are providing quality care and to comply with legal requirements. This notice applies to all your medical information that we maintain, whether created by our staff or others.
We are required by law to give you this notice of our legal duties and privacy practices with respect to your medical information, to follow the terms of this Privacy Notice, and to notify you following a breach of the privacy or security of your unsecured medical information.
How we may use and disclose medical information about you
For each category of use and disclosure, we will try to give some examples, although not every use or disclosure in the category will be listed.
a. Treatment
We may use your medical information so that we and other health-care providers may provide you with medical treatment or services. Different health professionals may share your medical information in order to coordinate the different services you need. We may disclose your medical information to people outside our offices and locations who may be involved in your medical care after you leave our care.
b. Payment
We may disclose your medical information so that treatment and services you receive may be billed by us to a third party. For example, your health plan may need to know about treatment you received so they will pay us for the services provided. We may also disclose your medical insurance information to obtain prior approval from your health plan.
c. Health-care operations
We may use and disclose your medical information for our internal operations, such as business management, administrative activities, legal and auditing functions, and insurance-related activities. We may use medical information to make sure that all of our patients receive quality care, such as reviewing our processes or evaluating the performance of those caring for you. We may also disclose information to doctors, nurses, technicians, and other personnel for review and learning purposes. We may remove information that identifies you so others may use it to study healthcare and healthcare delivery without learning a specific patient’s identity. Under certain circumstances, we may disclose your medical information for the health-care operations of other health-care providers.
d. Health information exchange
We may participate in a Regional Health Information Organization (“RHIO”) which arranges for the electronic exchange of health information among health-care providers in the state where we are located. We may exchange your health information electronically through RHIO for the purposes described in this Notice. You have the right to request that your information not be included in this exchange.
e. Individuals involved in your care or payment of your care
We may release your medical information to a friend or family member who is involved in your medical care, or to someone who helped pay for your care.
f. Notification
We may release your medical information to notify a family member, personal representative or another person responsible for your care of your location, general condition, or death. We also may release your medical information for certain disaster-relief purposes.
g. Contacts
We may contact you to provide appointment reminders, information about treatment alternatives, or other health-related benefits and services that may be of interest to you.
h. Worker’s compensation
We may release medical information about you for worker’s compensation or similar programs that provide benefits for work-related injuries or illnesses.
i. Mental health information
State laws create specific requirements for the release of mental-health records. We will obtain your specific authorization to release mental health information when required by these laws.
j. Drug & alcohol treatment records
Specific rules apply to the release of certain drug and alcohol program records. We will obtain your specific authorization to release those records as required by Federal regulation 42 CFR, Part 2.
k. Miscellaneous
We may use or disclose your medical information without your prior authorization for several other reasons. Subject to certain requirements, we may give out your medical information without prior authorization for public-health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements, coroner’s investigations, organ donation, and emergencies. We also may disclose medical information when required by law in response to a request from law enforcement in specific circumstances, for specialized government functions including correctional, military or national-security purposes, in response to valid judicial or administrative orders, or to avoid a serious health threat. Additional specific rules may apply to mental-health records.
l. Other disclosures
Other uses and disclosures not described above will be made only with your written authorization. For example, we require your signed authorization for uses and disclosures that constitute the sale of your medical information and for most uses and disclosures of psychotherapy notes. Additionally, we will not use or disclose your medical information for marketing purposes unless we have a signed authorization from you — except that an authorization will not be required if (a) a communication occurs face-to-face, or (b) the communication consists of marketing gifts of nominal value. You may revoke your authorization at any time unless we have relied on your authorization, or your authorization was required as a condition of obtaining health-care services.
Your rights regarding medical information about you
a. Right to inspect and copy
In most cases you have the right to inspect or receive a copy of your medical information (or have a copy provided to an individual whom you designate) when you submit a written request. If your medical record is maintained electronically in a designated record set, you have the right to request a copy of the information in an electronic form and format. We may deny your request in certain circumstances. If you are denied access to your medical information, you may appeal.
b. Right to amend
If you believe the information in your record is incorrect or incomplete, you have the right to request an addendum be added to your record by submitting a written request giving your reason. We may deny your request under certain circumstances. If we deny it, we may advise you in writing of the reason or explain your rights to submit a statement of explanation.
c. Right to an accounting of disclosures
You have the right to a list of those instances where we have disclosed your medical information other than for treatment, payment, or health-care operations, or where a disclosure was specifically authorized, for the organization’s directory, to persons involved in your care, and certain other limited situations. To request an accounting of disclosures, please submit a written request to our Support Department.
d. Right to a paper copy of this notice
If this notice was sent to you electronically you have a right to a paper copy. You may request that we send other communications of protected health information by alternative means, or to an alternative location. This request must be made in writing to the contact listed in the Contact Information section below. We are required to accommodate only reasonable requests. Please specify in your correspondence exactly how you want us to communicate with you, and if you are directing us to send it to a particular place, the contact and address information.
e. Right to request restrictions
You may request in writing that we not use or disclose your medical information except when specifically authorized by you, when required by law, or in an emergency. Except in the case of certain requests related to disclosures to health plans, we are not required by law to agree to your request, but we will consider it. We will inform you of our decision.
f. Right to request restrictions on disclosures to health plans
You may request in writing that we restrict disclosures of your medical information to a health plan for purposes of carrying out payment or health-care operations if the disclosure is not required by law and the medical information pertains solely to a health-care item or service for which you (or a person other than the health plan acting on your behalf) have paid us out of pocket and in full at the time of service. We must agree to a request that meets these requirements.
Changes to this notice
We reserve the right to change this Notice at any time. Changes will apply to medical information we already hold, as well as new information after the change occurs. We will post a copy of our current notice within our office and on our website.
Complaints and requests
If you have questions about this notice or want to talk about a problem without filing a formal complaint, please contact ICHANGE using the contact information below or email complaints@ichangeprocess.org. Complaints are reviewed by the Executive Director and responded to within ten (10) business days.
If you believe your privacy has been violated, you may file a complaint with our organization or with the Secretary of the U.S. Department of Health and Human Services. Information about how to file a complaint with the Department of Health and Human Services may be found at hhs.gov/ocr/privacy/hipaa/complaints. You will not be penalized for filing a complaint.
Contact information
If you have any questions about this Notice, please contact us by email or regular mail at:
ICHANGE
PO Box 81172
Lansing, MI 48908
community@ichangeprocess.org