HIPAA
NOTICE OF PRIVACY PRACTICES
Effective
Date:
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.
This
notice describes our hospital’s practices and that of:
Ø Any health care professional
authorized to enter information into your hospital medical record.
Ø All departments and units of Park
Hospital District DBA/
Ø Any member of a volunteer group we
allow to help you while you are in Park Hospital District DBA/
Ø All employees, staff and other Park
Hospital District DBA/
Ø
Any
employee, member or volunteer of Medical Specialty Clinic, and/or Family
Medical Clinic follow the terms of this notice.
In addition, these entities may share medical information with each
other for treatment, payment or hospital operations purposes described in this
notice.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We
are required by law to:
·
make
sure that medical information that identifies you is kept private;
·
give
you this notice of our legal duties and privacy practices with respect to
medical information about you; and
·
follow
the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL
INFORMATION ABOUT YOU
Ø
For Treatment.
We may use medical information about you to provide you with medical
treatment or services. We may disclose
medical information about you to doctors, nurses, technicians, medical
students, or other EPMC personnel who are involved in taking care of you at
EPMC. For example, a doctor treating you
for a broken leg may need to know if you have diabetes because diabetes may
slow the healing process. In addition,
the doctor may need to tell the dietitian if you have diabetes so that we can
arrange for appropriate meals. Different departments of EPMC also may share
medical information about you in order to coordinate the different things you
need, such as prescriptions, lab work and x-rays. We also may disclose medical information
about you to people outside of EPMC who may be involved in your medical care
after you leave EPMC, such as family members, clergy or others we use to
provide services that are part of your care.
Ø
For Payment.
We may use and disclose medical information about you so that the
treatment and services you receive at EPMC may be billed to and payment may be
collected from you, an insurance company or a third party. For example, we may need to give your health
plan information about surgery you received at EPMC so your health plan will
pay us or reimburse you for the surgery.
We may also tell your health plan about a treatment you are going to
receive to obtain prior approval or to determine whether your plan will cover
the treatment.
Ø
For Health Care Operations.
We may use and disclose medical information about you for EPMC's
operations. These uses and disclosures
are necessary to run the EPMC and make sure that all of our patients receive
quality care. For example, we may use
medical information to review our treatment and services and to evaluate the
performance of our staff in caring for you.
We may also combine medical information about many EPMC's patients to
decide what additional services EPMC should offer, what services are not
needed, and whether certain new treatments are effective. We may also disclose information to doctors,
nurses, technicians, medical students, and other EPMC personnel for review and
learning purposes. We may also combine
the medical information we have with medical information from other hospitals
to compare how we are doing and see where we can make improvements in the care
and services we offer. We may remove
information that identifies you from this set of medical information so others
may use it to study health care and health care delivery without learning who the
specific patients are.
Ø
Appointment Reminders.
We may use and disclose medical information to contact you as a reminder
that you have an appointment for treatment or medical care at EPMC.
Ø
Treatment Alternatives.
We may use and disclose medical information to tell you about or
recommend possible treatment options or alternatives that may be of interest to
you.
Ø Health-Related Benefits and Services.
We may use and disclose medical information to tell you about
health-related benefits or services that may be of interest to you.
Ø
Fundraising Activities.
We may use medical information about you to contact you in an effort to
raise money for EPMC and its operations.
We may disclose medical information to a foundation related to EPMC so
that the foundation may contact you in raising money for EPMC. We only would release contact information,
such as your name, address and phone number and the dates you received
treatment or services at EPMC. If you do
not want to be contacted you for fundraising efforts, you must notify Estes
Park Medical Center Administration in writing using the appropriate form.
Ø
Hospital Census.
We may include certain limited information about you in the hospital
directory while you are a patient at EPMC.
This information may include your name, location in the hospital, and
your general condition (e.g., fair, stable, etc.). The census information may also be released
to people who ask for you by name. This is so your family, friends and clergy
can visit you in the hospital and generally know how you are doing. The information may also be shared with the
hospital Chaplain.
Ø
Individuals Involved in Your Care
or Payment for Your Care. We may release
medical information about you to a friend or family member who is involved in
your medical care. We may also give information
to someone who helps pay for your care.
We may also tell your family or friends your condition and that you are
in the hospital. In addition, we may
disclose medical information about you to an entity assisting in a disaster
relief effort so that your family can be notified about your condition, status
and location.
Ø As Required By Law. We will
disclose medical information about you when required to do so by federal, state
or local law.
Ø
To Avert a Serious Threat to Health
or Safety. We may use and disclose medical information
about you when necessary to prevent a serious threat to your health and safety
or the health and safety of the public or another person. Any disclosure, however, would only be to someone
able to help prevent the threat.
SPECIAL
SITUATIONS
Ø
Organ and Tissue Donation.
If you are an organ donor, we may release medical information to
organizations that handle organ procurement or organ, eye or tissue
transplantation or to an organ donation bank, as necessary to facilitate organ
or tissue donation and transplantation.
Ø
Military and Veterans.
If you are a member of the armed forces, we may release medical
information about you as required by military command authorities. We may also release medical information about
foreign military personnel to the appropriate foreign military authority.
Workers' Compensation.
We may release medical information about you for workers' compensation
or similar programs. These programs
provide benefits for work-related injuries or illness.
Ø Public Health Risks. We may
disclose medical information about you for public health activities. These activities generally include the
following:
·
to
prevent or control disease, injury or disability;
·
to
report births and deaths;
·
to
report child abuse or neglect;
·
to
report reactions to medications or problems with products;
·
to
notify people of recalls of products they may be using;
·
to
notify a person who may have been exposed to a disease or may be at risk for
contracting or spreading a disease or condition;
·
to
notify the appropriate government authority if we believe a patient has been
the victim of abuse, neglect or domestic violence. We will only make this disclosure if you
agree or when required or authorized by law.
Ø
Health Oversight Activities.
We may disclose medical information to a health oversight agency for
activities authorized by law. These
oversight activities include, for example, audits, investigations, inspections,
and licensure. These activities are
necessary for the government to monitor the health care system, government
programs, and compliance with civil rights laws.
Ø
Lawsuits and Disputes.
If you are involved in a lawsuit or a dispute, we may disclose medical
information about you in response to a court or administrative order. We may also disclose medical information
about you in response to a subpoena, discovery request, or other lawful process
by someone else involved in the dispute, but only if efforts have been made to
tell you about the request or to obtain an order protecting the information
requested.
Ø
Law Enforcement.
We may release medical information if asked to do so by a law
enforcement official:
·
In
response to a court order, subpoena, warrant, summons or similar process;
·
To
identify or locate a suspect, fugitive, material witness, or missing person;
·
About
the victim of a crime if, under certain limited circumstances, we are unable to
obtain the person's agreement;
·
About
a death we believe may be the result of criminal conduct;
·
About
criminal conduct at EPMC; and
·
In
emergency circumstances to report a crime; the location of the crime or
victims; or the identity, description or location of the person who committed
the crime.
Ø
Coroners, Medical Examiners and
Funeral Directors. We may release medical information to a
coroner or medical examiner. This may be
necessary, for example, to identify a deceased person or determine the cause of
death. We may also release medical
information about patients of the hospital to funeral directors as necessary to
carry out their duties.
Ø
National Security and Intelligence
Activities. We may release medical information about you
to authorized federal officials for intelligence, counterintelligence, and
other national security activities authorized by law.
Ø
Protective Services for the
President and Others. We may disclose medical
information about you to authorized federal officials so they may provide
protection to the President, other authorized persons or foreign heads of state
or conduct special investigations.
In general, we may disclose a minor
patient’s PHI to a parent or guardian, but we may deny the parent’s access to
the minor patient’s PHI in some situations according to Colorado Laws regarding
parents’ and minors.
OTHER
USES OF MEDICAL INFORMATION.
Other
uses and disclosures of medical information not covered by this notice or the
laws that apply to us will be made only with your written permission. If you provide us permission to use or
disclose medical information about you, you may revoke that permission, in
writing, at any time. If you revoke your
permission, we will no longer use or disclose medical information about you for
the reasons covered by your written authorization. You understand that we are unable to take
back any disclosures we have already made with your permission, and that we are
required to retain our records of the care that we provided to you.
YOUR RIGHTS REGARDING
MEDICAL INFORMATION ABOUT YOU.
You
have the following rights regarding medical information we maintain about you:
Ø
Right to Inspect and Copy.
You have the right to inspect and copy medical information that may be
used to make decisions about your care.
Usually, this includes medical and billing records, but does not include
psychotherapy notes.
To inspect
and copy medical information that may be used to make decisions about you, you
must submit your request in writing to the Health Information Management
department. If you request a copy of the
information, we will charge a fee for the costs of copying, mailing or other
supplies associated with your request.
We may deny your request to inspect
and copy in certain very limited circumstances.
If you are denied access to medical information, you may request that
the denial be reviewed. Another licensed
health care professional chosen by EPMC will review your request and the
denial. The person conducting the review
will not be the person who denied your request.
We will comply with the outcome of the review.
Ø
Right to Amend.
If you feel that medical information we have about you is incorrect or
incomplete, you may ask us to amend the information. You have the right to request an amendment
for as long as the information is kept by or for EPMC.
To request an amendment, your request
must be made in writing and submitted to the Chief Privacy Officer. In addition, you must provide a reason that
supports your request.
We may deny your request for an
amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you
ask us to amend information that:
·
Was
not created by us, unless the person or entity that created the information is
no longer available to make the amendment;
·
Is
not part of the medical information kept by or for EPMC;
·
Is
not part of the information which you would be permitted to inspect and copy;
or
·
Is
accurate and complete.
Ø Right to an Accounting of Disclosures.
You have the right to request an "accounting of
disclosures." This is a list of the
disclosures we made of medical information about you.
To request this list or accounting
of disclosures, you must submit your request in writing to the Chief Privacy
Officer. Your request must state a time
period which may not be longer than six years and may not include dates before
Ø
Right to Request Restrictions.
You have the right to request a restriction or limitation on the medical
information we use or disclose about you for treatment, payment or health care
operations. You also have the right to
request a limit on the medical information we disclose about you to someone who
is involved in your care or the payment for your care, like a family member or
friend. For example, you could ask that
we not use or disclose information about a surgery you had.
We are not required to agree to your request. If we do agree, we will comply with your
request unless the information is needed to provide you emergency treatment.
To request restrictions,
you must make your request in writing to the Chief Privacy Officer. In your request, you must tell us (1) what
information you want to limit; (2) whether you want to limit our use,
disclosure or both; and (3) to whom you want the limits to apply, for example,
disclosures to your spouse.
Ø
Right to Request Confidential
Communications. You have the right to request that we
communicate with you about medical matters in a certain way or at a certain
location. For example, you can ask that
we only contact you at work or by mail.
To request
confidential communications, you must make your request in writing to the Chief
Privacy Officer. We will not ask you the
reason for your request. We will
accommodate all reasonable requests.
Your request must specify how or where you wish to be contacted.
Ø
Right to a Paper Copy of This
Notice. You have the right to a paper copy of this
notice. You may ask us to give you a
copy of this notice at any time. Even if
you have agreed to receive this notice electronically, you are still entitled
to a paper copy of this notice.
You may obtain a copy of this
notice at our website, www.epmedcenter.com.
To
obtain a paper copy of this notice, mail your request to: Chief Privacy
Officer, Estes Park Medical Center, 555 Prospect AVE, PO Box 2740, Estes Park,
CO 80517
CHANGES
TO THIS NOTICE
Ø
We
reserve the right to change this notice.
We reserve the right to make the revised or changed notice effective for
medical information we already have about you as well as any information we
receive in the future. We will post a
copy of the current notice in EPMC. The
notice will contain on the first page, the effective date. In addition, each time you register at or are
admitted to EPMC for treatment or health care services as an inpatient or
outpatient, we will offer you a copy of the current notice in effect.
COMPLAINTS
If you
believe your privacy rights have been violated, you may file a complaint with
EPMC or with the Secretary of the Department of Health and Human Services. To file a complaint with EPMC, contact Nancy
Dietz, RHIT, Chief Privacy Officer, Estes Park Medical Center, 555 Prospect
AVE, PO Box 2740, Estes Park, CO 80517; 970-586-2317, ext. 452. All complaints must be submitted in writing.
You will not be penalized
for filing a complaint.