NOTICE OF PRIVACY POLICIES FOR OHIO VALLEY HEARTCARE
THIS NOTICE DESCRIBES HOW
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE REVIEW IT
CAREFULLY.
At Ohio Valley HeartCare, we are committed
to treating and using protected health information about you responsibly. This Notice of Health Information Practices
describes the personal information we collect, and how and when we use or
disclose that information. It also
describes your rights as they relate to your protected health information. This Notice is effective April 14, 2003, and
applies to all protected health information as defined by federal regulations.
Understanding
Your Health Record/Information
Each time you visit Ohio Valley
HeartCare, we make a record of your visit. Typically, this record contains your
symptoms, examination and test results, diagnoses, treatment, and a plan for
future care or treatment. This information, often referred to as your health or
medical record, serves as a:
• Basis for planning your care and
treatment,
• Means of communication among the many
health professionals who contribute to your care,
• Legal document describing the care you
received,
• Means by which you or a third-party payer
can verify that services billed were actually provided,
• A tool in educating heath professionals,
• A source of data for medical research,
• A source of information for public health
officials charged with improving the health of this state and the nation,
• A source of data for our planning and
marketing,
• A tool with which we can assess and
continually work to improve the care we render and the outcomes we achieve.
Understanding what is
in your record and how your health information is used helps you to: ensure its
accuracy, better understand who, what, when, where, and why others may access
your health information, and make more informed decisions when authorizing
disclosure to others.
Your
Health Information Rights
Although your health record is the
physical property of Ohio Valley HeartCare, the information belongs to you. You
have the right to:
• Obtain a paper copy of this notice of
privacy practices upon request. You may ask for a copy at any time.
• Inspect and copy your health information,
such as medical and billing records, that we may use to make decisions about
your care. You must submit a written request to the Privacy Officer in order to
inspect and /or copy your health information. If you request a copy, we may
charge a fee for the costs of copying, mailing or other associated supplies. We
may deny your request to inspect and /or copy in certain limited circumstances.
If you are denied access to your health information, you may ask that the
denial be reviewed. If such a review is
required by law, we will select a licensed healthcare professional to review
your request and our denial. The person conducting the review will not be the
person who denied your request, and we will comply with the outcome of the
review.
• Amend your health information if you
believe that 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 as
long as the information is kept by this office. To request an amendment,
complete and submit a Medical Record Amendment/Correction form to the Privacy
Officer. 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:
a)
We did not create.
b)
Is not part of the health information we keep.
c)
You would not be permitted to inspect and copy.
d)
Is accurate and complete.
• Obtain an accounting of disclosures of
your health information. This is a list of the disclosures we made of medical
information about you for purposes other than treatment, payment and healthcare
operations. To obtain this list, you must submit your request in writing to the
Privacy Officer. It must state a time period, which may not be longer than six
years and may not include dates before April 14, 2003. Your request should
indicate in what form you want the list. We may charge you for the cost of
providing the list. We will notify you of the cost involved and you may choose
to withdraw or modify your request at that time before any costs are incurred.
• Request communications of your health
information by alternative means or at alternative locations.
• Request a restriction on certain uses and
disclosures of your information. You
also have the right to request a limit on the health information we disclose
about you to someone who is involved in your care or the payment for it, such
as family member or friend. For example, you could ask that we not disclose
information about a surgery you had. To request such restrictions, you may
complete and submit the Request For Restriction On Use/Disclosure of Medical
Information and or Confidential
Communication to the Privacy Officer. We will not ask you the reason for your
request. We will accommodate all reasonable requests. We are not required to agree to your request. If we do agree, we
will comply with your request unless we need the information to provide you
emergency treatment.
• Revoke your authorization to use or
disclose health information except to the extent that action has already been
taken.
Our
Responsibilities
Ohio Valley HeartCare is required to:
• Maintain the privacy of your health
information,
• Provide you with this notice as to our
legal duties and privacy practices with respect to information we collect and
maintain about you,
• Abide by the terms of this notice,
• Notify you if we are unable to agree to a
requested restriction, and
• Accommodate reasonable requests you may
have to communicate health information by alternative means or at alternative
locations.
We reserve the right to change our
practices and to make the new provisions effective for all protected health
information we maintain. Should our
information practices change, we will mail a revised notice to the address
you’ve supplied us, or if you agree, we will email the revised notice to you.
We will not use or
disclose your health information without your authorization, except as
described in this notice. We will also
discontinue to use or disclose your health information after we have received a
written revocation of the authorization according to the procedures included in
the authorization.
For
More Information or to Report a Problem
If have questions and would like
additional information, you may contact the practice’s Privacy Officer, Karen
Jones, at Ohio Valley HeartCare, 1400
Professional Boulevard, Evansville, IN 47714 or at (812) 473-2642.
If you believe your privacy rights
have been violated, you can file a complaint with Ohio Valley HeartCare’s Privacy Officer, or with the Office for
Civil Rights, U.S. Department of Health and Human Services. There will be no
retaliation for filing a complaint with either the Privacy Officer or the
Office for Civil Rights.
Examples
of Disclosures for Treatment, Payment and Health Operations
We
will use your health information for treatment.
For
example: Information obtained by a nurse, physician, or other member of
your health care team will be recorded in your record and used to determine the
course of treatment that should work best for you. Your physician will document
in your record his or her assessments of your condition, the plan of care for
your treatment and your responses to treatments. Members of your health care
team will also record their actions and their observations. In that way, the
physician will know how you are responding to treatment.
We may use and disclose health
information about you to physicians, nurses, technicians, office staff or other
personnel who are involved in taking care of you and your health. For example: We may be treating you for a heart condition and may need to know
if you have other health problems that could complicate your treatment. The
doctor may use your medical history to decide what treatment is best for you.
The doctor may also tell another doctor about your condition so that the doctor
can help determine the most appropriate care for you.
Different personnel in our office may
share information about you and disclose information to people who do not work
in our office in order to coordinate your care, such as phoning in
prescriptions to your pharmacy, scheduling lab work and ordering x-rays. Family
members and other healthcare providers may be part of your medical care outside
this office and may require information about you that we have.
We will also provide your personal or
referring physician or a subsequent health care provider with copies of various
reports that should assist him or her in treating you once you’re discharged
from our care.
We
will use your health information for payment.
For
example: We may use and disclose health information about you so that the
treatment and services you receive at this office may be billed to and payment
may be collected from you, an insurance company or a third party. We may need to give your health plan
information about a service you received here so that your health plan will pay
us or reimburse you for the service. 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 treatment.
We
will use your health information for regular health operations.
For
example: We may use and disclose health information about you in order to
run the office and make sure that you and our other patients receive quality
care. We may use your health information to evaluate the performance of our
staff in caring for you. We may also use health information about all or many
of our patients to help us decide what additional services we should offer, how
we can become more efficient, or whether certain new treatments are effective.
Appointment
Reminders: We may contact you as a reminder that you have an appointment for
treatment or medical care at the office. We may contact you if you miss an
appointment to reschedule. This notification may be by phone call or mail. We
may also call you by name in the waiting room when your provider is ready to
see you.
Treatment
Alternatives: We may contact you by phone or other means to provide results
from exams or tests and to provide information that describes or recommends
treatment options or alternatives regarding our care. Also, we may contact you
to provide information about other health-related benefits and services offered
by our office that may be of interest to you.
Business
Associates: There are some services provided in our organization through
contacts with business associates. When these services are contracted, we may
disclose your health information to our business associate so that they can
perform the job we’ve asked them to do and bill you or your third-party payer
for services rendered. To protect your health information, however, we require
the business associate to appropriately safeguard your information.
Communication
with Family: Health professionals, using their best judgment, may disclose to
a family member, other relative, close personal friend or any other person you
identify, health information relevant to that person’s involvement in your care
or payment related to your care.
We may use or disclose health
information about you without your permission for the following purposes,
subject to all applicable legal requirements and limitations:
As
Required by Law: We may use or disclose your protected health information to
the extent that the use or disclosure is required by law.
Workers’
Compensation: Your protected health information may be disclosed, by us, as
authorized, to comply with workers’ compensation laws and other similar
legally-established programs.
Public
Health: As required by law, we may disclose your health information to
public health or legal authorities charged with preventing or controlling
disease, injury, or disability.
Law
Enforcement: We may disclose health information for law enforcement purposes
as required by federal, state or local law or in response to a valid subpoena.
Or if you were a member of the armed forces or part of the national security or
intelligence community, we may be required to release health information about
you.
Health
Care Oversight: Your health information may be released to an appropriate health
oversight agency for activities authorized by law, such as audits,
investigations, and inspections.
Printed
copies of this Privacy Policy are also available at our office: Ohio Valley
HeartCare, 1400 Professional Boulevard, Evansville, IN 47714.