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.
If
you have any questions about this Notice, please contact our Privacy Officer
at (269) 781-6207.
PROVIDERS
COVERED BY THIS NOTICE
In addition,
We and the medical staff
physicians may share your health information for purposes of providing you with
treatment, obtaining payment for medical services, and for health care
operations. Examples of sharing information for purposes of treatment, payment,
and health care operations are described below.
OUR PLEDGE TO
YOU:
We understand
that health information about you and your health care is personal. We are
committed to protecting health information about you. We create a record
of the care and services you receive from us. We need this record to
provide you with quality care, bill for your care, and comply with legal
requirements. This Notice applies to all of the records of your care that
we maintain, whether made by our staff, or by the physicians and other health
care professionals working with us.
HOW WE MAY USE
AND DISCLOSE HEALTH INFORMATION ABOUT YOU.
Our doctors,
nurses, pharmacists, laboratory technicians, and other health care
professionals may use health information about you to provide you with health
care
treatment or services. We may also
disclose health information about you to others who are involved in taking care
of you. For example, we may send health information about you to a physician
specialist as part of a referral. Or, we may share information with a
local nursing home in order to continue your care.
We may use and
disclose health information about you to obtain payment
for the treatment and services you receive from us or from the doctors and other
health care professionals that treat ou at the hospital. For example, we
may send billing information to your insurance company or Medicare.
We may use and
disclose health information about you to support our health care operations. For example, we may use health information to review
the treatment and services we provide to you and to evaluate the performance of
our staff in caring for you. You may also receive a telephone call asking if
you were satisfied with the care you received.
Unless you object,
we may disclose information to a family member or other person responsible for your care about your condition, status, and location.
Unless you tell
us otherwise, we will include your name, location in the hospital, your general
condition (good, fair, etc.), and religious affiliation in our patient directory and make this information available to anyone who asks for
you by name. Unless you object, we may disclose this information to a member of
the clergy.
We may use and
disclose health information to contact you for an appointment reminder, to tell you about health-related
services or to recommend possible
treatment options or alternatives that may
be of interest to you. We may contact
you about supporting our fund raising
efforts.
Subject to certain
requirements, we may use or disclose health information about you without your
prior authorization for other reasons:
We may give out
health information about you for public health purposes;
to report
abuse or neglect; for health oversight
reviews; in research
studies, so long as provision is made for the protection of your health
information; to medical examiners; for funeral arrangements and organ donation; in
response to special law enforcement
requests, valid judicial or administrative orders, or for authorized national
security and intelligence activities; for workers’ compensation purposes; to avert a serious threat
to your health or safety or those of the public or another person; and when required by law (for example, state law requires certain reports to cancer
registries). If you are or were a member of the armed forces, we may release
information about you as required by military command authorities or the
Department of Veterans Affairs. If you are an inmate of a correctional
institution or under the custody of a law enforcement official, we may release
health information about you to the correctional institution or law enforcement
official. We must also release your health information when required by the
Department of Health and Human Services to investigate our compliance with the
privacy laws.
Your health
information is protected by both federal and state laws. In situations where
both laws apply, we will comply with the law that is most protective of your
health information and/or gives you additional rights. For example, in some situations Michigan law
gives more protection to information contained in mental health records.
For any other
purpose not covered by this Notice, we will ask for your written authorization before using or disclosing your health information. You
may revoke this authorization at any time by notifying us in writing,
except to the extent we have taken an action in reliance on your authorization.
YOUR RIGHTS
REGARDING HEALTH INFORMATION ABOUT YOU.
You have the
right to request in writing that you inspect and obtain a copy of the health information we maintain. We may charge a fee
for the costs of copying, mailing or other supplies and services associated
with your request. In certain circumstances, we may deny your request. You
may request that this denial be reviewed.
If you believe
that health information we have about you is incorrect or incomplete, you may
ask us to amend your health information. The
request must be in writing, and should state the reason for the amendment and
the specific information to be amended.
You
have the right to make a written request for a list of disclosures we have made of your health information. This list will not include disclosures made
for treatment, payment, and health care operations, to your family, or those
disclosures you authorized.
You have the
right to request
a restriction on the health information we
use or disclose about you, including a right to request restrictions on
disclosures to family members or friends.
You must submit this request in writing. We are not required to agree to your
request for restrictions. If we do agree, we will comply with your request unless
the information is needed to provide you emergency treatment, or we are
otherwise required by law to make a disclosure.
You have the
right to request that confidential communications with you be made in an alternative manner or location.
This request must be in writing, but you do not need to state the reason for
your request. For example, you may ask us to send information to your work
address instead of your home address, or in a blank envelope with no
distinguishing marks. We will accommodate all reasonable requests. Your
request must specify how or where you wish to be contacted.
WRITTEN
REQUESTS
All written
requests should be submitted to our Privacy Officer at 200 N. Madison, Marshall, MI 49068.
COPIES OF
NOTICE AND CHANGES
You have the
right to obtain a paper copy of this Notice at any time, upon request, even if
you have agreed to accept this Notice electronically. You may also obtain
a copy of this Notice at our website, www.oaklawnhospital.org
We reserve the
right to change this Notice, and to make the changed Notice effective for
health information we already have about you as well as any information we
receive in the future. Upon your request, we will provide you with any revised
Notice. A revised Notice will also be posted in waiting areas throughout our
facilities and at our website, www.oaklawnhospital.org
If you are
concerned that your privacy rights may have been violated or you disagree with
a decision we make about your health information, you may file a complaint with
our Privacy Officer. You may also send a written complaint to the U.S.
Department of Health and Human Services. Our Privacy Officer can provide you
with the address.
Under no circumstances will we ever ask you to waive your
rights under this Notice or retaliate against you in any manner for filing a
complaint.
This Notice was published and became effective on April 14, 2003.