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Notice of Privacy Practices
How Your Medical
Information Is Used
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.
This Notice applies to the following organizations and
their clinics:
- The Nebraska Medical Center (Clarkson and University
Hospital) and its medical staff, including academic and private practice
physicians, and allied health professionals while providing services at these
locations, as an organized health care arrangement.
- University of Nebraska Medical Center (UNMC)
- UNMC Physicians
- University Dental Associates (UDA)
The organizations listed above will use and distribute
this Notice as their Joint Notice of Privacy Practices and follow the
information practices described in this Notice when using or disclosing records
and information. They will share your health information with each other,
as necessary, to carry out treatment, payment, or health care operations as
described in this Notice.
Understanding Your Health Information
Each time you visit a hospital, clinic, physician, or other health care
provider, a record of your visit is made. Typically, this health record
contains your medical history, symptoms, examination and test results,
diagnosis, treatment, care plan, insurance, billing, and employment
information. This health information, often referred to as your health
record, serves as a basis for planning your care and treatment and is a vital
means of communication among the many health professionals who contribute to
your health care. Your health information is also used by insurance
companies and other third-party payers to verify the appropriateness of billed
services.
Our Responsibilities
We are required by law to:
- Maintain the privacy of your health
information.
- Provide you with an additional
current copy of our Notice upon request.
- Abide by the terms of our current
Notice.
We will not use or disclose your
health information without your written authorization, except as described in
this Notice. Such authorization may be revoked in writing at any time except
with respect to any actions we have taken in reliance on it.
Examples of Using Health Information for Treatment, Payment and Health Care
Operations
We will use and disclose your health
information for treatment purposes.
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. Health
care team members will communicate with one another personally and through the
health record to coordinate care provided. We will also provide your
physician or subsequent health care provider with copies of various reports
that should assist him or her in treating you in the future.
We will use and disclose your
health information for payment purposes.
For example: A bill may be
sent to you or a third-party payer. The information on or accompanying the
bill may include information that identifies you, as well as your diagnosis,
procedures, and supplies used. We may disclose health information about you
to other qualified parties for their payment purposes. For example, if you
are brought in by ambulance, we may disclose your health information to the
ambulance provider for its billing purposes.
We will use and disclose your
health information for health care operations.
For example: Members of the
medical staff, the risk or quality improvement manager, or members of the
quality improvement team may use information in your health record to assess
the care and outcomes in your case and others like it. This information will
then be used in an effort to continually improve the quality and effectiveness
of health care we provide. In some cases, we will furnish your health
information to other qualified parties for their health care operations. The
ambulance company, for example, may want information regarding your condition
to help them know whether they have done an effective job of stabilizing your
condition.
Teaching:
As the primary teaching site for UNMC, residents, fellows, and students in
medicine, dentistry, nursing, pharmacy, allied health and graduate studies,
may be assisting with your care under the supervision of a licensed health
care provider as a part of their professional health care training program.
Other Uses and Disclosures of Your
Health Information
Notification.
We may use or disclose health information to
notify or assist in notifying a family member, personal representative, or
another person responsible for your care of your location and general
condition.
Communication With Family and
Others. We may disclose
relevant health information to a family member, friend, or other person involved
in your care. We will only disclose this information if you agree, are given
the opportunity to object and do not, or if in our professional judgment, it
would be in your best interest to allow the person to receive the information or
act on your behalf.
Directory.
Unless you notify us that you object, or we are otherwise prohibited by law, we
may use your name, location in the facility, general condition, and religious
affiliation for directory purposes. This information may be provided to members
of the clergy, and, except for religious affiliation, to other people who ask
for you by name.
Business Associates.
There are some services provided in our organization through contracts with
business associates. When these services are contracted, we may disclose your
health information to our business associates so that they can perform such
services. However, we require the business associate to appropriately
safeguard your information.
Appointment Reminders.
We may contact you as a reminder that you have an appointment for treatment or
medical care.
Treatment Alternatives.
We may contact you about treatment alternatives or other health-related benefits
and services that may be of interest to you.
Fundraising.
We may contact you in an effort to raise money for clinical programs, research
and education. If you do not want us to contact you for fundraising efforts,
you must notify the Office of Development in writing at 987430 Nebraska Medical
Center, Omaha, Nebraska, 68198-7430.
Research.
Research is conducted under strict UNMC Institutional Review Board (IRB)
guidelines designed to protect the subjects of research. Health information
about you may be disclosed to researchers preparing to conduct a
research project. For
example, it may be necessary for researchers to look for patients with specific
medical characteristics or treatments. We would obtain your specific
authorization prior to using your health information in research studies if
information that directly identifies you is disclosed. The only exception would
be granted under rare circumstances when the IRB is permitted by federal
regulations to grant a waiver of authorization.
Public Health.
We may disclose health information about you for
public health activities. These activities may include disclosures:
- To a public health
authority authorized by law to collect or receive such information for the
purpose of preventing or controlling disease, injury, or disability;
- To appropriate
authorities authorized to receive reports of abuse and neglect;
- To FDA-regulated
entities for purposes of monitoring or reporting the quality, safety or
effectiveness of FDA-regulated products; or
- 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.
Workers’ Compensation.
We may disclose health information to the
extent authorized and necessary to comply with laws relating to workers’
compensation or other similar programs established by law.
Correctional Institutions.
If you are an inmate of a correctional institution or under custody of a law
enforcement official, we may disclose to the correctional institution, its
agents or the law enforcement official your health information necessary for
your health or the health and safety of other individuals.
Law Enforcement.
We may disclose health information if asked to do so by a law enforcement
official as required or permitted by law or in response to a subpoena.
Health Oversight Activities.
We may disclose health information for health oversight activities authorized by
law. For example, oversight activities include 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.
Threats to Health or Safety.
Under certain circumstances, we
may use or disclose your health information if we believe it is necessary to
avert or lessen a serious threat to health and safety and is to a person
reasonably able to prevent or lessen the threat or is necessary for law
enforcement authorities to identify or apprehend an individual involved in a
crime.
Specialized Government Functions.
We may disclose your information for national security and intelligence
activities authorized by law, for protective services of the president; or if
you are a military member, to the military under limited circumstances.
As Required by Law.
We will use or disclose your health
information as required by federal, State or local law.
Lawsuits and Administrative
Proceedings. We may release your
health information in response to a court or administrative order. We may also
provide your information in response to a subpoena or other discovery request,
but only if efforts have been made to tell you about the request or to obtain an
order protecting the information requested.
Funeral Directors, Medical
Examiners, and Coroners. We may
disclose your health information to funeral directors, medical examiners, and
coroners consistent with applicable law to carry out their duties.
Organ Procurement Organizations.
Consistent with applicable law,
we may disclose health information to organ procurement organizations or other
entities engaged in the procurement, banking, or transplantation of organs for
the purpose of tissue donation and transplant.
Incidental Uses and Disclosures.
There are certain incidental uses or disclosures of your health information that
occur while we are providing services to you or conducting our business. For
example, after surgery the nurse or doctor may need to use your name to identify
family members that may be waiting for you in a waiting area. Other individuals
waiting in the same area may hear your name called. We will make reasonable
efforts to limit these incidental uses and disclosures.
Your Health Information Rights
You have the following rights regarding your
health information:
Right to Inspect and Copy.
You may request to look at your medical and billing records and obtain a copy.
You must submit your medical records request to the Medical Records Department.
Contact the office listed on your billing statement to request a copy of your
billing record. If you ask for a copy of your records, we may charge a fee for
the cost of copying, mailing, or other supplies needed to respond to your
request.
Right to Request Amendment.
You may request that your health information be amended if you feel that the
information is not correct. Your request must be in writing and provide
rationale for the amendment. Please send your request to the Medical Records
Department. We may deny your request, and will notify you of our decision in
writing.
Right to an Accounting of
Disclosures. You may request an
accounting of certain disclosures of your health information showing with whom
your health information has been shared (does not apply to disclosures to you,
with your authorization, for treatment, payment or health care operations, and
in certain other cases).
To request an accounting of disclosures, you must send a written request to the
Medical Records Department. Your request must state a time period that may not
be longer than six years and may not include dates before April 14, 2003.
Right
to Request Restrictions.
You may request restrictions on how your health information is used for
treatment, payment or health care operations, or to certain family members or
others who are involved in your care. We may deny your request. If we agree to
a restriction, the restriction may be lifted if use of the information is
necessary to provide emergency treatment.
To
request a restriction, you must send a written request to the Medical Records
Department, specifying what information you wish to restrict and to whom the
restriction applies. You will receive a written response to your request.
Right to Request Private Communications.
You may request that we communicate
with you in a certain way in a certain location. You must make your request in
writing to the patient registration area and explain how or where you wish to be
contacted.
Right to a Paper Copy of this
Notice.
You may request an additional paper copy of this Notice at any time from any
patient registration area.
You
may contact the Medical Records Department at:
989100 Nebraska Medical Center
Omaha, Nebraska 68198-9100
Phone: 402-559-4705
Hours: 8:00 a.m. – 4:30 p.m. CST
Changes to this Notice
We reserve the right to change this Notice
as our privacy practices change and to make the new provisions effective for all
health information we maintain. We will post a current Notice in patient
registration areas and on our websites.
For More Information or to Report a Problem
If you have questions or would like
additional information, you may contact the Patient Relations Department. If
you believe your privacy rights have been violated, you may file a complaint
with the Patient Relations Department or with the Secretary of Health and Human
Services. There will be no retaliation for filing a complaint.
You may contact the Patient Relations
Department at:
982133 Nebraska Medical Center
Omaha, Nebraska 68198-2133
Phone: 800-647-6216 or 402-559-8158
Hours: 8:30 a.m. – 5:00 p.m. CST
Effective Date: 4/01/2006
Version No. 3
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