Effective Date: April 14, 2003
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 is provided to you by the Rochester Medical Center, P.C., which includes The Women’s Center, located at 134 W. University Drive, Rochester, The Rochester Family Care Center, The Rochester Diagnostic Center, The EECP Center, located at 543 Main Street, Rochester, The Atallah Heart Center located at 610 Main Street, Rochester and The Shelby Family Care Center located at 53960 Van Dyke, Shelby Township. If you are a patient of any of these facilities and if you have questions about this Notice, you may direct them to the Custodian of Vital Records, Rochester Medical Center, P.C. , P.O. Box 82177, Rochester, MI. 48308.
Your medical information is, and always has been, personal and confidential. As physicians, nurses and related health care providers we are committed to safeguarding your medical information. We create a record of the care you receive at our facilities. We need this record to provide you with quality care, and to comply with legal requirements. This Notice applies to all the records of your medical care generated by this office, or any other of our offices, whether made by your personal physician, or by one of the facility’s employees.
This Notice will tell you about the ways in which we may use and disclose your medical information to a third party. This Notice will also describe your rights and our obligations regarding the use and disclosure of your medical information to anyone other than yourself.
The Health Insurance Portability and Accountability Act of 1996 requires that medical information that identifies you as an individual is kept private. It also requires that you receive this Notice, and that the terms of the Notice are followed.
This facility has always adhered to the highest standards in maintaining patient privacy and the confidentiality of medical information. This has been an ethical obligation of physicians and nurses from the beginning of nursing and medical practice. As health care delivery has changed, and with the increase in electronic data processing, medical information has become increasingly vulnerable to exposure. Recently the Federal government has enacted legislation to increase the protection of health information of each individual.
HOW THIS FACILITY MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION
It is important to note that your medical information belongs to you. It does not belong to your spouse, your children, your significant other, or your friends. You will find that the employees of this facility are zealous in guarding your medical information from disclosure to any unauthorized third party.
The following describes the different ways in which your medical information may be used or disclosed by this facility. For clarification we have included some examples. Not every possible use or disclosure is specifically mentioned. However all of the ways we are permitted to use and disclose your medical information will fit within one of these general categories: medical treatment, payment, or health care operations. Any other use will require a written authorization from the patient. This authorization may be revoked in writing at any time.
USE AND DISCLOSURE FOR TREATMENT
We will use medical information about you to provide you with medical treatment and services. We may disclose medical information about you to our doctors, and those physicians who are substituting and providing coverage for them, our nurse practitioners and those who are substituting and covering for them, our nurses, our technicians, and our office personnel who are involved in providing your medical treatment.
We may use and disclose medical information about you so that the treatment and services you receive at any of our facilities may be billed to your insurance company, to a third party whom you have authorized, or to you. We may need to give your health plan information about your diagnoses and treatment you have received at our facility so that your plan will reimburse us for services rendered. We may also tell your health plan about your condition in order to obtain prior approval for a treatment or diagnostic test.
FOR HEALTH CARE OPERATIONS
We may use and disclose medical information about you for office operations. We may contact you as a reminder that you have an appointment for medical care or treatment at our facility. We may use and disclose medical information about you for routine data collection used for in-house research. The personnel necessary for office operations may include, but is not limited to the following personnel: receptionists, secretaries, transcriptionists, billers, technicians, technologists, medical assistants, nurses, physicians, students, volunteers, patient care associates, and ancillary personnel. Uses and disclosures of medical information are necessary to run our office and to insure that all of our patients receive quality care. For example, we may use medical information to review and audit our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many of our patients to decide what additional services the office should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, and other office personnel for review and learning purposes. We may remove information that identifies you from this set of medical information so that others may use it to study health care and health care delivery without learning the identify of the specific patients.
FOR BUSINESS ASSOCIATES
We may disclose information about you to our business associates. Business associates are persons or entities, who on behalf of our facility, perform activities and render services that may involve the use or disclosure of protected health information by our facility. Examples of types of business associate activities include: claims processing, data analysis, computer repair, copying services, utilization management, quality assurance, billing and collection services, benefit management, third party administrative activities, practice management services, legal, accounting, insurance, actuarial, consulting, management, and administrative.
Under certain circumstances we may use and disclose medical information about you for research purposes. The research project would be first approved by an Institutional Review Board. After approval has been obtained, your medical record would be accessed by a facility member to gather medical information. For example, a research project may involve comparing the health and recovery of all patients who receive one medication to those who received another medication for the same condition. Your name and identity would not be revealed in the research outcomes.
AS REQUIRED BY LAW
We will disclose medical information about you when required to do so by state, local or federal law. For example, disclosure may be required by Worker’s Compensation statutes and various public health statues in connection with required reporting of certain diseases, child or elderly abuse and neglect, domestic violence, adverse drug reactions, etc.
TO AVERT A SERIOUS THREAT OF 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 of another person. Any disclosure, however, would only be to someone able to help prevent the threat.
HEALTH OVERSIGHT ACTIVITIES
We may disclose medical information to a governmental, regulatory, or other authorized oversight agencies for activities mandated or authorized by law. For example, disclosure of your medical information may be made in connection with audits, civil, administrative or criminal proceedings, investigations, inspections, licensure renewals, etc.
LAWSUITS AND DISPUTES
If you are involved in a lawsuit or a dispute we may use your medical information to defend our office, facility, doctor or other health care provider, or to respond to a court order.
We will release medical information about you when we are required to do so by law. This includes release of information to appropriate law enforcement officials and to the medical examiner, in matters where that office has jurisdiction, to identify a deceased person or to determine the cause of death.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION
The information regarding your medical condition belongs to you and is given to you verbally by your health care provider at the time of your visits. The medical record, prepared and maintained by the medical staff, belongs to the medical facility. The paper on which your medical information is printed and related electronic records belong to the medical facility.
You have a right to visually inspect and copy your medical record with the exception of any psychotherapy notes. If you request to inspect or copy the information, you must submit your request in writing. We require that an appointment be made in advance for this so that appropriate arrangements can be made for your privacy and so that patient care will not be interrupted.
You have the right to a copy of the original record. This request must be in writing and must be signed by the patient. Additional safeguards may be required by the facility, such as photo identification, to assure the identity of the requestor. If you submit a request for a copy of the record we will charge a fee for the costs of document retrieval, copying, mailing, handling, and supplies associated with your request.
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 this office. To request an amendment, your request must be made in writing and submitted to the Custodian of Vital Records. In addition, you must provide a valid reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a valid reason to support the request. In addition, we may deny your request if you ask us to amend information that:
RIGHT TO AN ACCOUNTING OF DISCLOSURES
You have the right to request a list of the disclosures this office has made of your medical information. To request this accounting of disclosures, you must submit your request in writing to the Custodian of Vital Records. Your request must state a time period, which is not longer than six (6) years, and may not include dates before February 26, 2003. We may charge for handling, copying, mailing and associated costs.
RIGHT TO REQUEST RESTRICTIONS
You have the right to request restrictions or limitations on the use or disclosure we make of your medical information. We are not required to agree to your request for a restriction. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions address your request in writing to the Custodian of Vital Records.
RIGHT TO REQUEST MANNER OF CONFIDENTIAL COMMUNICATIONS
You have the right to request that we communicate with you only in a certain manner. For example, you can request that we only contact you at work, or by mail. To request confidential communications in a specified manner, you must make your request in writing to the Custodian of Vital Records.
RIGHT TO PAPER COPY OF THIS NOTICE
You have a right to a paper copy of this Notice. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You may obtain a copy of this Notice at our website, www.rochestermedicalcenter.com. To obtain a paper copy of this Notice make your request at any of our office locations.
REVISIONS TO THIS NOTICE
We reserve the right to revise this Notice at any time without notice. Any revised Notice will be effective for medical information that we already have about you, as well as any information that we receive in the future. We will post a copy of any revised Notice in this office and on our internet site. Any Revised Notice will contain the effective date in the upper right-hand side of the first page. In addition, each time you visit the office we will have available for your inspection the current Notice in effect.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of your medical information not covered by this Notice of Privacy Practices will be made only with your written authorization. If you provide us with such an authorization, you may revoke it in writing at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.
This Notice of Privacy Practices shall remain in full force and effect until
such time as it is amended by the health care facility, revoked or amended by
the patient, or modified by law.
The Rochester Medical Center