OSU Physicians, Inc.
NOTICE
OF PRIVACY PRACTICES
Effective Date: 4/1/2003
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.
If
you have any questions about this notice, please contact the OSU Physicians,
Inc. Patient Privacy Manager at 614-784-7806.
WHO IS COVERED BY THIS
NOTICE.
This
notice describes the privacy practices of the affiliated physician practice
plans of The Ohio State University Health System, including:
·
Family
Medicine Foundation, LLC.
·
OSU
Emergency Medicine, LLC.
·
OSU
Eye Physicians and Surgeons, LLC.
·
OSU
GYN and OB Consultants, LLC.
·
OSU
Histology Lab, LLC.
·
OSU
Internal Medicine, LLC.
·
OSU
Neurosciences Center, LLC.
·
OSU
Otolaryngology Head & Neck Surgery, LLC.
·
OSU
Pathology Services, LLC.
·
OSU
Physicians, Inc.
·
OSU
Physical Medicine, LLC.
·
OSU
Psychiatry, LLC.
·
OSU
Radiology, LLC.
·
OSU
Radiation Medicine, LLC.
·
OSU
Surgery, LLC.
·
Any
health care professional authorized to enter information into your medical
record maintained by OSU Physicians, Inc. or an affiliated practice plan.
·
Faculty and medical staff.
·
Any member of the Volunteer Services program we
allow to help you while you are in the health system.
·
All
employees, staff, and students who participate in OSU Physicians, Inc. or an
affiliated practice plan services.
These entities, sites and locations may
share health information with each other for treatment, payment or health
system operations purposes described in this notice.
OUR PLEDGE REGARDING
MEDICAL INFORMATION.
We
are required by law to:
·
make sure that your health information is kept
private;
·
give
you this notice of our legal duties and privacy practices; and
·
follow
the terms of the notice that is currently in effect.
We
understand that your health information is personal. We create a record of the
care and services you receive. We need
this record to provide you with quality care and to comply with certain legal
requirements. We are committed to
protecting this information.
This
notice will tell you about:
·
the
ways in which we may use and disclose your health information.
·
your rights; and
·
our
obligations regarding the use and disclosure of health information.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
Ø For Treatment. It is important that we be able to use or
share your information to treat you. We
may share your information to doctors, nurses, technicians, medical students,
or other personnel who are involved in taking care of you. Different
departments of the health system 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 may share your
information with health care providers outside of the Ohio State University
Health System for your treatment
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. We may need to share your
information in order to schedule you for a surgery or procedure. Or a health care provider may need to know
about any drug allergies that you have in order to provide you with appropriate
medication.
Ø For Payment:
We may use or share your health information so that we are paid for the cost of
your care. We may share your
information with another provider so that they may be paid for services as
well. We may bill, and share information with other providers, an insurance
company, you, or a third party.
For example, we may need to give your health
plan information about your diagnosis and treatment so your health plan will
pay us or reimburse you for the care we provided. 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. We may also share
your health information in order to facilitate payment to another provider who
has participated in your care.
Ø For Health Care
Operations. We may
use and share your health information for health system operations. These uses and disclosures are necessary to
run the health system 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 health system patients to decide what additional
services the health system should offer, what services are not needed, and
whether certain new treatments are effective.
We may also disclose information to doctors, nurses, technicians,
student trainees, and other health system personnel for review and learning
purposes. We may combine the medical
information we have with medical information from other health systems to
compare how we are doing and see where we can make improvements in the care and
services we offer. When we share
information with other health systems for this type of comparison, we 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
you 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 within the health system.
If you do not wish to receive appointment
reminders, or wish to be contacted at a certain telephone number, be sure to
tell your health care provider.
Ø Health-Related
Benefits and Services.
We may use and disclose medical information to tell you about treatment
options, health-related benefits, or services that may be of interest to
you.
Ø Fundraising Activities. We may use your health information to
contact you in an effort to raise money for the Health System toward fulfilling
its missions of patient care, teaching, and research. We may provide demographic information (such as your name,
address, phone number, gender, employer, birth date, spouse’s name and the
dates you received treatment or services) to Development Office personnel or to
a foundation related to the Health System.
If you do not want to be contacted for
fundraising efforts, you must notify, in writing, the Senior Director, Medical
Center Development & Alumni Affairs, at the following address: 1375 Perry
Street, Building 13, 5th Floor, Columbus OH 43210.
Ø Individuals Involved
in Your Care or Payment for Your Care. We may release medical information about you
to a family member or other designated person who is involved in your medical
care. We may also give information to someone who helps pay for your care.
For example: We may need to tell the person who
comes to pick you up after appointment what he or she may need to do to help
you once you get home.
In the event of an emergency, we may need to use or
share information about you in order to inform your family or persons
responsible for your care where you are, and your condition. In addition, we may disclose medical information
about you to an agency assisting in a disaster relief effort so that your
family can be notified about your condition, status and location.
SPECIAL
SITUATIONS: Additional uses and
disclosures for which authorization or opportunity to agree or object is not
required by HIPAA.
Ø Research. Research is one of the missions of The Ohio
State University Health Systems. It can
help find cures for diseases and help you and many other people. You have the opportunity to be a part of
research at The Ohio State University Health System. Under certain circumstances, we may use and disclose medical
information about you for research purposes, or we may contact you about
research projects that you may qualify for. All research projects are subject
to a special approval process before we use or disclose medical information
We also may disclose medical information about
you to people preparing to conduct a research project. They may be looking for patients with
specific medical needs or for certain information. The medical information they review will be kept confidential.
Often, you will need to give permission before
we share your information with others for use in research. If your information
is used, the researcher must keep your information safe and confidential.
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.
Ø Organ and Tissue
Donation. We may
release medical information to organizations that handle organ, tissue and eye
procurement as necessary, to facilitate organ, tissue, and eye donation and
transplantation. These organizations may review death charts to determine
compliance with federal and state regulations related to donation, procurement,
and requests for transplantation.
Ø Workers' Compensation. We may release medical information to Workers'
Compensation, as required by workers’ compensation laws. This program provides
benefits for work-related injuries or illness.
Ø Public Health Risks.
As required by law, we may disclose your health information to public health
authorities for purposes related to: preventing or controlling disease, injury,
or disability; reporting medical device safety issues and adverse events to the
federal Food and Drug Administration’s MedWatch program; and reporting disease
or infection exposure.
Ø Victims of Abuse,
Neglect, or Domestic Violence. We may disclose
certain health information to government agencies authorized by law to receive
reports of abuse, neglect, or domestic violence if we believe that you have
been a victim.
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.
Ø Judicial and
Administrative Proceedings. We may disclose your health information in
the course of an administrative or judicial proceeding, such as in response to
a court order
Ø Law Enforcement. We may release medical information to a law
enforcement official if required or permitted by law.
Ø Deceased Person Information. We may release medical
information to a coroner or medical examiner, or a funeral director as
necessary to carry out their duties.
Ø Specialized Government
Functions We may
release medical information about you to authorized federal officials for
national security and intelligence, military, or veterans activities required
by law.
USES OF MEDICAL INFORMATION
THAT REQUIRE AUTHORIZATION
In all other situations (situations that
are not treatment, payment, health systems operations or special situations, as
we told you about above), we may only share information with your specific
written authorization.
You may revoke that authorization, 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, except to the extent
that we already have used or disclosed your information.
YOUR RIGHTS
REGARDING MEDICAL INFORMATION ABOUT YOU
Although the physical form of your medical information
or designated record set is our business record and is the property of the
health system, the information contained in those records is your information,
and you have certain rights regarding that information.
You
have the following rights regarding medical information we maintain about you:
Ø Right to Review and
Copy. You
have the right to inspect and obtain a copy of medical information that may be
used to make decisions about your care.
Usually, this information includes medical and
billing records, but does not include psychotherapy notes, information compiled
for use in or created in anticipation of a civil, criminal or administrative
action or proceeding, or certain lab test results subject to the Clinical
Laboratories Improvement Act of 1988.
You
must submit your request for your medical information in writing to the office
manager of the office where you received your care. If you request a copy of the information, we may charge a fee for
the costs of copying, mailing, or other supplies associated with your
request.
Ø Right To Appeal a
Denial of Access to Medical Information
You have the right to access your medical
information. There are some limitations
on that right. If for clear treatment
reasons your health provider has determined that access to your health
information is likely to have an adverse effect on you, the health care
provider shall provide the record to a practitioner designated by you to help
you with your review of the information.
Your access is limited to your Designated Record Set. Your designated record set is information we
used to make decisions about your care.
It does not include:
·
Information compiled for use in or created in
anticipation of a civil, criminal or administrative action or proceeding, or
·
Certain
lab test results subject to the Clinical Laboratories Improvement Act of 1988.
·
Other
types of information that we did not use to make decisions about your health
care.
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 maintained. We may deny your request if you
ask us to amend information that:
·
is
not part of the information which you would be permitted to inspect and copy;
or
·
we
believe is accurate and complete.
Submit your request to the office manager of the
office where you received your care.
Your request must be made in writing and include a reason that supports
your request.
Ø
Right to an Accounting of Disclosures.
You have the right to request an
accounting of disclosures. An
accounting of disclosures is a listing of releases of your health information
that we have made for the “Special Situations” listed in this Notice. We must document these disclosures and
provide you with an accounting of them if we did not obtain your authorization
before we released your information.
You must submit your request
in writing to the HIPAA Privacy Contact in the office where you were seen.
Your request must:
·
tell
us the calendar dates you want to see. The time period cannot include more than
six years of information, and cannot begin prior to April 14, 2003.
·
indicate
in what form you want the list (paper copy or electronic).
Charges: There will
be no charge for the first list you request within a 12-month period. We may charge you for the costs of providing
any additional lists. We will notify
you of the cost involved. You may
choose to withdraw or modify your request at that time before any costs are
incurred.
Ø Right to Request
Restrictions.
You have the right to request a restriction or limitation on the health
information we use or disclose about you for treatment, payment or health care
operations. 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.
You
must make your request for any restrictions in writing to the office manager of
the office where you received your care.
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.
You
must make your request for confidential communications in writing to office
manager where you received your care.
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. For example, if you
wish to be contacted by telephone, be sure to provide an appropriate telephone
number.
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.
Contact a member of the office staff for a copy. You may also print a
copy of this notice at http://www.osuphysicians.com/cs/hipaa
CHANGES TO THIS NOTICE
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. Current copies of this notice will be
available at our office sites. The
current notice will also be posted at the website listed above.
The effective date of the notice will be
posted on the first page, in the top right-hand corner,
COMPLAINTS
If
you believe your privacy rights have been violated, you may file a complaint
with our health system by either contacting the office manager at the office
where you received your care or to HIPAA Customer Service; OSU Physicians, Inc.;
700 Ackerman Rd, Ste 505; Columbus, OH 43202 or with the U.S. Office of Civil
Rights, Washington, DC. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.