Notice of Privacy Practices
Effective July 1, 2005
This notice describes how your medical information may be used and shared and how you can receive access to this information. Please review it carefully. When you sign the registration form, you agree to this notice.
- Our pledge regarding your protected health information (PHI)
- Who We Are
- Ways We Can Use and Share Your PHI Without Your Written Permission
- Uses and Disclosures Requiring Your Written Permission
- Patient Rights Regarding Protected Health Information
- Changes to this Notice
We are committed to protecting the privacy of all health information we create and maintain as a result of the health care we provide you. Your “protected health information” (PHI) includes information about your past, present or future health, health care we provide you and payment for your health care contained in the record of care and services provided by Saint Xavier University Health Center. The purpose of this notice is to explain who, what, when, where and why your PHI may be used or disclosed, and to assist you in making informed decisions when authorizing anyone to use or disclosure of your PHI.
This notice describes the privacy practices of the Saint Xavier University Health Center and their collaborating physicians, nurse practitioners, nurses, other staff and volunteers.
We may use and disclose your PHI in many situations that are common in many clinics. In certain other situations we will need your written permission in order to use or share your PHI (these will be listed under Use or Disclosure with Your Permission). We do not need any type of permission from you for the following uses and disclosures:
- Treatment. We may use and disclose your PHI to anyone involved in the provision of health care to you, including, but not limited to, the University Health Center collaborating physician, nurse practitioners, nurses, and additional medical and counseling professionals, including nursing students, nurse practitioner students and faculty who may be involved. In addition, we may contact you to provide appointment reminders or information about treatment options. We may tell you about other health-related benefits and services that might interest you. We may also disclose your PHI to outside treating medical professionals and staff as deemed necessary for your health care.
- Payment. We may use and share your PHI to obtain payment for services that we provide to you. For example we may share information with insurance companies, employers (contracted with Saint Xavier University Health Center), Medicare, Medicaid or other companies or programs that arrange or pay the cost of some or all of your health care.
- Health Care Operations. We may use and share your PHI for our health care operations. Saint Xavier University Health Center physicians, nurse practitioners, nurses, managers, staff and outside consultants, may look at your health information to complete a quality review to assess the care and results in your case and others like yours. The University is a teaching facility so we may use your information in the process of educating and training students. For example, we may use your PHI to review the quality and skill of our practitioners and staff.
- Your Other Health Care Providers. We may also share PHI with your doctor and other health care providers when they need it to provide treatment to you.
- Business Associates. There are some services provided through our health center, that require outside contracts and services. These services require that the individuals involved have access to your health records. An example of this would be the technical services people who may be retrieving data for our reports and research projects. To protect your health information, however, we require the business associate to protect your information.
- Research Associates and Projects. Under certain circumstances, we may use and disclose medical information about you for research purposes. All research projects, however, are subject to a special approval process.
- Legally Required Disclosures and Public Health. We may disclose PHI as required by
law, including to government officials to prevent or control disease, to report child,
adult or spouse abuse, to report reactions or problems with products, and to report
births and deaths. The PHI information may be released to the following type entities
but not limited to:
- Food and Drug Administration
- Public Health or legal authorities charged with disease prevention
- Correctional Institutions
- Workers Compensation Agents
- Organ and Tissue Donation Organizations
- Military Command Authorities
- Health Oversight Agencies
- Funeral Directors, Coroners and Medical Examiners
- National Security and Intelligence Agencies
- Law enforcement as required by law or in accordance with a valid subpoena
We will not use information in your records for marketing.
- Use or Disclosure with Your Permission. For any purpose other than the ones described above in the previous sections, we may only use or share your PHI when you grant us your written permission. For example, you will need to give us your permission before we send your PHI to your life insurance company.
- Uses and Disclosures of Your Highly Confidential Information. Federal and state law
requires special privacy protections for certain highly confidential information about
you, including any portion of your PHI that is:
- kept in psychotherapy notes
- about mental health and developmental disabilities services;
- about alcohol and drug abuse prevention, treatment and referral
- about HIV/AIDS testing, diagnosis or treatment
- about venereal disease
- about genetic testing
- about child abuse and neglect
- about domestic abuse of an adult with a disability
- about sexual assault
Before we share your highly confidential information for a purpose other than those permitted by law, we must obtain your written permission.
You have the right to:
- Request a restriction on certain uses and disclosures of your information; 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 emergency treatment.
- Obtain a paper copy of the notice of information practices upon request.
- Inspect and obtain a copy of your health records.
- Obtain an accounting of disclosures of your health information.
- Request communication of your health information in a certain way or at a certain location. For example, you can ask that we use an alternative address for billing purposes.
- Revoke your authorization to use or disclosure health information except to the extent that action has already been taken.
Our Duties are to:
- Maintain the privacy of your health information.
- Provide you with a notice as to our legal duties and privacy practices with respect to information we collect about you through this notice.
- Abide by the terms of this notice.
- Notify you if we are unable to agree to a requested restriction.
- Accommodate reasonable requests you have to communicate health information by alternative means or at alternative locations.
We reserve the right to change the terms of this notice and to make new notice provisions effective for all PHI that we maintain by posting the revised notice in our Health Center, making copies of the revised notice upon request to the facility or posting the revised notice on our Web site.