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
Madison
County Hospital uses health information about you for treatment,
to obtain payment for treatment, for administrative purposes, and
to evaluate the quality of care that you receive. Your health information
is contained in a medical record that is the physical property of
Madison County Hospital.
How
Madison County Hospital May Use or Disclose Your Health Information
For
Treatment. Madison County Hospital may use your health information
to provide you with medical treatment or services. For example,
information obtained by a health care provider, such as a physician,
nurse, or other person providing health services to you, will record
information in your record that is related to your treatment. This
information is necessary for health care providers to determine
what treatment you should receive. Health care providers will also
record actions take by them in the course of your treatment and
note how you respond to the actions.
For
Payment. Madison County Hospital may use and disclose your health
information to others for purposes of receiving payment for treatment
and services that you receive. For example, a bill may be sent to
you or a third-party payor, such as an insurance company or health
plan. The information on the bill may contain information that identifies
you, your diagnosis, and treatment or supplies used in the course
of treatment.
For
Health Care Operations. Madison County Hospital may use and
disclose health information about you for operational purposes.
For example, your health information may be disclosed to members
of the medical staff, risk or quality improvement personnel, and
others to:
• evaluate the performance of our staff;
• assess the quality of care and outcomes in your cases
and
similar cases;
• learn how to improve our facilities and services; and
• determine how to continually improve the quality and
effectiveness of the health care we provide.
Appointments.
Madison County Hospital may use your information to provide appointment
reminders or information about treatment alternatives or other health-related
benefits and services that may be of interest to you.
Fund Raising. Madison County Hospital may use your information
to raise funds which are used to improve hospital services and facilities
Required by law. Madison County Hospital may use and disclose
information about you as required by law. For example, Madison County
Hospital may disclose information for the following purposes:
• for judicial and administrative proceedings pursuant to
legal
authority;
• to report information related to victims of abuse, neglect
or
domestic violence; and
• to assist law enforcement officials in their law enforcement
duties;
Public Health. Your health information may be used or disclosed
for public health activities such as assisting public health authorities
or other legal authorities to prevent or control disease, injury,
or disability, or for other health oversight activities.
Decedents. Health Information may be disclosed to funeral
directors or coroners to enable them to carry out their lawful duties.
Organ/Tissue Donation. Your health information may be used
or disclosed for cadaveric organ, eye or tissue donation purposes.
Research.
Madison County Hospital may use your health information for research
purposes when an institutional review board or privacy board that
has reviewed the research proposal and established protocols to
ensure the privacy of your health information has approved the research.
Health and Safety. Your health information may be disclosed
to avert a serious threat to the health or safety of you or any
other person pursuant to applicable law.
Government Functions. Specialized government functions such
as protection of public officials or reporting to various branches
of the armed services that may require use or disclosure of your
health information.
Workers Compensation. Your health information may be used
or disclosed in order to comply with laws and regulations related
to Workers Compensation.
Your Health Information Rights
You have the right to:
• request a restriction on certain uses and disclosures or
your
information as provided by 45 C.F.R. §164.522; however,
Madison County Hospital is not required to agree to a
requested restriction;
• obtain a paper copy of the notice of information practices
upon request;
• inspect and obtain a copy of your health record as provided
for in 45 C.F.R. §164.524;
• amend your health record as provided in 45 C.F.R.
§164.526;
• request communications of your health information by
alternative means or at alternative locations;
• revoke your authorization to use or disclose health
information except to the extent that action has already
been
taken; and
• receive an accounting of disclosures made of your health
information as provided by 45 C.F.R. §164.528.
Complaints
You may complain to Madison County Hospital and to the United States
Department of Health and Human Services if you believe your privacy
rights have been violated. You will not be retaliated against for
filing a complaint.
Obligations of Madison County Hospital
Madison County Hospital is required to:
• maintain the privacy of protected health information;
• provide you with this notice of its legal duties and privacy
practices with respect to your health information;
• abide by the terms of this notice;
• notify you if we are unable to agree to a requested
restriction on how your information is used or disclosed;
• accommodate reasonable requests you may make to
communicate health information by alternative means or at
alternative locations; and
• obtain your written authorization to use or disclose your
health information for reasons other than those listed above
and permitted under law.
Madison County Hospital reserves the right to change its information
practices and to make the new provisions effective for all protected
health information it maintains. Revised notices will be made available
to you by in our Medical records or Registration Departments.
Contact Information
If you have any questions or complaints, please contact:
Madison County Community Hospital Privacy Coordinator
210 N. Main St.
London, Ohio 43140
Phone: 740 - 845 - 7000
|
