Illinois Heart & Lung Associates
NOTICE OF PRIVACY PRACTICES
EFFECTIVE APRIL 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED, DISCLOSED,
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
A federal regulation, known as the “HIPAA Privacy Rule”, requires
that Illinois Heart and Lung Associates (“IHLA”) provide detailed
notice to you in writing about the way in which we may use and disclose
medical information about you, and your rights. We know this Notice is
long, but the Privacy Rule requires we address many things about your private
health information.
UNDERSTANDING YOUR HEATH RECORD/INFORMATION:
Each time your visit a hospital, physician, or other healthcare provider,
a record of your visit is made. Typically, this record contains your symptoms,
examination, and test results, diagnoses, treatment and a plan for future
care or treatment.
This information often referred to as your health
record, medical record, or PHI (protected health information) is a:
- way to plan your care and treatment.
- way to communicate between the many health professionals
that aid in your care.
- tool that we can use to continually improve
the care we give to our patients and outcomes we achieve.
OUR RESPONSIBILITIES:
Our practices are required to:
- keep your medical information private.
- provide this notice to you letting you know
our legal duties, and privacy practices about the information we collect
and maintain about you.
- follow the terms of this agreement.
- accept reasonable requests you may have to
communicate medical information by an alternate means or to alternate locations.
We have the right to change our practices and to make the new provisions
effective for all protected health information we maintain. Should our information
practices change, we will mail you a revised notice to the address you have
given us.
We will not use or give out your health information without your authorization,
except as described in this notice.
The following categories describe different ways that we use and disclose
medical information. Not every use or disclosure may be listed, but every
use or disclosure will fall into one of these categories:
USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS:
*We will use your medical information for your treatment: Members of your
healthcare team will use or disclose medical information in your records
to treat you or assist others who treat you. For example, a nurse may take
your blood pressure and document it in your record. The doctor may review
your blood pressure reading, along with other information in your record.
All of the information in your records allows the doctor to treat you, track
your response to treatment, and to make any changes necessary.
We may also provide your primary care physician
or other subsequent healthcare provider with copies of various reports that
should assist him or her in treating you.
*We will use your medical information for
payment: For Example: A bill may be sent to you or a third-party payer, i.e. your
health plan. This includes commercial insurance, Medicare, Medicaid, Medigap,
and CHAMPUS. The information on or with the bill may include information
that identifies you and your diagnosis, any procedures done, and cardiac
and/or pulmonary equipment checked. We may also tell your health plan about
a treatment you are going to receive to obtain approval or to determine whether
your plan will cover the treatment.
*We will use your medical information for
regular health care operations: We may use information from your health record to
develop ways to help our physicians and staff in deciding how we can improve
the medical treatment we provide.
For Example: Reviewing and improving the quality, efficiency and cost of
care that we provide to our patients in order to:
Improve health care and lower costs for groups of people who have similar
health problems and/or helping to manage and coordinate the care for these
groups of people. We may use the information from your health record to identify
groups of people with similar health problems to give them information, for
instance, about treatment alternatives, and provide educational classes.
Review and evaluate the skills, qualifications, and performance of our health
care providers taking care of you and our other patients.
Participate in internship programs for nursing, physician assistants, health
information management and other allied health professionals, as a requirement
of their schooling.
Cooperate with outside organizations that evaluate, certify, or license
health care providers or staff in a particular field or specialty. We may
also cooperate with organizations that assess the quality of care that we
provide, for example, certification agencies.
OTHER USES AND DISCLOSURES OF YOUR MEDICAL INFORMATION THAT WE ARE PERMITTED
OR REQUIRED BY LAW TO MAKE:
The HIPAA Privacy Rule allows us to make uses and disclosures of your medical
information in other circumstances besides treatment, payment, and health
care operations. Some of these circumstances are:
*Business Associates: There are some services provided in our offices through
contacts called business associates.
Examples include accounting firms, attorneys,
information technology services, and third-party payer billing services.
When these services are contracted, we may disclose your health information
to our business associate so they may perform the job we’ve asked
them to do. To protect your health information, however, we require the
business associate to appropriately safeguard your information.
*Notification: We may use or disclose information to notify or assist in
notifying a family member, personal representative, or another person responsible
for your care, your location and general condition, unless otherwise specified
in writing.
*Communications with family: Health professionals,
using their best judgement, may disclose to a family member, other relative,
close personal friend or any other person you identify, medical information
relevant to that person’s
involvement in your care or payment related to your care. You may agree
to this use or disclosure by signing a form, or by telling an IHLA health
professional. Otherwise IHLA may use or disclose your health information
to a person responsible for your care if an IHLA health professional reasonably
infers from the circumstances, based on the exercise of professional judgement,
that you would not object to the disclosure.
*Treatment Alternatives and Health Related
Benefits and Services: We may
use and disclose medical information to tell you about or recommend possible
treatment options or alternatives as well as health-related benefits and
services that may be of interest to you.
*Research: We may disclose medical information to researchers when their
research has been approved by an Institutional Review Board that has reviewed
the research proposal and established protocols to ensure the privacy of
your health information.
*Funeral Directors: We may disclose medical information to funeral directors
consistent with applicable law to carry out their duties.
*Organ procurement organizations: Consistent with applicable law, we may
disclose medical information to organ procurement organizations or their
entities engaged in the procurement, banking, or transplantation of organs
for the purpose of tissue donation and transplant.
*Appointment Reminders: We may contact you to provide appointment reminders.
*As Required by Law: We will disclose medical information about you when
required to do so by federal, state, or local law.
*Fund Raising: We may contact you as a part of a fund-raising effort.
*Food and Drug Administration (FDA): We may disclose to the FDA medical
information relative to adverse events with respect to food, supplements,
product and product defects, or post marketing surveillance information to
enable product recalls, repairs or replacement.
*Workers Compensation: We may disclose medical information, to the extent
authorized by and to the extent necessary, to comply with laws relating to
workers compensation or other similar programs established by law.
*Public Health: As required by law, we may disclose your medical information
to public health or legal authorities charged with preventing or controlling
disease, injury or disability.
*Law Enforcement: We may disclose medical information
for law enforcement purposes as required by law or in response to a valid
subpoena; to identify or locate a suspect or missing person; about the
victim of a crime. If under certain limited circumstances, we are unable
to obtain the person’s
agreement; about a death we believe may be the result of criminal conduct;
or in emergency circumstances.
*Health Oversight Activities: Federal law makes provision for your medical
information to be released to an appropriate health oversight agency, public
health authority or attorney, provided that a work force member or business
associate believes in good faith that we have engaged in unlawful conduct
or have otherwise violated professional or clinical standards and are potentially
endangering one or more patients, workers or the public.
*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.
*Military and Veterans: If you are a member of the armed forces, we may
release medical information about you as required by military command authorities.
We may also release medical information about foreign military personnel
to the appropriate foreign military authority.
*National Security and Intelligence Activities: We may release medical information
about you to authorized federal officials for intelligence, counterintelligence,
and other national security activities authorized by law.
*Protective Services for the President and
Others: We may disclose medical
information about you to authorized federal officials so they may provide
protection of the President, other authorized persons or foreign heads of
state or conduct special investigations.
YOUR MEDICAL INFORMATION RIGHTS:
The “HIPAA Privacy Rule” says
that you may:
*Request a Restriction on Certain Uses and
Disclosures. You have the right
to request a restriction or limitation on the medical information we use
or disclose about you for treatment, payment, or health care operations.
You also have the right to request a limit on the medical information we
disclose about you to someone who is involved in your care or the payment
of your care, like a family member or friend. You should note that IHLA does
not have to agree to your request.
*Have a Paper Copy of This Notice, Upon Request: We will give you a copy
of this Notice. If we decide to give you a copy of this notice electronically,
you have the right to receive a paper copy in addition.
*Review and Copy Your Medical Information: This right does not include information
compiled for use in a legal proceeding. 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. We may deny your request to inspect and copy
in certain very limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed. To inspect and
copy medical information that may be used to make decisions about you, you
must submit your request in writing to Medical Records.
*Request a List of Disclosures: You have the right to request that a list
of places your record was release to. The list WILL NOT include disclosures
that we made to you, that were made to people involved in your care, or that
were made pursuant to an authorization. The list will not include disclosures
that were made for treatment, payment or health care operations. In addition,
we will not include on the list medical information disclosed as required
by law, that will compromise national security, or that were made pursuant
to an authorization.
To request this list or accounting of disclosures, you must submit your
request in writing to the Compliance Specialist. Your request must state
a time period which may not be longer than 6 (six) years and may not include
dates before April 13, 2003. Your request should indicate what form you want
the list (for example electronically or on paper). We will do our best to
honor your request. We may charge you for the costs of providing the list.
We will notify you of the cost involved and you may choose to withdraw or
modify your request at the same time before any costs are incurred.
*Right to Request Confidential Communications: You have the right to ask
that your medical information be communicated in another way, or to a different
location (a location other than your home, for example).
*Cancel Your Authorization for Us to Use or
Release Medical Information. You may request to cancel or revoke your authorization for us to use or disclose
medication information about you. However, we will honor your request except
if we have already released the information or otherwise relied upon your
authorization.
*Request an Amendment or Correction to Your
Records: 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 or correction
for as long as the information is kept by IHLA. To request a correction or
an amendment, your request must be submitted in writing and submitted to
Medical Records. In addition, you must provide a reason that supports your
request.
We may deny your request for an amendment or correction if it is not in
writing or does not include a reason to support the request. We may also
deny your request if we determine that your record is accurate and complete;
if under the HIPAA Privacy Rule we do not have to make your record available
to you for inspection; or if your record was not originated by IHLA.
FOR MORE INFORMATION OR TO REPORT A PROBLEM:
If you believe your privacy rights have been violated, you can file a complaint
with the Office of Civil Rights, U.S. Department of Health and Human Services-
in writing, or with the Compliance Specialist at IHLA. There will be no retaliation
for filing a complaint.
Illinois Heart and Lung Associates
Julie Bennett, RHIA- Compliance Specialist
1300
Franklin Avenue, Suite 350
Normal, IL 61761
(309) 663-5712, Press #6
Approved: 04/03/03
Reviewed:08/24/04, 12/30/05, 10/23/06
Revised: 06/22/05, 12/30/05
