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Notice of Privacy Practices (Memorial Health University Physicians)
This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
At Memorial Health we are committed to treating and using protected health information about you responsibly. This Notice of Privacy Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information or PHI. This Notice is effective September 15, 2013, and applies to all PHI as defined by federal regulations.
Memorial Health reserves the right to change the terms of this Notice of Privacy Practices and to make the new Notice provisions effective for all PHI we maintain. When we make a significant change in our Notice of Privacy Practices, we will post the new Notice in the front entrance of our locations.
Understanding Your Health Record/Information
Each time you visit Memorial Health, 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 or medical record, serves as a:
Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.
Your Health Information Rights
Although your health record is the physical property of Memorial Health, the information belongs to you. You have the right to:
Memorial Health is required by law to:
How We May Use and Disclose Medical Information About You
We can only use your PHI in certain ways. The law allows us to use your PHI without your permission for treatment, payment and operations.
Treatment: This generally means the delivery of health care and related services among health care providers, consultation between health care providers regarding your care or the referral of your treatment from one health care provider to another.
Payment: This involves the various activities of Memorial Health to obtain payment for their services and to fulfill your health plans’ coverage responsibilities, and to obtain or provide reimbursement for the provision of health care. Included are:
Operations: Certain administrative, financial, legal and quality improvement activities are necessary to run the business and to support the core functions of treatment and payment. Operational activities may include:
The law also allows us to use your PHI without your permission in the following ways: Health Plans: We may also share PHI with other health care providers and health plans where you’ve been a patient in the past. We would only share this information to help them provide better care or to help them watch for fraud or abuse. Directories: We keep lists of patients who are in our facilities. We keep track of their names, room numbers, general condition (i.e. stable, fair, etc.), and religion. We can share some of this information with people who ask about you by name. However, you can ask to be removed from the directory to keep this information confidential. 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. Communication with Family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. Research: We may disclose 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 health information to funeral directors consistent with applicable law to carry out their duties. Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant. Appointment Reminders and Other Items of Interest: We may also contact you for appointment reminders, or to tell you about or recommend possible treatment options, alternatives, or health-related benefits or services that may be of interest to you. Fundraising: We may contact you as part of a fundraising effort. If you do not want to receive fundraising information please notify the Memorial Health Foundation at (912) 350-6370. Food and Drug Administration (FDA): We may disclose to the FDA health 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 health 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 health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability. Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Health Oversight Activities: We may disclose medical information to governmental, licensing, auditing, and accrediting agencies as authorized or required by law. As Required by Law: We will disclose medical information about you when required to do so by federal or state law. Other Uses and Disclosures: For any category of use or disclosure that is not described above or authorized by law, we must obtain your written authorization. This includes (i) most uses and disclosures of psychotherapy notes (if recorded by a covered entity); (ii) uses and disclosures of PHI for marketing purposes, including subsidized treatment communications; (iii) disclosures that constitute a sale of PHI. If you give us your written authorization, you may revoke (cancel) it at any time by submitting a written revocation to the office or location that originally received your authorization, or to the Privacy Officer at the address listed below. Your revocation will be effective except to the extent that we have already acted upon your authorization. For More Information or to Report a Problem If you are concerned that your privacy may have been violated, or you disagree with a decision that we made about your health information, you may write or call our Privacy Office, or our Compliance and Ethics alertline, a 24-hour phone service, at the numbers listed below: Memorial Health University Medical Center Compliance and Audit ServicesPrivacy Officer4700 Waters Avenue, Savannah Ga. 31404Office (912) 350-8681 Compliance & Ethics alertline, 1-800-555-8497
Memorial Health University Medical Center Health Information Management 4700 Waters Avenue, Savannah Ga. 31404 Office (912) 350-8667
If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer at the contact information above or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below: Roosevelt Freeman, Regional Manager Office of Civil Rights U.S. Department of Health and Human Services Atlanta Federal Center, Suite 3B70 61 Forsyth Street, S.W. Atlanta, GA 30303-8909 (404) 562-7881
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