This Notice describes how medical information about you may be used and disclosed and how you may gain access to this information.
HAMPTON REGIONAL MEDICAL CENTER NOTICE OF PRIVACY PRACTICES
Hampton Regional Medical Center and all the members of its medical staff (referred to in this Notice as "we," "us," or the "Hospital") understand that information about you and your health is personal. We will refer to your health information in this Notice as your "protected health information" or "PHI." We are committed to protecting the privacy and confidentiality of your protected health information. This Notice is required by law and applies to all of the PHI contained in the records of your care generated at or maintained by the Hospital, whether made by the Hospital personnel, or by a member of our medical staff or by another healthcare provider.
1.UNDERSTANDING YOUR PROTECTED HEALTH INFORMATION
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made so that we may provide you with quality of care and comply with certain legal requirements. Typically, this record contains documentation of your symptoms, examination and test results, diagnosis, treatment and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a basis for planning your care and treatment and serves as a means of communication among the many health professionals who contribute to your care. Other information related to payment for your care and treatment is also part of your protected health information. Understanding what is in your record and how your PHI is used helps you to ensure its accuracy, better understand who, what, when, where, and why others may access your protected health information, and make more informed decisions when authorizing disclosure to others.
2.HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION WITHOUT AUTHORIZATION
For Treatment: We may use your PHI to provide you with health care treatment or services. For example: Information obtained by a health care practitioner will be recorded in your record and used to determine the course of treatment that should work best for you. By way of example, your physician will document in your record their expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. We may disclose the information to other health care providers who provide treatment to you, such as pharmacists who are filling your prescriptions. We may also disclose the information to others who may assist us to coordinate and manage your care.
For Payment:We may use and disclose your PHI so that the treatment and services you receive at the Hospital may be billed to and payment may be collected from you, an insurance company or a third party. For example: A bill may be sent to you or a third party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. Other payment activities may include eligibility or coverage for benefits, claims, collection activities, review of services provided, utilization review, and disclosures to consumer reporting agencies. We may also need to obtain authorization from your insurance company before providing certain types of treatment.
For Health Care Operations:We will use and disclose your health information as necessary to run the Hospital and make sure that all of our patients receive quality care. We will use and disclose your PHI to:
For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.
Appointment Reminder, Treatment Options or Health-Related Benefits and Services: We may contact you to remind you or any appointments, healthcare treatment options or other health services that may be of interest to you.
For example: We may contact you in advance of a procedure that has been scheduled by your physician at our facility to remind you of the scheduled date and time.
As Required By Law: We may use or disclose your PHI as required by law so long as the requirements for disclosures related to abuse, neglect or domestic violence reporting, law enforcement or for legal proceedings are followed.
For Public Health Activities: We may use or disclose your PHI to public health authority that is authorized by law to receive such information to:
Prevent or control disease, injury or disability
Report child abuse or neglect
Report adverse events with respect to food, drugs and product defects
Enable product recalls, repairs or replacement
We may also disclose PHI to your employer, as allowed by occupational health and safety laws, regarding work-related illness or injury or concerning medical surveillance.
For Abuse, Neglect or Domestic Violence Reporting: If we believe that you have been a victim of abuse, neglect or domestic violence, we may disclose your PHI to a government authority or agency authorized by law to receive such reports.
For Health Oversight Activities: We may disclose your PHI to a health oversight agency for activities authorized by law, such as audits, civil, administrative or criminal investigations, inspections, licensure or disciplinary actions.
For Legal Proceedings: We may disclose your PHI in the course of any judicial or administrative proceedings in response to an order of the court, administrative tribunal, subpoena, discovery request or other lawful request.
For Law Enforcement: We may disclose your PHI for law enforcement purposes in response to a court order, court ordered warrant, subpoena, summons, a grant jury subpoena, administrative request or similar process.
Coroners, Medical Examiners and Funeral Directors: We may disclose your PHI to coroners, medical directors and funeral directors as required by law to carry out their duties.
For Organ and Tissue Donation: If you are an organ donor, we may use or disclose your PHI to organ procurement organizations or other organizations that handle procurement, banking or transplantation of organs for the purpose of tissue donation and transplantation.
For Research: We may use or disclose your PHI to researchers provided that the use or disclosure has been approved and procedures have been established to ensure the privacy of your PHI.
To Prevent Serious Threat to Health and Safety: We may use or disclose your PHI if, in good faith, we believe the use or disclosure is necessary to prevent or lessen a serious threat to your health or safety or to the health and safety of the public or another person.
Military Activity, Veterans, and National Security: If you are a member of the Armed Forces, we may use or disclose your PHI for activities deemed necessary by appropriate military command authorities to assure the proper execution of the military mission. We may disclose PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Worker's Compensation: We may use or disclose your PHI to comply with worker's compensation or other similar programs established by law for work related injuries or illness.
3.OTHER USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION THAT MAY BE MADE IF WE PROVIDE YOU WITH THE OPPORTUNITY TO OBJECT.
Notification to Individuals Involved in your Care: We may use or disclose PHI to a family member, close friend, or any other person you identify to the extent it is relevant to that person's involvement in your treatment. We may also disclose your PHI to your family or friends if it is apparent from the circumstances and based on our professional judgment that you would not object. For example, we may assume that you do not object to disclosure of your PHI to your spouse if you permit your spouse to accompany you during treatment or to be present while treatment is discussed.
Hospital Directory: Unless you notify us that you object, we will use and disclose your name, location in the facility, condition (in general terms) and religious affiliation for directory purposes. This information, except for religious affiliation, will be disclosed to people who ask for you by name. Only members of the clergy will be told of your religious affiliation.
Disaster Relief Purposes: Unless you object, we may disclose your PHI to a public or private entity authorized to assist in disaster relief efforts. Your objection will be honored to the extent that we, in the exercise or our professional judgment, determine that the objection does not interfere with our ability to respond to the emergency circumstances.
4.USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION THAT REQUIRE YOUR WRITTEN AUTHORIZATION.
Other uses and disclosures of your PHI will be made only with your written authorization for its use or disclosure. You may revoke your authorization to use or disclose your health information at any time except to the extent that your PHI has already been used or disclosed before you revoke your authorization. You must revoke your authorization in writing.
If we receive PHI from a facility covered by the Alcohol and Drug Rehabilitation Act, or if we receive or create certain psychiatric protected health information, we will not further disclose that PHI without your express permission without a court order.
5.YOUR RIGHTS CONCERNING YOUR PROTECTED HEALTH INFORMATION AND THIS NOTICE
Although the Hospital is the owner of your health record, you have certain rights concerning your protected health information. You have the right to:
Amend Your Health Record: If you believe the PHI we have about you is incorrect or incomplete, you may ask us to amend the information for as long as we maintain your protected health information. If you wish to request an amendment, then you must do so in writing and submit that request to the HIPAA Officer via U.S. mail at 595 Carolina Avenue West, PO Box 338, Varnville, SC 29944. The request must provide the reason(s) you are making the request. Your request may be subject to certain exceptions and limitations. We may deny your request to amend your PHI. We will not amend PHI that was not created at the Hospital, unless the individual or entity that created the information is no longer available to amend the information.
Inspect and Copy Your Health Information: You have the right to inspect and copy your protected health information. You must submit a written request to the HIPAA Officer via U.S. mail at 595 Carolina Avenue West, PO Box 338, Varnville, SC 29944 in order to inspect and/or copy your protected health information. In certain circumstances, we may deny your request to inspect and/or copy your records. If you request a copy of your health information, reasonable copying fees may be charged.
Receive an Accounting of Disclosures: You have the right to receive an accounting of disclosures of your PHI that we may make after April 14, 2003 but within six (6) years of the date of request. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice. The right to receive this information is subject to certain exceptions, restrictions and limitations. If you wish to request an accounting, then you must do so in writing and submit that request to the HIPAA Officer via U.S. mail at 595 Carolina Avenue West, PO Box 338, Varnville, SC 29944. The first request for an accounting within any 12-month period will be provided to you at no charge. We may charge you a reasonable copying fee for additional requests.
Request Restrictions: You have the right to request restrictions or limitations on the PHI we use or disclose about you to carry out treatment, payment, healthcare operations or make notifications to individuals involved in your care as described in this Notice. If you wish to request a restriction, then you must do so in writing and submit that request to the HIPAA Officer via U.S. mail at 595 Carolina Avenue West, PO Box 338, Varnville, SC 29944. The written request must include the PHI you wish to restrict, whether you want to restrict its use or disclosure or both, and to whom you wish the restrictions to apply. We are not required to agree to your request for restriction. If the restricted PHI is needed to provide emergency treatment, we may disclose such information to your health care provider for the purpose of providing treatment.
Request Confidential Communications: You may request that we communicate with you about your PHI in a certain way or at a certain location. We will accommodate reasonable requests. For example, you may request that we contact you at work. If you wish to request confidential communications, you must make the request in writing and submit it to the HIPAA Officer via U.S. mail at 595 Carolina Avenue West, PO Box 338, Varnville, SC 29944. The request must include how and where you wish to be contacted.
Obtain a Paper Copy of This Notice: You have a right to obtain a paper copy of this Notice even if you have agreed to receive it electronically. We will provide you with a copy of our Notice upon your request.
6.REQUIREMENTS OF THE HOSPITAL
We are required by law to maintain the privacy of PHI and to abide by the terms of this notice. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all of the PHI that we maintain.
We will post a copy of the current Notice in the Hospital. The Notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at or are admitted to the Hospital for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current Notice in effect. Additionally, upon your request, we will provide you with a revised notice. You may request a revised Notice be sent to you in the mail or you may ask for a revised copy at the time of your next visit. If we maintain a web site that provides information about our customer services or benefits, we will post our new notice on that Web site.
If you believe your privacy rights have been violated, you may file a complaint with the Hospital or with the Office of Civil Rights, U.S. Department of Health and Human Services. To file a complaint with the Hospital, contact the HIPAA Officer via U.S. mail at 595 Carolina Avenue West, PO Box 338, Varnville, SC 29944, via telephone at (803)943-1259 or via electronic mail to HRMCHIPAA@hamptonregional.org
All complaints must be submitted in writing, either paper or electronically. The complaint must name the entity that is the subject of the complaint, and describe the acts or omissions believed to be in violation of the requirements or standards. A complaint must be filed within 180 days of when the complainant knew or should have known that the act or omission complained of occurred, unless the Secretary (HHS) for good cause shown waives this time limit. You will not be penalized for filing a complaint.
8. SOUTH CAROLINA HEALTH INFORMATION EXCHANGE
Your doctor or health care provider has become a member of the South Carolina Health Information Exchange ("SCHIEx"). This Notice tells you how doctors and other health care providers may use or share your electronic health information through SCHIEx EXCHANGE and with whom it may be shared.
About SCHIEx Exchange:SCHIEx EXCHANGE makes it possible for your doctor to share your medical history, including medications, allergies, diagnoses, and procedures, with other doctors and health care providers involved in your care. It is a safe and secure network that makes sure your personal health information is available to the aforementioned persons when and where it is needed. SCHIEx does not keep or store your personal health information.
By allowing your doctors and other health care providers to use and share your personal health information through SCHIEx EXCHANGE:
How your electronic health information may be used or shared:Your privacy and your personal health information are protected by federal and state law. Those federal and state laws also govern the way your personal and electronic health information is used or shared through SCHIEx. Your doctors will use and share your electronic health information with other health care providers involved in your care to provide, coordinate, or manage your health care and any related services. This includes coordinating your health care with other health care providers who have signed on as members of SCHIEx and agreed to follow all of the SCHIEx EXCHANGE policies and procedures.
SCHIEx EXCHANGE members may include health care providers licensed in the State of South Carolina, including medical doctors, dentists, chiropractors, optometrists, podiatrists, pharmacists, physician assistants, and nurse practitioners. SCHIEx EXCHANGE members also may include organizations such as hospitals, ambulatory surgical facilities, home health agencies, pharmacies, case management providers, telemonitoring providers, health information exchanges and organizations within which eligible individuals practice.
In emergencies, including any visits to a hospital's emergency department that is a member of SCHIEx EXCHANGE, we will allow emergency room doctors and nurses to see your personal health information, so you may receive the most appropriate care. Personal health information that may be shared includes personally identifiable information, general information, diagnoses, test results, prescriptions, claims data, and clinical notes.
Participating in SCHIEx exchange or not:You may 'Opt Out' of SCHIEx EXCHANGE. By opting out, your personal health information will not be shared through SCHIEx EXCHANGE. If you wish to opt out of SCHIEx EXCHANGE, you must ask for, complete, and sign an Opt Out form that tells us in writing that you do not want your personal health information included in or shared through SCHIEx EXCHANGE. Should you wish to opt out using a signed Opt Out form, we will take steps to make sure your personal information cannot be viewed, used, or shared through SCHIEx EXCHANGE.
IMPORTANT!Please understand that if you opt out, your personal health information will not be used or shared by any doctor or health care provider through SCHIEx EXCHANGE except where required by law. If you change your mind and wish to have your electronic health information shared through SCHIEx EXCHANGE, you may cancel your Opt Out. To cancel your Opt Out, you or your personal representative must complete, and submit a signed SCHIEx form to the office staff stating that you allow us to share your electronic health information through SCHIEx EXCHANGE. We will use our best efforts to make all of your electronic health information available through SCHIEx EXCHANGE. However we cannot guarantee that all of your personal health information will be available at that time. You are required to sign this form, acknowledging that you have received this SCHIEx EXCHANGE Notice of Participation. If you choose to allow your providers to share your electronic health information, you do not need to do anything else. If you choose to Opt Out of sharing your electronic information through SCHIEx EXCHANGE, please complete the information on the form provided.
Click here to download a printable version of the SCHIEx Notice of Participation.