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Notice of Privacy Practices
Effective Date: April 2003
CoxHealth Includes:
Burrell Behavioral Health
Burrell Foundation
Cox HealthCare Foundation
Cox Health Plans, HMO
Cox Health Plans, LLC
Insurance Company of Springfield
CHS Insurance Company
Lester E Cox Medical Centers: North, South, and Walnut Lawn
Cox Monett
Cox Regional Services
Ferrell Duncan Clinic
OxfordHealthCare
Home Parenteral Services
Home Support Services
Primrose Nursing Home
Primrose Health Care System
Medical Staff
Emergency Physicians of Springfield, Inc – (physicians who staff the
ER)
Litton-Giddings Radiological Associates, Inc – (radiologists)
Ozark Anesthesia Associates, Inc (anesthesiologists)
Ozark Magnetic Imaging
Ozark Health Ventures (aka Ozark Neuro Rehab)
Pathology Services of Springfield, PC
PRIVACY PRACTICES top
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 CAREFULLY15.
15 This header is required to be on every covered entity’s
notice of privacy practices in exactly this language. While the wording
or phrasing
of other portions of this notice may be modified, do not modify or alter
this section. This notice is intended to inform you about our practices related to
the protection of the privacy of your medical records. Generally, we
are required by law to ensure that medical information that identifies
you is kept private. Further, we must give you this information related
to our legal duties and privacy practices with respect to medical information
we create or receive about you. We are required by law to follow the
terms of the notice that is currently in effect.
This notice will explain how we may use and disclose your medical information,
our obligations related to the use and disclosure of your medical information
and your rights related to medical information that we have about you.
This notice applies to the medical information that is generated in or
by CoxHealth.
With a few exceptions, we are required to obtain your authorization
for the use or disclosure of information for reasons other than for treatment,
payment or health care operations. We have listed some of the reasons
why we might use or disclose your medical information and some examples
of the types of uses or disclosures below. Not every use or disclosure
is covered, but all of the ways that we are allowed to use and disclose
information will fall into one of the categories
If you have any questions about the content of this Notice of Privacy
Practices, or if you need to contact someone at CoxHealth about any of
the information contained in this Notice of Privacy Practices, the contact
person is: Name of Contact: Robin Gann
Title: Privacy Officer & Director,
Health Information Management
Address: CoxHealth,
3801 S. National Avenue,
Springfield, MO 65807
Phone number: (417) 269-6144 In addition to CoxHealth hospital departments, clinics, employees, medical
staff, and other CoxHealth personnel, the following persons will also
follow the practices described in this Notice of Privacy Practices:
- Any health care professional who is authorized to enter
information in your medical record;
- Any member of a volunteer group that we allow to help
you while you are in CoxHealth; and
- Students conducting internships, clinical practice.
Students who care for you or observe in any of our settings.
-
CoxHealth entities are listed on page one of this Notice of Privacy Practices.
These entities follow the terms of this Notice of Privacy Practices.
In addition, these entities may share medical information for treatment,
payment or health care operations as they are described in this Notice
of Privacy Practices. These entities are hereinafter referred to collectively
with the hospital as “CoxHealth.”
Use
and Disclosure of Medical Information for Treatment, Payment or Health
Care Operations top We can use or disclose medical information about you regarding
your treatment, payment for services or for CoxHealth operations.
For
Treatment: To provide you with medical treatment or services,
we may need to use or disclose information about you to doctors,
nurses, technicians,
students
or other CoxHealth personnel who are involved in your treatment. For example,
a doctor may need to know what drugs you are allergic to before prescribing
medications. Departments or entities throughout CoxHealth may share medical
information about you to coordinate your care. For instance, the laboratory
may request information to complete lab work. We also may disclose information
to covered entities that are not affiliated with the hospital for your
treatment (e.g., pharmacists, emergency medical providers, and unaffiliated
physicians).
For Payment: We may use and disclose your medical
information for CoxHealth to bill and receive payment for the treatment
you received.
For example,
we may use or disclose your medical information to your insurance company
about
a service you received at CoxHealth so that your insurance company can
pay us or reimburse you for the service. We may also ask your insurance
company
for prior authorization for a service to determine whether the insurance
company will cover it. We may use or disclose your medical information
to a Court about
a service you received at CoxHealth in order to collect an unpaid account.
We also may disclose your information so that other covered entities may
obtain payment for treatment that they have provided (e.g., ambulance service
providers,
Emergency Physicians of Springfield, Litton-Giddings Radiological Associates,
Inc., Ozark Anesthesia Associates, Inc., Pathology Services of Springfield,
P.C.). Please be aware that you may receive separate bills from these independent
contract groups.
For Health Care Operations: We can use and disclose
medical information about you for CoxHealth operations. These include
uses
and disclosures
that are
necessary to run CoxHealth and make sure that our patients receive quality
care. For
example, we may use or disclose medical information about you to evaluate
our staff’s performance in caring for you. Medical information about
you and other patients may also be combined to allow us to evaluate whether
CoxHealth
should offer additional services or discontinue other services and whether
certain treatments are effective. We may also compare this information
with other health care systems to evaluate whether we can make improvements
in
the care and services that we offer.
Uses and Disclosures
of Medical Information that do not Require Your Authorization top
We can use or disclose health
information about you without your authorization when there is
an emergency, when we are required by law to treat you,
when we are required by law to use or disclose certain information,
or when
there are substantial communication barriers to obtaining consent from
you.
- As allowed by the regulations, we may use or disclose your health
information without your authorization in the following circumstances:
- When
it is required by law;
- When it involves use and disclosure for
public health activities, such as mandated disease reporting, etc.;
- When reporting information about victims of abuse, neglect or
domestic violence;
- When disclosing information for the purpose of
health oversight activities, such as audits, investigations, licensure
or disciplinary actions
or legal proceedings.
- When disclosing information for judicial and administrative
proceedings in accordance with state and/or federal law, for instance,
in response
to a court order, such as a court-ordered subpoena;
- When disclosing information
for law enforcement purposes, for instance, to locate or identify
a suspect, fugitive, witness or missing person
or regarding a victim of a crime who can not give authorization because of incapacity;
- When
disclosing information about deceased persons to medical examiners,
coroners and funeral directors;
- When disclosing or using information
for organ and tissue donation purposes;
- When disclosing information
related to a research project when a waiver of authorization has
been approved by the Institutional Review Board
- When we believe
in good faith that the disclosure is necessary to avert a serious
health or safety threat to you or to the public’s safety;
- When
disclosure is necessary for specialized government functions, such
as military service, for the protection of the president or
for national
security and intelligence activities;
- When required by military command authorities,
if you are a member of the armed forces (or if foreign military
personnel, to appropriate
foreign military authorities);
- In the case of a prison inmate, information can
be released to the correctional facility in which he or she resides
for the following purposes:
(1) for the institution to provide the inmate with health care; (2) to protect
the
health
and safety of the inmate or the health and safety of others; or
(3) for the
safety and security of the correctional facility; and
- When disclosure
is necessary to comply with worker’s compensation
laws or purposes.
Planned Uses or Disclosures
to Which You May Object top
We will use
or disclose your health information for the purposes described in
this section unless you object to or otherwise restrict
a particular
release. You must direct your written objections or restrictions
to
Name of Contact: Robin
Gann
Title: Privacy Officer & Director,
Health Information Management
Address: CoxHealth, 3801
S. National Avenue, Springfield, MO 65807
Phone number: (417) 269-6144
- We may use or disclose your health
information to contact you and to remind that you have an appointment
for treatment or medical care.
- Your physician may automatically
or upon your request mail follow up letters and results of diagnostic
tests to your preferred mailing
address.
- We may use or disclose your health information to provide you
with information about or recommendations of possible treatment
options,
alternatives
or health benefits or services that may interest you.
- We may use and
disclose your health information to inform you about health benefits
or services that may interest you.
- The Hospital may use or disclose
your health information in order to include you in the Hospital's
patient directory. Directory information
includes your
name, location in CoxHealth. In addition, a member of clergy
may obtain your religious affiliation, even if they do not ask for you by name.
- We may use health information about you to contact you
in an effort to raise money for the Cox HealthCare Foundation or
Children's
Miracle Network. A Foundation related to CoxHealth may receive contact
information, which includes your name, address and phone number and
the dates that you received services from CoxHealth.
- With your
approval, we may from time to time disclose your protected health
information to designated family, friends, and others who
are involved in your care in order to facilitate that person’s
involvement in caring for you. If you are incapacitated, or facing
an emergency
medical situation, and we determine that a limited disclosure may
be in your best interest, we may share limited protected health information
with such individuals without your approval. We can also give this
information to someone who will help or is helping to pay for your
care.
- We may disclose health information about you to a public
or private entity that is authorized by law or its charter to assist
in
disaster relief efforts, i.e., the American Red Cross, for the purpose
of notification of family and/or friends of your whereabouts and
condition.
Other
Uses or Disclosures top
Uses or disclosures not covered in this
Notice of Privacy Practices will not be made without your written
authorization. If you provide us written
authorization to use or disclose information, you can change your mind
and revoke your authorization at any time, as long as it is in writing.
If you revoke your authorization, we will no longer use or disclose
the information. However, we will not be able to take back any disclosures
that we have made pursuant to your previous authorization.
Your Rights
with Respect to Health Information top
- Right to Request Restrictions: You have the right to request that we restrict use or disclosure
of your health information. We are
obligated to determine if the request is reasonable and appropriate.
After analysis, we may determine that the requested restrictions
cannot be honored. If we do agree to adhere to your restrictions,
we will comply
with your request unless the information is needed to provide you
with treatment. Requests to restrict uses or disclosures must be
made in writing
to, the Privacy Officer. Your request must indicate (1) what information
you want limited; (2) whether you want to limit our use, disclosure
or both; and (3) to whom you want the limits to apply.
- Right to Receive Information in Certain Form and Location: You have the right to receive information about your health in
a certain
form and location. For instance, you can request that we not contact
you at work. To request confidential communications, you must make
your request in writing to the Privacy Officer or manager of each
clinic or
entity. The request must tell us how and/or where you want to receive
information. We will accommodate reasonable requests.
- Right to Inspect and Copy PHI: You have the
right to inspect and copy your protected health information that
may be
used to make decisions
about your care, with the exception of psychotherapy notes. If you
want to see or copy your medical information, you must submit your
request
in writing to the Privacy Officer or manager of each clinic or entity.
If you request copies of information, we will charge a fee for costs
associated with your request, including the cost of copies, mailing
or other supplies in accordance with Federal and/or State regulations.
In limited circumstances we can deny access to your health information.
If access is denied, you can request that the denial be reviewed.
Another licensed health care professional chosen by CoxHealth
will review your
request and the denial. We will adhere to the decision of the reviewer.
- Right to Request Amendment to PHI: You have
a right to request that your protected health information be amended
if you believe
that it is
incorrect or incomplete. You have a right to request an amendment
for as long as CoxHealth keeps the information. To request an amendment
in
your information, you must submit a written request to the Privacy
Officer or manager of each clinic or entity. This written request
must include
why you want the information amended and why you believe the information
is incorrect or incomplete.
We can deny your request if it is not
in writing and if it does not include a reason why the information
should be amended. We
can also deny your request
for the following reasons: (1) the information was not created by CoxHealth,
unless the person or entity that did create the information is no longer
available; (2) the information is not part of the medical record
kept by or for CoxHealth;
(3) the information is not part of the information that you would be
permitted to inspect and copy; or (4) we believe the information
is accurate and
complete.
- Right to an Accounting of Disclosures: You have the right
to receive an accounting of disclosures of medical information
that we have
made, with some exceptions. You must submit your request in writing
to the Privacy Officer or manager of each clinic or entity . Your
request
must state the time period that may not be longer than six (6) years
and may not include dates before April 14, 2003. You should include
how you want the information reported to you, i.e., by paper, electronically,
etc. You have the right to receive a free accounting every twelve-
(12)
months. If you request more than one (1) accounting in a twelve (12)
month period, we may charge you a reasonable fee for the costs of
providing that list. We will notify you of the charge for such
a request and you
can then choose to withdraw or change your request before any costs
are incurred.
- You have the right to a paper copy of this Notice of
Privacy Practices,even if you have agreed to receive this notice
in another form.
To obtain a paper copy of this notice, contact the Privacy Officer.
You may obtain a copy of this notice at our Web site, www.coxhealth.com.
Complaints top If you believe that we have violated your privacy rights or have not
adhered to the information contained in this Notice of Privacy Practices,
you can file a complaint by putting it in writing and sending it to:
Name of Contact: Robin
Gann
Title: Privacy Officer & Director,
Health Information Management
Address: CoxHealth, 3801
S. National Avenue, Springfield, MO 65807
Phone number: (417) 269-6144 You
may also file a complaint with the Secretary of the U.S. Department
of Health and Human Services. You will not be retaliated against for
filing a complaint with either CoxHealth or the U.S. Department of Health
and Human Services.
Changes to This Notice of Privacy
Practices top
We reserve the right to change or modify the information contained
in this Notice of Privacy Practices. Any changes that we make
can be effective
for any health information that we have about you and any information
that we might obtain. Each time you receive services from CoxHealth,
we will have available the most current copy of our Notice of Privacy
Practices. The most recent version of Privacy Practices will be posted
in our building. Also, you can call or write our contact person,
whose information is included in this Notice of Privacy Practices,
to obtain
the most recent version of this Manual. Reference: Missouri Hospital Association’s
HIPAA Manual
Top of page
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Patient
Rights & Responsibilities
Guaranteeing Your Rights
Notice of Privacy Practices
Release of Patient Information
Notice of Privacy Practices
CoxHealth Includes Privacy Practices
Use and Disclosure of Medical Information for Treatment, Payment or Health
Care Operations
Uses and Disclosures of Medical Information that do not Require Your
Authorization
Planned Uses or Disclosures to Which You May Object
Other Uses or Disclosures
Your Rights with Respect to Health Information
Complaints
Changes to This Notice of Privacy Practices |
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