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Privacy Policy
IBERIA MEDICAL CENTER NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
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.
If you cannot read or understand this document, someone will read or explain it to you.
UNDERSTANDING YOUR HEALTH RECORD/INFORMATION:
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record may contain, among other things, demographic information about you; information about your health insurance coverage; symptoms and diagnoses; consents for treatment; medical assessments and examinations, including your past medical history; treatment and procedure records; progress notes; physicians' orders; test results; plans and/or instructions for your future care or treatment; and your charge and payment history. All of this information, often referred to as your health or medical record, serves as a:
• Basis for planning your care and treatment
• Means of communication among the many health professionals who contribute to your care
• Legal document describing the care you received
• Means by which you or a health insurance plan can verify that services billed were actually provided
• A tool in educating health professionals
• A source of data for medical research
• A source of information for public health officials charged with improving the health of the nation
• A source of data for facility planning and marketing
• A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at each of our health care delivery sites (the hospital, outpatient rehabilitation center, home health, Children's Center, Children's Practice, and Jeanerette Rural Health Clinic). We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by each of our health care delivery sites, whether made by our employees or your personal doctor.
This notice will tell you about the ways in which we may use and disclose medical information about you. It will also describe your rights and our obligations regarding the use and disclosure of your medical information.
WHO WILL FOLLOW THIS NOTICE.
This notice describes Iberia Medical Center's practices and that of:
• Anyone authorized to enter information into your chart.
• All departments and units of Iberia Medical Center, including Iberia Medical Center's Rehabilitation Center, Home Health, Children's Center, Children's Practice, and Jeanerette Rural Health Clinic.
• Any member of a volunteer group we allow to help while you are receiving care from one of our health care delivery sites.
• All employees, staff and other personnel at each of our health care delivery sties.
• All physicians on staff at Iberia Medical Center follow the terms of this notice in regards to services rendered by our health care delivery sites. These physicians may have different policies or notices regarding his/her use and disclosure of your medical information created in his/her office or clinic. Our health care delivery sites and the physicians on our medical staff may share medical information with each other for treatment, payment or operational purposes as described in this notice.
WE ARE REQUIRED BY LAW TO:
• Make sure that medical information that identifies you is kept private.
• Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
• Abide by the terms of the notice that is currently in effect.
• Notify you if we are unable to agree to a restriction or an amendment that you request.
• Accommodate reasonable requests you may have to communicate health information by alternate means or at alternative locations.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
We will not use or disclose your health information without your authorization except as provided by law or described in this notice. The following categories describe different ways that we may use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
• For Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, students, or other personnel who are involved in your care at the each of our health care delivery sites. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. Different departments of each of our health care delivery sites also may share medical information about you in order to coordinate your care, such as when you need prescriptions, lab work and x-rays. Medical information about you may be disclosed to people outside each of our health care delivery sites who may be involved in your medical care after you leave each of our health care delivery sites, such as family members, your physicians, or a subsequent health care provider in order to assist them in treating you once you are discharged from our facility.
• For Payment. We may use and disclose medical information about you so that we may receive payment for services rendered by each of our health care delivery sites. For example, we may need to give your health insurance plan some information (such as your diagnoses, procedures performed, supplies used) about surgery you received at each of our health care delivery sites so your health insurance plan will pay us or reimburse you for the surgery. We may also tell your health insurance plan about a treatment you are going to receive to obtain prior approval or to determine whether your insurance plan will cover the treatment. In the event payment is not made, we may also provide limited information to collection agencies, attorneys, credit reporting agencies, and other organizations as is necessary to collect for services rendered.
• For Health Care Operations. We may use and disclose medical information about you for our healthcare operations, such as quality assurance, performance improvement, competency review, training, case management, accreditation, certification, licensing, credentialing, medical review, legal, auditing, and business planning activities. These uses and disclosures are necessary to run each of our health care delivery sites and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many hospital patients to decide what additional services each of our health care delivery sites should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, students, and other hospital personnel for learning purposes. The medical information we have may be combined with medical information from other health care providers to compare how we are doing and see where we can make improvements in the care and services we offer.
• Business Associates. There are some services provided in our organization through contracts with business associates. Examples include physician services in the emergency department, certain laboratory tests, collection agencies, and a copy service we might use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we've asked them to do and to allow them to bill you or your health insurance plan for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
• Hospital Directory. Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name.
• 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 about your location and general condition.
• Communication with others. Health professionals, using their best judgment, may disclose relevant health information to a family member or any other person you identify, regarding your health care or health care payment obligations.
• Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at each of our health care delivery sites.
• Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
• Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
• Fundraising Activities. We may use medical information about you to contact you in an effort to raise money for each of our health care delivery sites and its operations. We may disclose medical information to a foundation related to each of our health care delivery sites so that the foundation may contact you in raising money for each of our health care delivery sites. We would release only contact information, such as your name, address and phone number and the dates you received treatment or services at each of our health care delivery sites. If you do not want to be contacted for fundraising efforts, you must notify our Director of Marketing in writing.
• As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.
• Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:
• to prevent or control disease, injury or disability;
• to report births and deaths;
• to report child abuse or neglect;
• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
• to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
• 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.
• Your Employer. We may disclose medical information about you to your employer, if we were requested by your employer to conduct pre-employment testing or examinations upon you, to evaluate the medical surveillance of your employer's workplace, or to determine if you have a work-related illness or injury. Your employer must receive this information in order to comply with federal or state law relating to workplace safety and workman's compensation.
• Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
• Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
• Law Enforcement. We may release medical information if asked to do so by a law enforcement official:
• In response to a court order, subpoena, warrant, summons or similar process;
• To identify or locate a suspect, fugitive, material witness, 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;
• About criminal conduct at each of our health care delivery sites; and
• In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
• Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of each of our health care delivery sites to funeral directors as necessary 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 tissue or organs for the purpose of tissue donation and transplantation.
• 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.
• 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. Any disclosure, however, would only be to someone able to help prevent the threat.
• Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
• 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 authorize federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
• Workers' Compensation. We may release health information to the extent authorized by and the extent necessary to comply with laws relating to workers' compensation or other similar programs established by law.
• Change of Ownership. In the event this organization is sold or merged with another organization, your health information will become property of the new owner.
• Other Disclosures. Federal law provides for your health information to be released to an appropriate health oversight agency, public health authority, attorney, or health care accreditation organization, 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.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION:
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the following rights regarding the medical information we maintain about you:
• Right to Inspect and Copy. You have the right to inspect and request a copy of those items or documents within your health record, as described in the section on page 1 entitled "Understanding Your Health Record/Information." Note, however, that psychotherapy notes are excluded and are not available for your inspection or copying.
To inspect and receive a copy of your medical information, you must submit your request in writing, using our "Authorization for Release of Medical Information" form. This form may be obtained from the Health Information Services Department of Iberia Medical Center or from the records custodian at each of our other health care delivery sites. 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 limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by each of our health care delivery sites will review your request and the denial. We will comply with the outcome of the review.
• Right to Amend. 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 for as long as the information is kept by or for each of our health care delivery sites.
To request an amendment, your request must be made in writing on a "Request for Amendment" form. This form may be obtained from and submitted to the Health Information Services Department of Iberia Medical Center or the records custodian at our other health care delivery sites. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
• Is accurate and complete;
• Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
• Is not part of the medical information kept by or for each of our health care delivery sites; or
• Is not part of the information that you would be permitted to inspect and copy.
• Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you.
To request an accounting of disclosures, you must submit your request in writing to the Health Information Services Department of Iberia Medical Center or to the records custodian at our other health care delivery sites. Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what format you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists, 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 that time before any costs are incurred.
• Right to Request Restrictions. 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 for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.
We are not required to agree to your request; however, if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must submit your request in writing to our Privacy Officer, whose address is listed below. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
• Right to Receive Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must submit your request in writing to our Privacy Officer, whose address is listed below. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
• Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
You may obtain a copy of our most current notice from our website, www.iberiamedicalcenter.com, or in person from any Registration area at each of our health care delivery sites, or by mailing a written request and a self-addressed, stamped envelope to our Privacy Officer at: Iberia Medical Center; Privacy Officer; 2315 East Main St.; New Iberia, LA 70560.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. Understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice at each of our healthcare delivery sites (hospital, clinics, outpatient rehabilitation facility, home health, etc.) and on our website. 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 one of our healthcare delivery sites for treatment or health care services, we will offer you a copy of the current notice in effect.
FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have a question or would like additional information, you may contact our Privacy Officer at: Iberia Medical Center; Privacy Officer; 2315 East Main St.; New Iberia, LA 70560. Our Privacy Officer's phone number is (337) 364-0441, extension 7566. If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. There will be no retaliation for filing a complaint.
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