Patient Rights/Privacy
This Notice of Privacy Practices describes all the ways in which we may use or disclose our patients’ information. It also lists patient rights regarding the privacy of their health information and tells how to fulfill those rights. You may obtain a paper copy of this notice at any time at any of our health centers.
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.
This notice covers services and medical information for all HealthNet services.
If you have any questions about this notice, please contact HealthNet Administration at 317-788-9769. Ask for the Privacy Officer.
Our pledge about health information:
We are required by law to maintain the privacy of your health information. We will provide you with a notice of our legal duties and privacy practices.
How we may use and disclose your health information:
The categories below describe ways that we may use and disclose your health information. For each category we will explain what we mean and give an example. Not every use or disclosure in a category will be listed. Yet, all of the ways we are allowed to use and disclose information fall within one of the categories. Information may be disclosed in writing, orally, or by computer.
For Treatment
• We will use your medical information to treat you, provide you with services, or coordinate the things you need.
• We may disclose your medical information to doctors, nurses, technicians, medical students, or others involved in your care. They may work at our offices or other places like another doctor’s office, lab, x-ray or pharmacy that we refer you to.
• For example, a doctor treating you for a broken leg may need to know if you have diabetes. This may affect the healing process.
For Payment
• We may use and disclose your medical information to get paid for the treatment and services you receive.
• * For example, we may give information about your health and the treatment you receive to your insurance company so they will pay us or repay you. We may also tell your insurance company about treatment you are going to receive to find out if they will pay for it.
For Health Care Operations
• We may use and disclose your health information to run our business. We need these uses and disclosures to make sure that all of our patients get quality care.
• For example, we may use health information to review our treatment and services to check how we are doing.We may combine health information about many patients to decide what other services we should offer, what services are not needed, and whether new treatments are useful.
• We may combine the health information we have with medical information from other health care places. This helps us to see how we are doing compared to others and where we can improve.
• We may remove information that tells who you are. Others may use it to study health care and health care delivery without learning who you are.
For Business Associates
• We contract with outside organizations, called business associates. These business associates perform some services for us.
• For example, we may contract with a lab. When these services are done, we disclose the needed health information to these companies so that they can bill you or your insurance for the services. To protect your health information, we require the business associate to safeguard your information.
For Appointment Reminders
• We may use and disclose your medical information to remind you of health care visits, yearly exams or prescription refills.
For Treatment Options
• We may use and disclose medical information to tell you about treatment options.
• For example, a program for low-cost medicine.
For Health Benefits and Services
• We may use and disclose medical information to tell you about health benefits or services. (For example, a new diabetes program that we offer.)
Individuals Involved in Your Care or Payment for Your Care
If it is okay with you, we will share your health information with a family member or close friend that is involved in your care. If you are unable to agree or to object to sharing this information, we may use our judgment to disclose this information if it is in your best interest. We may use or disclose your health information to help in disaster relief efforts.
The Following Areas Are Required or Allowed by Law
To Avert a Serious Threat to Health or Safety: We may use and disclose your health information when needed to prevent a serious threat to your health and safety. This includes the health and safety of the public or another person. Any disclosure would only be to someone able to help prevent the threat.
Military and Veterans: If you are a member of the armed forces or separated/discharged from military services, we may release your health information as required by the military. This includes foreign military.
Workers’ Compensation: We may release your health information for workers’ compensation or such programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks and Patient Safety Issues: We may disclose your health information for public health programs or to ensure your safety. For example: disease, injury, births, deaths, abuse or neglect.
Health Oversight Activities: We may disclose your health information to a health group that oversees activities allowed by law. These activities might include an audit to see how we are doing or a licensure to make sure that we can treat patients. These activities are needed for the government to check the health care system.
Grants: Places that give us money can review health information. They review the information to make sure we are giving quality care and doing what the grant says.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose your health information as required by law.
Law Enforcement: We may release health information if asked by law enforcement. For example: when a judge tells us to send a record or there is a question about criminal conduct.
Coroners, Medical Examiners and Funeral Directors: We may release health information to a coroner or medical examiner. This may be needed to identify a deceased person or find the cause of death. We may also release health information to funeral directors when asked to do so.
National Security and Intelligence Programs: We may release your health information to federal officials for security activities authorized by law.
Protective Services for the President and Others: We may disclose your health information to federal officials so they can protect the President, or to other persons that do special investigations.
Inmates: If you are in custody, we may release your health information to law enforcement. The release would be for them to treat you, protect your health and safety, or the health and safety of others.
The rights listed in this notice will not apply to inmates.
Your rights about your health information?
Although your health record belongs to HealthNet, the information belongs to you. You have the:
• Right to Look Over and Copy. You have the right to request to look over and/or get a copy of your health care information. This includes medical and billing records. You can look over or copy this information as long as we keep it.
Your request must be given in writing. If there is a fee for these services, you will be told in advance. We may deny your request to look over and copy in a few situations. If you are denied access to health information, you may ask that the denial be reviewed. A manager chosen by HealthNet will review your request and the denial. The person doing the review will not be the person who denied your request. We will comply with the outcome of the review.
• Right to Amend. If you feel that your health information is incorrect, you may ask to amend the information. You have the right to ask for an amendment for as long as we keep the information.
Your request must be given in writing and include a reason. We may deny your request if:
• It is not in writing or does not include a reason;
• We did not create the information, unless the provider that created it is no longer available;
• It is not part of the health information kept by HealthNet;
• It is not part of the information which you would be allowed to look over and copy; or
• It is inaccurate and incomplete.
We will respond to your request within 90 days.
• Right to an Accounting of Disclosures. You have the right to request a list of the disclosures we made that are not related to treat you, get paid for services, to run our business, or that you authorized.
Your request must be given in writing. It must state a time period that may not be longer than seven years and may not include dates before April 14, 2003. You may receive one free list each year. For extra lists, we may charge you. If there is a fee for this, we will tell you in advance.
We will mail you a list of disclosures within 90 days.
* Right to Request Restrictions. You also have the right to ask us to limit your health information that we disclose to someone who is involved in your care or the payment for your care. For example, you could ask that we not use or disclose information about a surgery you had to a family member or friend.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed for an emergency or if the law requires it. Your request must be given in writing. Tell us what information you want to limit and to whom you want the limits to apply. For example, disclosures about a test to your spouse.
* Right to Request Confidential Communications. You have the right to request that we communicate with you about health 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.
Your request must be in writing. We will not ask you the reason for your request. We will try to comply with your request. Your request must state 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 – by computer, you can still get a paper copy of this notice.
Changes to this notice
We have the right to change this notice. We will post a copy of the current notice in all HealthNet locations. The notice will have the effective date. Each time you receive services, you can get a copy of the notice.
Complaints
If you have a complaint about your privacy rights, fill out a Grievance Form located in the waiting room and put it in the suggestion box.
You may also complain to the Office of Civil Rights. The law requires your complaint:
* To be submitted in writing, either on paper or electronically – by computer.
* Name the person or company, and describe the situation.
* Be filed within 180 days – 6 months - of when it happened, unless you can state why the time limit should be waived.
Send your complaint to:
OCR Headquarters
Robinsue Frohboese, Acting Director
200 Independence Avenue, SW
Room 509F HHH Building
Washington, DC 20201
1-866-OCR-PRIV
Region V: CHICAGO
Lisa Simeone, Regional Manager
233 N. Michigan Avenue, Suite 240
Chicago, IL 60601
(312) 886-2359
(312) 886-1807 fax
(312) 353-5693 TDD
You will not be penalized for filing a complaint.
You may also file a complaint with the Joint Commission, which accredits HealthNet. Written complaints should be addressed to:
Division of Accreditation Operations
Account Representative, The Joint Commission
One Renaissance
Boulevard, Oakbrook Terrace, IL 60181
OTHER USES OF MEDICAL INFORMATION. Other uses and disclosures of health information not in this notice or law will be made only with your written consent. If you give us consent, you may cancel it in writing at any time. If you cancel your consent, we will no longer use or disclose your health information for the reasons in your consent. This does not apply to any disclosures we have already made. We are required to keep your original records.
