|
NORTHERN ARIZONA HEALTHCARE
CORPORATION
Flagstaff Medical Center, Northern Arizona
Homecare and Hospice,
VVMC - Sedona Campus, and Verde Valley Medical Center
NOTICE OF PRIVACY PRACTICES
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 Privacy Notice applies to all patients of Flagstaff Medical Center,
Northern Arizona Homecare and Hospice, VVMC - Sedona Campus, and Verde
Valley Medical Center (collectively and individually referred to as
“Facility”).
We are committed to protecting the confidentiality of your medical
information and are required by law to do so. This Notice describes how we
may use your medical information within the Facility and how we may
disclose it to others outside the Facility. This Notice also describes the
rights you have concerning your own medical information. Please review it
carefully and let your healthcare provider know if you have questions.
HOW WILL WE USE AND DISCLOSE YOUR
MEDICAL INFORMATION?
Treatment: We may use your medical information to provide
you with medical services and supplies. We also may disclose your medical
information to others who need that information to treat you, such as
doctors, physician assistants, nurses, healthcare professions students,
technicians, therapists, emergency service and medical transportation
providers, medical equipment providers, and others involved in your care.
For example, we will allow your physician to have access to your Facility
medical record to assist in your treatment at the Facility and for
follow-up care.
We also may use and disclose your medical information to contact you to
remind you of an upcoming appointment, to inform you about possible
treatment options or alternatives, or to tell you about health-related
services available to you.
Patient Directory: In order to assist family members and other
visitors in locating you while you are in the Facility, the Facility
maintains a patient directory. This directory includes your name, room
number, and your religious affiliation (if any). The directory may also
include your general condition (such as good, fair, serious, or critical).
We will disclose this information to someone who asks for you by name,
including but not limited to family members, visitors, and the media.
However, we will disclose your religious affiliation only to clergy
members. If you do not want to be included in the Facility’s patient
directory, please notify your Patient Registrar or Nurse. He/She will
explain the implications and have you sign a “Notice to Patients
Requesting No Information/Special Confidentiality” form.
Family Members and Others Involved in Your Care: We may disclose
your medical information to a family member or friend who is involved in
your medical care or to someone who helps to pay for your care. We also
may disclose your medical information to disaster relief organizations to
help locate a family member or friend in a disaster. If you do not want
the Facility to disclose your medical information to family members or
others who will visit you, please notify your Nurse.
Payment: We may use and disclose your medical information to get
paid for the medical services and supplies we provide to you. For example,
your health plan or health insurance company may ask to see parts of your
medical record before they will pay us for your treatment.
Facility Operations: We may use and disclose your medical
information if it is necessary to improve the quality of care we provide
to patients or to run the Facility. We may use your medical information to
conduct quality improvement activities, to obtain audit, accounting or
legal services, or to conduct business management and planning. For
example, we may look at your medical record to evaluate whether Facility
personnel, your doctors, or other healthcare professionals did a good job.
Many of our patients like to make contributions to the Facility. The
Facility or its Foundation may contact you in the future to raise money
for the Facility. If you do not want the Facility or its Foundation to
contact you for fundraising, please notify the Foundation in writing.
Research: We may use or disclose your medical information for
research projects, such as studying the effectiveness of a treatment you
received. These research projects must go through a special process that
protects the confidentiality of your medical information.
Required by Law: Federal, state, or local laws sometimes require us
to disclose patients’ medical information. For instance, we are required
to report child abuse or neglect and must provide certain information to
law enforcement officials in domestic violence cases. We also are required
to give information to the Arizona Workers’ Compensation Program for
work-related injuries.
Public Health: We also may report certain medical information for
public health purposes. For instance, we are required to report births,
deaths, and communicable diseases to the State of Arizona. We also may
need to report patient problems with medications or medical products to
the FDA, or may notify patients of recalls of products they are using.
Public Safety: We may disclose medical information for public
safety purposes in limited circumstances. We may disclose medical
information to law enforcement officials in response to a search warrant
or a grand jury subpoena. We may also disclose medical information to
assist law enforcement officials in identifying or locating a person, to
prosecute a crime of violence, to report deaths that may have resulted
from criminal conduct, and to report criminal conduct at the Facility. We
also may disclose your medical information to law enforcement officials
and others to prevent a serious threat to health or safety.
Health Oversight Activities: We may disclose medical information to
a government agency that oversees the Facility or its personnel, such as
the Arizona Department of Health Services, the federal agencies that
oversee Medicare, the Arizona Medical Board or the Board of Nursing. These
agencies need medical information to monitor the Facility’s compliance
with state and federal laws.
Coroners, Medical Examiners and Funeral Directors: We may disclose
medical information concerning deceased patients to coroners, medical
examiners and funeral directors to assist them in carrying out their
duties.
Organ and Tissue Donation: We may disclose medical information to
organizations that handle organ, eye or tissue donation or
transplantation.
Military, Veterans, National Security and Other Government Purposes:
If you are a member of the armed forces, we may release your medical
information as required by military command authorities or to the
Department of Veterans Affairs. The Facility may also disclose medical
information to federal officials for intelligence and national security
purposes or for presidential protective services.
Judicial Proceedings: The Facility may disclose medical information
if the Facility is ordered to do so by a court or if the Facility receives
a subpoena or a search warrant. You will receive advance notice about this
disclosure from the attorney requesting your record in most situations so
that you will have a chance to object to sharing your medical information.
Information with Additional Protection: Certain types of medical
information have additional protection under state or federal law. For
instance, medical information about communicable disease and HIV/AIDS,
drug and alcohol abuse treatment, genetic testing, and evaluation and
treatment for a serious mental illness is treated differently than other
types of medical information. For those types of information, the Facility
is required to get your permission before disclosing that information to
others in many circumstances.
Other Uses and Disclosures: If the Facility wishes to use or
disclose your medical information for a purpose that is not discussed in
this Notice, the Facility will seek your permission. If you give your
permission to the Facility, you may take back that permission any time,
unless we have already relied on your permission to use or disclose the
information. If you would ever like to revoke your permission, please
notify the Medical Records Custodian in writing.
WHAT ARE YOUR RIGHTS?
Right to Request Your Medical Information: You have the
right to look at your own medical information and to get a copy of that
information. (The law requires us to keep the original record for 10 years
for adults and 25 years for minors). This includes your medical record,
your billing record, and other records we use to make decisions about your
care. To request your medical information, write to the Medical Records
Custodian. If you request a copy of your information, we may charge you
for our costs to copy the information. We will tell you in advance what
this copying will cost. You can look at your record at the Facility at no
cost.
Right to Request Amendment of Medical Information You Believe Is
Erroneous or Incomplete: If you examine your medical information and
believe that some of the information is wrong or incomplete, you may ask
us to amend your record. To ask us to amend your medical information,
write to the Medical Records Custodian. Please note that we may deny the
request if we did not create the information or if the record is accurate
and complete.
Right to Get a List of Certain Disclosures of Your Medical Information:
You have the right to request a list of many of the disclosures we make of
your medical information. If you would like to receive such a list, write
to the Medical Records Custodian. We will provide the first list to you
free, but we will charge you for any additional lists you request during
the same year. We will tell you in advance what this list will cost.
Right to Request Restrictions on How the Facility Will Use or Disclose
Your Medical Information for Treatment, Payment, or Healthcare Operations:
You have the right to ask us not to make uses or disclosures of your
medical information to treat you, to seek payment for care, or to operate
the Facility. We are not required to agree to your request, but if we do
agree, we will comply with that agreement. If you want to request a
restriction, write to the Medical Records Custodian and describe your
request in detail.
Right to Request Confidential Communications: You have the right to
ask us to communicate with you in a way that you feel is more
confidential. For example, you can ask us not to call your home, but to
communicate only by mail. To do this, write to the Medical Records
Custodian. You may also ask to speak with your healthcare providers in
private outside the presence of other patients.
Right to a Paper Copy: If you have received this notice
electronically, you have the right to a paper copy at any time. You may
download a paper copy of the notice from our Web site, at
www.nahealth.com, or you may obtain a paper copy of the notice at
Health Information Management.
CHANGES TO THIS NOTICE
From time to time, we may change our practices concerning how we use or
disclose patient medical information, or how we will implement patient
rights concerning their information. We reserve the right to change this
Notice and to make the provisions in our new notice effective for all
medical information we maintain. If we change these practices, we will
publish a revised Notice of Privacy Practices. You can get a copy of our
current notice of Privacy Practices at any time by downloading it from our
website or requesting a paper copy at Health Information Management or
Home Health.
WHICH HEALTHCARE PROVIDERS ARE
COVERED BY THIS NOTICE?
This Notice of Privacy Practices applies to the Facility and its
personnel, volunteers, students, and trainees. The notice also applies to
other healthcare providers that come to the Facility to care for patients,
such as physicians, physician assistants, therapists, other healthcare
providers not employed by the Facility, emergency service providers, and
medical transportation companies. The Facility may share your medical
information with these providers for treatment purposes, to get paid for
treatment, or to conduct healthcare operations. These healthcare providers
will follow this notice for information they receive about you from the
Facility. These other healthcare providers may follow different practices
at their own offices or facilities.
DO YOU HAVE CONCERNS OR COMPLAINTS
Please tell us about any problems or concerns you have with your privacy
rights or how the Facility uses or discloses your medical information. If
you have a concern, please contact the Privacy Officer at (928) 773-2567.
If for some reason the Facility cannot resolve your concern, you may also
file a complaint with the federal government. We will not penalize you or
retaliate against you in any way for filing a complaint with the federal
government.
DO YOU HAVE QUESTIONS?
The Facility is required by law to give you this Notice and to follow the
terms of the Notice that is currently in effect. If you have any questions
about this Notice, or have further questions about how the Facility may
use and disclose your medical information, please contact the Medical
Records Custodian at the following numbers:
Flagstaff Medical Center: 928 773-2072
Northern Arizona Homecare and Hospice: 928 773-2238
Verde Valley Medical Center or VVMC - Sedona Campus: 928 639-6280
Effective date: April 14, 2003
|
