Regional Medical Center (TRMC)
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
I. Our responsibilities
to safeguard your protected health information.
We are required
by law to provide you with this notice about the hospital’s
privacy practices that explains how, when, and why we use and disclose
your protected health information. With some exceptions, we may not
use or disclose any more than the minimum necessary protected health
information to accomplish the purpose of the use or disclosure. We
are legally required to follow the privacy practices that are described
in this notice.
However, we reserve
the right to change the terms of this notice and our privacy policies
at any time. Any changes will apply to the protected health information
we already have. Before we make an important change to our policies,
we will promptly change this notice and post a new notice in all reception
areas. You can also request a copy of this notice from the hospital’s
Privacy Officer or view a copy of the notice on our web site at www.dreammovies.us.
II. How your protected
health information may be used.
A. We use health
information about you for treatment purposes, obtain payment for treatment,
and for healthcare operations.
For some of these
uses or disclosures, we do not need your prior consent. Below, we
describe the different categories of our uses and disclosures that
do not need your consent and give you some examples of each category.
treatment. For example: Information obtained by a nurse,
physician, or other member of your healthcare team will be recorded
in your record and used to determine the course of treatment that
should work best for you. Members of our healthcare team will
then record the actions they took and their observations. That
way, the physician will know how you are responding to treatment.
We will also provide your physician or a subsequent healthcare
provider with copies of various reports (lab,x-ray) that should
assist him or her in treating you If you were treated as an outpatient,
we will provide your test results to the ordering physician via
fax or courier.
obtain payment for treatment. We may use and disclose
your protected health information in order to bill and collect
payment for the treatment and services provided to you. For example,
we may provide portions of your protected health information to
our billing department and your health plan to get paid for the
health care services we provided you. We may also provide your
protected health information to our business associates, such
as billing companies, claims processing companies, and others
that process our health care claims. We may also release information
to other providers that performed a service to you while here.
For example: ambulance, radiologist and anesthesiologist, etc.
health care operations. Health care operations” are
certain administrative, financial, legal and quality improvement
activities of a covered facility that are necessary to run its
business and to support the core functions of treatment and payment.
Here are a few activities that would fall under health care operations:
quality assessment and improvement activities
b. Conducting or arranging for medical review, legal and auditing
services including fraud and abuse.
c. Business planning and development, such as conducting cost-management
and planning analyses related to managing and operating the facility.
By state or
federal law we maybe required to report certain circumstances,
wherein we may use and disclose your protected health information
without your authorization. Below are a few of those examples:
a disclosure is required by federal, state or local law, judicial
or administrative proceedings, or law enforcement. For
example, we make disclosures when a law requires that we report
information to government agencies and law enforcement personnel
about victims of abuse, neglect, violent crime or domestic violence;
also when dealing with gunshot and other wounds; or when ordered
in a judicial or administrative proceeding.
public health activities. For example, we report information
about births, deaths, and various contagious diseases, to government
officials in charge of collecting that information, and we provide
coroners, medical examiners, and funeral directors necessary information
relating to an individual’s death.
health oversight activities. For instance, we will provide
information to assist the government when it conducts an investigation
or inspection of a health care provider or organization.
purposes of organ donation. We may notify organ procurement
organizations to assist them in organ, eye, or tissue donation
avoid harm. In order to avoid a serious threat to the
health and safety of a person or the public, we may provide patient
protected health information to law enforcement personnel or persons
able to prevent or lessen such harm.
specific government functions. We may disclose patient
protected health information of military personnel and veterans
in certain situations. And we may disclose patient protected health
information for national security purposes, such as protecting
the President of the United States or conducting intelligence
workers’ compensation purposes. We may provide
patient protected health information in order to comply with workers’ compensation
reminders and health-related benefits or services. We
may use patient protected health information to provide appointment
reminders or give you information about treatment alternatives,
or other health care services or benefits we offer.
B. There are certain
uses and disclosures to which you will have the opportunity to object.
In the following
situations we may disclose your protected health information if we
inform you about the disclosure in advance and you do not object.
If there is an emergency and you cannot be given the opportunity to
object, we may disclose your health information consistent with any
prior expressed wishes if it is determined by a healthcare professional
that it is in your best interests. If you are unable to consent in
an emergency, you will be given the opportunity to object as soon
as you are able to do so.
directories. We may include your name, location in this
facility, general condition, and religious affiliation, in our
patient directory for use by clergy and visitors who ask for you
by name, unless you object in whole or in part.
to family, friends, or others. We may provide your protected
health information to a family member, friend, or other person
that you indicate is involved in your care or the payment for
your health care, unless you object in whole or in part.
C. All other uses
and disclosures require your prior written authorization. In any other
situation not described previously we will ask for your written authorization
before using or disclosing any of your protected health information.
If you choose to sign an authorization to disclose your protected
health information, you can later revoke that authorization in writing
to stop any future uses and disclosures (to the extent that we haven’t
already taken any action relying on the authorization).
III. Your rights
regarding your protected health information.
A. You have the
right to ask that we limit how we use and disclose your protected
health information. We will consider your request but are not legally
required to accept it. If we accept your request, we will put any
limits in writing and abide by them except in emergency situations.
You may not limit the uses and disclosures that we are legally required
or allowed to make.
B. You have the
right to ask that we send information to you to an alternate address
(for example, sending information to your work address rather than
your home address) or by alternate means (for example, e-mail instead
of regular mail). We must agree to your request so long as we can
easily provide it in the format you requested.
C. In most cases,
you have the right to look at or get copies of your protected health
information that we have, but you must make the request in writing.
If we do not have your protected health information but we know who
does, we will tell you how to get it. We will respond to you within
30 days after receiving your written request. In certain situations,
we may deny your request. If we do, we will tell you, in writing,
our reasons for the denial and explain your right to have the denial
D. If you request
copies of your protected health information, we will charge you $.25
for each page. Instead of providing the protected health information
you requested, we may provide you with a summary or explanation of
the information as long as you agree to that and to the cost in advance.
E. You have the
right to get a list of instances in which we have disclosed your protected
health information. The list will not include uses or disclosures
made for treatment, payment, or health care operations, directly to
you, to your family, or in our facility directory. The list also will
not include uses and disclosures made for national security purposes,
to corrections or law enforcement personnel, or before April 14, 2003.
We will respond
within 60 days of receiving your request. The list we will give you
will include disclosures made in the last six years unless you request
a shorter time. The list will include the date of the disclosure,
to whom your protected health information was disclosed (including
their address, if known), a description of the information disclosed,
and the reason for the disclosure. We will provide the list to you
at no charge, but if you make more than one request in the same 12-month
period, we will charge you $5.00 for each additional request.
F. If you believe
that there is a mistake in your protected health information or that
a piece of important information is missing, you have the right to
request that we correct the existing information or add the missing
information. You must provide the request and your reason for the
request in writing. We will respond within 60 days of receiving your
request. If the provider is unable to act on the amendment within
60 days, the provider may extend the time for action by no more than
30 days. The provider must give the individual a written statement
and the reason for delay. We may deny your request in writing if the
protected health information is (i) correct and complete, (ii) not
created by us, (iii) not allowed to be disclosed, or (iv) not part
of our records. Our written denial will state the reasons for the
denial and explain your right to file a written statement of disagreement
with the denial. If you do not file one, you have the right to request
your request and our denial be attached to all future disclosures
of your protected health information. If we approve your request,
we will make the change to your protected health information, tell
you that we have done it, and others that need to know about the change
to your protected health information.
G. You have the
right to get a copy of this notice by e-mail. Even if you have agreed
to receive notice via e-mail, you also have the right to request a
paper copy of this notice.
III. How to Complain
about our privacy practices.
If you think that
we may have violated your privacy rights, or you disagree with a decision
we made about access to your protected health information, you may
file a complaint with the person listed in Section V below. You also
may send a written complaint to the Secretary of the Department of
Health and Human Services at the following address.
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.Room 515f HHH Bldg
Washington, D.C. 20201
Toll Free: (877) 696-6775
We will take no
retaliatory action against you if you file a complaint about our privacy
IV. Person to contact
for information about this notice or to complain about our privacy
If you have any
questions about this notice or any complaints about our privacy practices,
or would like to know how to file a complaint with the Office of Civil
Rights please contact: Internal HIPAA Auditor at 869 Cherry Street,
Tulare, CA 93274; (559) 685-3409 x612 or by e-mail to firstname.lastname@example.org
V. Effective Date
of this Notice.
April 14, 2003
Notice of Privacy Practices (HIPAA)
Attachments: Included – Privacy
Author: HIPAA Comm.
/ Robert Montion
Typist: Debra Campbell
Creation Date: 12/12/02
Prev. Dist. Date:
and Distribution – Debra Campbell
Policy # 10-1120