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Privacy Policy

NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION Effective 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!!

45 CFR 164.520 A covered entity is required to provide written “notice” to a patient of the covered entity’s privacy practices (unless the patient is an inmate). This “Notice” is an explanation of the covered entity’s privacy practices and the individual’s privacy rights. Certain laws require that you be provided “Notice” of our privacy practices relating to your medical information. Our privacy practices are contained within this “Notice”. This “Notice” applies to the protected health information (PHI) of your care provided by the PrairieStar Health Center and its employees, medical staff and volunteers. Any hospital or other health care provider, or your insurance plan may have different privacy policies regarding the use and disclosure of your health information. For additional information or if you have any questions regarding our privacy policy, please write us at:PrairieStar Health Center, Attention: Privacy Officer, 1600 N Lorraine, Suite 110, Hutchinson, KS 67501. Each time you visit a hospital, physician, or other healthcare provider, the provider makes a record of your visit. Typically, this record contains your health history, current symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. It also includes billing documents for these services. TREATMENT: Our practice may use and disclose your PHI to treat you. For example, a nurse obtains treatment information about you and records it in a health record, or during the course of your treatment, the physician determines he/she will need to consult with a specialist in the field. He/she will share the information with the specialist and obtain his/her input. We may disclose your PHI to a pharmacy or pharmaceutical company when we order a prescription for you. We will disclose your diagnosis to Hutchinson Hospital when we order lab, x-ray or other diagnostic tests. PAYMENT: Our practice may use and disclose your PHI in order to bill and collect payment for services and items you may receive from us. For example, we submit a request for payment to your health insurance company. The health insurance company requests information from us regarding medical care given. We will provide information to them about you and the care given. HEALTH CARE OPERATIONS: Our practice may use and disclose your PHI to operate our business. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine health information about many clinic patients to decide what additional services the clinic should offer, what services are not needed, and whether certain new treatments are effective. We may also use your health information for training and education. We may remove information that identifies you from the set of health information so others may use it to study health care delivery without learning who the specific patients are. There are some services provided at PSHC through contacts with business associates. Examples of our business associates include collections agencies and auditors. When we use these services, we may disclose your health information to our business associates so they may perform the job we have asked them to do. We require the business associate to protect your information.

YOUR HEALTH INFORMATION RIGHTS: Your health record that we maintain and billing records are the physical property of the PrairieStar Health Center. However, the information in it belongs to you. You have a right to:

  • Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information by making a request at our office.
  • Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request, but we will attempt to comply with any restriction requested.
  • Revoke authorizations that you made previously to use or disclose information except to the extent that PSHC has already taken action, by delivering a written revocation to PSHC.
  • Inspect and copy your health information upon request. Again, this right is not absolute. In certain situations, such as if access would cause harm, we can deny access. You do not have a right to access the following:

Psychotherapy notes, information compiled in reasonable anticipation of, or for use in civil, criminal, or administrative actions, information which was obtained from someone other than a healthcare provider under a promise of confidentiality and Social and Rehabilitation Services health examinations.

  • Appeal a denial of access to your protected health information except in certain circumstances.
  • Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to the PrairieStar Health Center using the form we provide to you upon request. (However, PSHC is not obligated to honor your request for amendment.) We may also deny your request for an amendment if it is not in writing or does not include a reason to support the request. Also, we may deny your request if you ask us to amend information that:

a. Was not created by the PrairieStar Health Center, unless the person or entity that created the information is no longer available to make the amendmentb. Is not part of the health information kept by or for PSHCc. Is not part of the information which you would be permitted to inspect and copyd. Is accurate and complete.· File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information.· Obtain an accounting of disclosures of your health information as required to be maintained by law. An “accounting” is a list of the disclosures we made of health information about you. To request this list or accounting of disclosures, you must use the form which PSHC provides to you. Your request must state a time period, which may not be longer than six (6) years and may not include dates before April 14, 2003. An accounting will not contain uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family or friends in the course of providing care.· You have the right to request a restriction on the health information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the health 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 (1) we not use or disclose information about a surgery you had or (2) that certain people not be told of certain information. We are not required to agree to your request. Only the Privacy Officer can agree to your request. If we do agree, you will be notified in writing and PSHC will comply with your request unless the information is needed to provide emergency treatment to you. You may terminate the restriction at any time. PSHC may also terminate the restriction, but we will notify you of this if so decided. To request any restrictions or limitations, you must make your request to the contact person listed on the first page of this “Notice”. It must include:· What information you want to limit· Whether you want to limit our use, disclosure, or both· To whom you want the limits to apply.· Request that communication of your health information be made using other means or at another location by delivering the request to PSHC using the form we will provide to you upon request. For example, you may ask us to communicate with you about healthcare operations only at home or by mail. To request confidential communications, you must notify us in writing. Your request must be specific and submitted to the contact person.

HOW PSHC MAY USE AND DISCLOSE YOUR HEALTH INFORMATION · PSHC may use and disclose health information to contact you, a family member or a friend involved in your health care as authorized by you as a reminder of upcoming appointments for treatment or medical care. We may also leave a voice mail/message on your phone reminding you of your appointments unless you inform us in writing not to do so.· PSHC may use and disclose health information to tell you about health-related benefits or services that may interest you. We may also use and disclose health information to tell you about or recommend possible treatment options or alternatives.· PSHC may release certain limited information about you while you are a patient in our clinic. This information may include your name, appointment date and/or time, and whether or not you are in the building. An example of this would be if a person called us to ensure they were coming to the right place to give the patient a ride home. If you do not want us to release this information, you must let the contact person know of this request in writing.· We may release health information about you to a friend or family member who is involved in your care. We may also give information to someone who helps pay for your care. The amount of information disclosed will depend on that person’s particular involvement in your care. If you want this information restricted, you must tell us by using the required procedure.· PSHC will disclose health information about you when required to do so by federal, state or local law. This may include reporting of communicable diseases, wounds, abuse, disease registries, health oversight matters and other public policy requirements. We may be required to report this information without your permission.· We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety, or to the health and safety of other persons. Any disclosure would only be to someone able to help prevent the threat. There are special circumstances where we may share your health information without your permission. Some examples are:

  • We may release information to organizations who handle organ and/or tissue donation.
  • If you are a member of the armed forces, we may release health information about you as required by military command authorities.
  • We may release health information about you if you are involved in Worker’s Compensation or other similar programs.
  • If you are involved in a lawsuit or dispute, we may disclose information about you in response to a court or administrative order. We may also disclose health information about you in response to a court or administrative order even if you aren’t involved in a lawsuit or dispute.
  • We may release 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; 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.
  • We may release health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. The information may also be released to funeral directors as necessary.
  • We may release information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. We may also disclose this information to federal officials so they may provide protection to the President.
  • If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release information to the official if it’s necessary for the institution to provide you with health care, protect your health or safety or the health and safety of others, or for the safety and security of the correctional institution.

 
REVOKING PREVIOUS PERMISSION TO USE OR DISCLOSE YOUR HEALTH INFORMATION Other uses and disclosures of health information not covered by this notice or laws that apply to us will be made only with your written permission. For certain disclosures of your health information, you must provide us with a complete “authorization” form. If you provide us permission to use or disclose health information, you may revoke that permission at any time, by submitting a written notice to the contact person listed on page 1 of this “Notice”. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are legally required to retain our records of the care we have given to you.
IF YOU HAVE A COMPLAINT CONCERNING MEDICAL RECORDS If you believe your privacy rights have been violated, you may file a complaint with PrairieStar Health Center or with the Secretary of the Department of Health and Human Services. To file a complaint with PrairieStar Health Center or receive additional information as to how to file a complaint with the Department of Health and Human Services, please speak with the Contact Person listed on page 1. All complaints must be submitted in writing. YOU WILL NOT BE PENALIZED FOR MAKING A COMPLAINT. You have a right to review this Notice before signing the consent authorizing use and disclosure of your protected health information for treatment, payment, and health care operations purposes. If you want to exercise any of the above rights, please contact PSHC at 1600 N Lorraine, Hutchinson, KS 67501. Phone number, 620-663-8484 or 888-603-8484. You will then be provided with information and assistance on the steps to take to exercise your rights.