To better enable the health and well-being of our community, Southwestern Medical Center is a tobacco-free facility. This policy is effective for all extensions of the Southwestern Medical Center complex, and includes banning the use of e-cigarettes and chewing tobacco.
You have privacy rights under a federal law that protects your health information. These rights are important for you to know. Federal law sets rules and limits on who can look at and receive your health information.
We are committed to protecting the healthcare information of our patients pursuant to the Federal Guidelines outlined in the Health Insurance Portability and Accountability Act (HIPAA.)
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.
PATIENT HEALTH INFORMATION
Under federal law, your patient health information is protected and confidential. Patient health information includes information about your symptoms, test results, diagnosis, Treatment, and related medical information. Your Health Information also includes Payment, billing, and insurance information.
HOW WE USE YOUR PATIENT HEALTH INFORMATION
We use Health Information about you for Treatment, to obtain Payment, and for Health Care Operations, including administrative purposes and evaluation of the quality of care that you receive. Under some circumstances, we may be required to use or disclose the information even without your permission.
EXAMPLES OF TREATMENT, PAYMENT, AND HEALTH CARE OPERATIONS
Treatment: We will use and disclose your Health Information to provide you with medical treatment or services. For example, nurses, physicians, and other members of your treatment team will record information in your record and use it to determine the most appropriate course of care. We may also disclose the information to other Health Care Providers who are participating in your Treatment, to pharmacists who are filling your prescriptions, and to family members who are helping with your care.
Payment: We will use and disclose your Health Information for Payment purposes. For example, we may need to obtain authorization from your insurance company before providing certain types of Treatment. We will submit bills and maintain records of Payments from your Health Plan. If you have a legal claim against a third party for causing your injuries, we may file a Facility lien in court to collect Payment from them.
Health Care Operations: We will use and disclose your Health Information to conduct our standard internal operations, including proper administration of records, evaluation of the quality of Treatment, and to assess the care and outcomes of your case and others like it.
We may use your information to contact you with appointment reminders. We may also contact you to provide information about Treatment alternatives or other health-related benefits and services that may be of interest to you.
OTHER USES AND DISCLOSURES
We may use or disclose identifiable Health Information about you for other reasons, even without your consent. Subject to certain requirements, we are permitted to give out Health Information without your permission for the following purposes:
Required by Law: We may be required by Law to report gunshot wounds, suspected abuse or neglect, or similar injuries and events.
Public Health Activities: As Required by Law, we may disclose vital statistics, diseases, information related to recalls of dangerous products, and similar information to public health authorities.
Health Oversight: We may be required to disclose information to assist in investigations and audits, eligibility for government programs, and similar activities.
Judicial and Administrative Proceedings: We may disclose information in response to an appropriate subpoena or court order.
Law Enforcement Purposes: Subject to certain restrictions, we may disclose information required by Law Enforcement Officials.
Deaths: We may report information regarding deaths to coroners, medical examiners, funeral directors, and organ donation agencies.
Serious Threat to Health or Safety: We may use and disclose information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Military and Special Government Functions: If you are a member of the armed forces, we may release information as required by military command authorities. We may also disclose information to Correctional Institutions or for national security purposes.
Research: We may use or disclose information for approved medical Research.
Workers Compensation: We may release information about you to workers compensation agencies and your employer to provide benefits for work-related injuries or illness.
Fundraising: We may contact you, or allow an institutionally-related foundation to contact you, for fundraising purposes. You have the right to opt out of receiving any fundraising communications.
We may also ask if we can disclose limited information about you to clergy or include it in the Facility directory. Under limited circumstances, we may disclose information to notify or locate your relatives or to assist disaster relief agencies. Most uses and disclosures of psychotherapy notes, uses and disclosures of medical information for marketing purposes, and disclosures that constitute a sale of medical information will only be made with your written authorization. In any other situation not described in this Notice, we will ask for your written authorization before using or disclosing any identifiable Health Information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and Disclosures.
You have the following rights with regard to your Health Information. Please contact the person listed below to obtain the appropriate form for exercising these rights.
Request Restrictions: The Facility is not required to grant a request for restrictions in all circumstances. However, the Facility must agree to a request for a restriction on the Disclosure of Protected Health Information to a Health Plan, or a Business Associate of a Health Plan, if the Disclosure is for the purposes or carrying out Payment or Health Care operation and is not otherwise Required by Law; and the Facility is paid out of pocket in full. In regards to other requests, restrictions will be granted only as follows: (a) it is the facility’s policy not to agree to any restrictions on uses or Disclosures for Treatment or Health Care Operations, except as stated above. The Privacy Officer must approve any exceptions in writing; (b) the facility is not allowed to grant requests to restrict Disclosures required for public health, law enforcement, or to comply with any other laws or regulations.
Confidential Communications: You may ask us to communicate with you confidentially by, for example, sending notices to a special address or not using postcards to remind you of appointments.
Inspect and Obtain Copies: In most cases, you have the right to look at or get a copy of your Health Information. There may be a charge for the copies based on state established rates.
Amend Information: If you believe that information in your record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information.
Accounting of Disclosures: You may request a list of instances where we have disclosed Health Information about you.
OUR LEGAL DUTY
We are required by Law to protect and maintain the privacy of your Health Information, to provide this Notice about our legal duties and privacy practices regarding Protected Health Information, to notify you of any breach of your Health Information that we are required by law to report, and to abide by the terms of the Notice currently in effect.
CHANGES IN PRIVACY PRACTICES
We may change our policies at any time. Before we make a significant change in our policies, we will change our Notice and post the new Notice in the admissions area. You can also request a copy of our Notice at any time. For more information about our privacy practices, contact the person listed below.
If you are concerned that we have violated your privacy rights, or if you disagree with a decision we made about your records, you may contact the person listed below. You also may send a written complaint to the U.S. Department of Health and Human Services. The person listed below will provide you with the appropriate address upon request. You will not be penalized in any way for filing a complaint.
If you have any questions, requests, or complaints, please contact the Facility Privacy Officer at: 580-531-4724.
Southwestern Medical Center and the physicians who practice here are independent contractors and do not hereby assume any liability for the services or conduct of the other.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information on page 1.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov.
- We will not retaliate against you for filing a complaint.
You have some choices in the way that we use and share information as we:
Tell family and friends about your condition
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
We’ll Never Share Your Information In These Cases:
Without your express permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the Case of Fundraising
We may contact you for fundraising efforts, but you can tell us not to contact you again.
Additionally, you have choices as to how we use and share your information in the following circumstances. To learn more about any situation below, please don’t hesitate to ask.
- Provide disaster relief
- Include you in a hospital directory
- Provide mental health care
- Market our services and sell your information
- Raise funds
Our Uses and Disclosures
We may use and share your information as we conduct the following actions. For more information, click any item below.
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we can mail a copy to you.
Effective date: October 1, 2013