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.
Each time you visit a hospital, physician, or other provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing information. This notice applies to all of the records of your care generated by the Hospital, whether made by Hospital personnel, agents of the Hospital, or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic. This Notice of Privacy Practices is being provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). This Notice describes how we may use and disclose your protected health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information in some cases. Your "protected health information" means any of your written, electronic, and orally transmitted health information, including demographic data that can be used to identify you. This is health information that is created or received by your health care provider, and that relates to your past, present, or future physical or mental health or condition.
We are required by law to maintain the privacy of your protected health information and provide you a description of our privacy practices.
We are required to abide by the terms of this notice.
This Hospital and its medical staff members have organized and are presenting you this document as a joint notice. Information will be shared as necessary to carry out treatment, payment and health care operations. Physicians and caregivers may have access to protected health information to assist in reviewing past treatment as it may affect treatment at the time. We ask that you sign a written acknowledgment that you have had the opportunity to read our Notice and to obtain a copy of it.
The following categories describe examples of the way we may use and disclose medical information about you.
FOR TREATMENT We may use medical information about you to provide, coordinate, or manage your and related services. We may disclose medical information about you to doctors, nurses, technicians, allied health professionals, and other Hospital and medical personnel who are involved in taking care of you. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Different departments of the Hospital also may share medical information about you in order to coordinate the different treatment and services you may need such as medications, lab work, meals, and x-rays. We may also provide your physician or a subsequent provider with copies of various reports that should assist him or her in treating you once you are discharged from this Hospital. Medical care assistance that is provided by family members or others will require revealing information about your treatment. In some cases, we may also disclose your protected health information to an outside treatment provider for purposes of the treatment activities of the outside provider.
FOR PAYMENT We may use and disclose medical information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer. For example, we may need to give your insurance company information about your surgery and Hospital stay so they will pay us or reimburse you for the treatment. We may also tell your health plan, your insurance company, or the party responsible to pay your bill about any proposed treatment to determine whether your plan or the responsible party will cover it. We may also disclose patient information to another health care provider involved in your care for the other health care provider's payment activities.
FOR HEALTH CARE OPERATIONS Members of the Hospital's medical staff, Hospital employees which may include physicians who serve in hospital clinics and medical offices, and agents and independent contractors of the Hospital may use information in your health record to assess the care and outcomes in your case and others like it. The information may then be used for quality assessment and improvement activities. For example, we may combine medical information about many patients to evaluate the need for new services or treatment. We may disclose information to doctors, nurses, and other students for educational purposes. We may combine medical information we have with that of other hospitals to see where we can make improvements. We may also use and disclose medical information:
- To remind you that you have an appointment for medical care
- To assess your satisfaction with our services
- To tell you about possible treatment alternatives
- To tell you about health-related benefits or services
- To contact you as part of fund raising efforts
- To inform funeral directors consistent with applicable law
- To conduct population-based activities relating to improving health or reducing health care costs
- To conduct training programs or review competence of health care professionals.
- For accreditation, certification, licensing, or credentialing activities.
- For review and auditing, including compliance reviews, medical reviews, legal services, and maintaining compliance programs.
- For business management, general administrative activities, and legal services.
We may post your name on the door to the room that you occupy. We may make a birthday announcement of your birthday or your child's within the Hospital, in its facility directory, and in outside publications. If it is your desire that we not post your name on the door to your room, include your name in our facility directory, or publish your birthday or other anniversary in a publication, please check the boxes on the admission forms indicating your intention to not have this information used or contact Guest Services at (985) 898-4669 who will provide the form to you for your signature indicating your desire to not be included in these activities.
BUSINESS ASSOCIATES There are some services provided in our organization through contracts with business associates. Examples include processing of certain laboratory tests and a copy service we use to make requested copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect your health information; however, we require the business associate to appropriately safeguard your information.
DIRECTORY We may include certain limited information about you in a directory while you are a patient at the Hospital. The information may include your name, location in the Hospital, your general condition, e.g., good or fair, and your religious affiliation. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name. If you would like to opt out of being in the facility directory, please contact the office shown on page 4 of the Notice.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE We may release medical information about you to a family member or a close personal friend who is directly involved in your medical care or who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
RESEARCH We may disclose information to researchers when an institutional review board that has reviewed and approved the research proposal and established protocols to ensure the privacy of your health information.
FUTURE COMMUNICATIONS We may communicate to you via newsletters or other means regarding treatment options, health information, disease management programs, wellness programs, or other community based initiatives or activities our facility is participating in.
FUND RAISING We may use certain information (name, address, telephone number, dates of service, age, gender) to contact you in the future to help support efforts. We may also provide this name to our institutionally related foundation, St. Tammany Hospital Foundation, only for the same purpose. The money raised will be used to expand and improve the services and programs we provide to the community. If you do not wish to be contacted for fund raising efforts, please see page 4 of the Notice regarding contacts.
AFFILIATED COVERED ENTITY Protected health information will be made available to Hospital personnel at local affiliated facilities as necessary to carry out treatment, payment and health care operations. Caregivers at other facilities may have access to protected health information at their locations to assist in reviewing past treatment information as it may affect treatment at this time.
LAW ENFORCEMENT/LEGAL PROCEEDINGS We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
CHANGE OF OWNERSHIP In the event that this organization is sold or merged with another organization, your health information will become the property of the new owner.
As required by law, we may also use and disclose health information for the following types of entities, including but not limited to:
- Food and Drug Administration (FDA)
- Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability
- Correctional Institutions
- Workers Compensation Agents
- Organ and Tissue Donation Organizations
- Military Command Authorities
- Health Oversight Agencies
- Funeral Directors, Coroners and Medical Directors
- National Security and Intelligence Agencies
- Protective Services for the President and Others
YOUR HEALTH INFORMATION RIGHTS
Although your health record is the physical property of the practitioner or facility that compiled it, you have the right to:
Inspect and Copy: You have the right to inspect and obtain a copy of your health information. Usually, this includes medical and billing records but does not include, for example, psychotherapy notes. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the Hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review. For additional information about this subject, see Contact Information listed on page 4.
Amend: If you feel that medical information we have about you is incorrect or incomplete, you may request that we amend your record. You have the right to request an amendment for as long as the information is kept by or for the Hospital. This request must be in writing and must include reason(s) to support the request. We may deny your request for an amendment, and if this occurs, you will be notified of the reason for the denial. For additional information about this subject, see Contact Information listed on page 4.
An Accounting of Disclosures: You have the right to request an accounting of disclosures. This is a list of certain disclosures we make of your medical record for purposes other than treatment, payment or operations. For additional information about this subject, see Contact Information listed on page 4. Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. For example, you could ask that we not use or disclose information about a surgery you had. The Hospital will investigate its ability to meet the request prior to agreeing to any restriction and may deny a request under certain circumstances. Requests for such restrictions must be presented in writing to the Health Information Management Department, 1202 S. Tyler, Covington, Louisiana, 70433.
Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you at work or by U.S. Mail. The Hospital will grant requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing to the Health Information Management Department 1202 S. Tyler, Covington, Louisiana, 70433, and the written request includes a mailing address where the individual will receive bills for services rendered by the Hospital and related correspondence regarding payment for services. Please realize we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.
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. A copy of the notice can be obtained from our Admitting Department or our Guest Services Office. You may also obtain a copy of this notice at our website: http://www.stph.org/.
CHANGES TO THIS NOTICE
We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted in the Hospital and include the effective date. In addition, each time you register at or are admitted to the Hospital for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with the Hospital by writing or sending a message electronically to the Guest Services Office:
St. Tammany Parish Hospital
c/o Guest Services
1202 South Tyler Street
Covington, Louisiana 70443
You may also call the Secretary of the Department of Health and Human Services at 1-877-696-6775. A complaint will not affect your current or future medical treatment at our facility.
If you have any questions about this Notice, please contact Guest Services by dialing (985) 898-4669.
If you would like to take advantage of our anonymity policy, please contact our Admitting Department at (985) 898-4401.
If you do not wish to be contacted for fund raising efforts, please notify the St. Tammy Hospital Foundation at (985) 898-4174 or in writing to 1202 S. Tyler Street, Covington, Louisiana 70433.
For additional information about the following, please contact the Health Information Management Department at (985) 898-4419, 1202 S. Tyler, Covington, Louisiana, 70433.
- Your right to inspect and obtain a copy of your health information
- Your right to request an amendment to your record
- Your right to request an accounting of disclosures
- Your right to request restriction or limitation on the medical information (request must be done in writing)
- Your right to request that we communicate with you about medical matters in a certain way or at a certain location (request must be done in writing).
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission in writing at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission and that we are required to retain our records of the care that we provided to you.