EFFECTIVE DATE - 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 THIS
INFORMATION CAREFULLY
This notice applies to Southern Tennessee Medical
Center/Emerald-Hodgson Hospital,
the doctors and other healthcare providers practicing at these
facilities. This notice also applies to
The Rehab Center, The Women’s Center ,
Southern Tennessee Skilled Facility and
Emerald-Hodgson Healthcare Center.
How your health
information may
be used
We
may use health information about you for your treatment purposes, to obtain
payment, or for healthcare operations and other administrative purposes. Examples of each item mentioned above
include:
Treatment: We may need to send your medical record
information to a specialist or physician as part of referral for continuity of
care.
Payment: We will use your health information and
other identifying information for billing Medicare, Medicaid or other health
insurance plans.
Operations or
administrative purposes:
We use your information when processing your medical records for
completeness and to compare patient data to improve our treatment methods.
How your health
information may
be disclosed
As a healthcare provider, we
are subject to certain requirements in which we have to disclose your health
information. These disclosures are generally
routine to all patients and are done without your specific authorization for
several reasons.
¨ State and Federal laws require us to report cases of abuse, neglect, or other reasons requiring law enforcement,
¨ public health activities,
¨ health oversight agencies,
¨ judicial and administrative proceedings,
¨ death and funeral arrangements,
¨ organ donation,
¨ special government functions including military and veteran requests, and
¨ to prevent serious threat to health or public safety.
We may also
contact you after your current visit for future appointment reminders or to
provide you with information regarding treatment alternatives or other health
related services that may be of benefit to you. We will obtain your written authorization for any other disclosures
beyond the reasons listed above.
Remember, if you
do authorize us to release your information, you always have the right to
revoke that authorization later. We
will be happy to honor that request except to the extent that we may have
already acted.
What your rights
are with regards to how your information
can be used and disclosed
In most cases, you have the right to look at or receive a copy of your health information. There may be a preparation fee associated with making the copies.
Accounting of Disclosures
You have the right to ask for a list of instances in which we have disclosed your information for reasons other than treatment payment and operations (see middle section of this brochure). We can provide you one list per year without charge, all additional requests in the same year will be subject to a nominal charge.
Amendment/Correction of Health Information
If you believe that the information we have about you is incorrect or if important information is missing, you have the right to request that we amend the existing information. There may be some reason that we cannot honor your request for which you submit a statement of disagreement.
Alternate/Confidential Communications
You can request that your health information be communicated to you at an alternate location or address from which you may have registered with, such as sending mail to an address other than your home.
Restrictions on Use/Disclosure of Your Health
Information
You can request in writing that we not use or disclose your information for any reasons in this brochure or to persons involved in your care except when specifically authorized by you or when required by law, or in emergency circumstances. We are not legally required to accept them, but will try to honor any reasonable requests.
Our Legal Duty
We are required
by law to protect the privacy of your information. We are providing this notice to you so that we can explain what
our privacy practices are. We will
follow the practices described in this notice or the current notice in effect.
We reserve the right to change our
policies and notice of privacy practices at any time. If we should make a significant change in our policies, we will change
this notice and post the new notice.
You can also request a copy of our notice at any time
Complaints
For more
information about our privacy practices or to place a complaint or report a
concern or conflict, call the number listed below:
Southern Tennessee Medical Center/Emerald Hodgson
Hospital’s Privacy Officer
(931) 967-8300
1-877-508-LIFE (5433).
You may also send a written
complaint to the United States Department of Health and Human Services, if you
feel we have not properly handled your complaint. You can use the contact listed above to provide you with the
appropriate DHHS address. Under no
circumstance will you be retaliated against for filing a complaint.