OSU
UNIVERSITY HEALTH SERVICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF
UNIVERSITY HEALTH SERVICES) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET
ACCESS TO THIS INFORMATION. PLEASE
REVIEW THIS NOTICE CAREFULLY.
Our
Duty to Safeguard Your Protected Health Information
Individually
identifiable information about your past, present, or future health or
condition, the provision of health care to you, or payment for the health
care is considered “Protected Health Information” (PHI).
We are required to extend certain protections to your PHI, and to
give you this Notice about our privacy practices that explains how, when
and why we may use or disclose your PHI.
Except in specified circumstances, we must use or disclose only the
minimum necessary PHI to accomplish the intended purpose of the use or
disclosure.
We
are required to follow the privacy practices described in this Notice,
though we reserve the right to change our privacy practices and the
terms of this Notice at any time.
You may request a copy of the new notice from University Health
Services or the Compliance Office 1202 Farm Road, Stillwater, OK 74078.
How
We May Use and Disclose Your Protected Health Information
We
use and disclose PHI for a variety of reasons.
We have a limited right to use and/or disclosure of your PHI for
purposes of treatment, payment or our health care operations.
For uses beyond that, we must have your written authorization
unless the law permits or requires us to make the use or disclosure
without your authorization. If
we disclose your PHI to an outside entity in order for that entity to
perform a function on our behalf, we must have in place an agreement from
the outside entity that it will extend the same degree of privacy
protection to your information that we must apply to your PHI. However,
the law provides that we are permitted to make some uses/disclosures
without your consent or authorization.
The following offers descriptions and some examples of our
potential uses/disclosures of your PHI.
Uses
and Disclosures Relating to Treatment, Payment, or Health Care Operations
Generally,
we may use or disclose your PHI as follows:
For
treatment:
We may disclose your PHI to doctors, nurses, and other health care
personnel who are involved in providing your health care.
For example, your PHI will be shared among members of your
treatment team and other UHS staff. Your
PHI may also be shared with outside entities performing ancillary services
relating to your treatment, such as for interpretation of
To
obtain payment:
We may use/disclose your PHI in order to bill and collect payment
for your health care services. For
example, we may contact and/or release portions of your PHI to a private
insurer to get paid for services that we delivered to you.
We may release information to third parties for collection
purposes. Any charges not paid at time of service will be transferred to
the OSU Bursar.
For
health care operations:
We may use/disclose your PHI in the course of operating our clinic.
For example, we may disclose your PHI to our accountant or attorney
for audit purposes. We may
disclose your PHI to designated staff in our facility or offices for
similar purposes.
Appointment
reminders:
Unless you provide us with alternative instructions, we may send
appointment reminders and other similar materials to your home, or notify
you of appointments by phone.
For uses and disclosures beyond treatment, payment and operations purposes we are required to have your written authorization, unless the use or disclosure falls within one of the exceptions described below. Authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we have already undertaken an action in relia
Uses
and Disclosures of PHI not requiring consent or authorization
The
law provides that we may use/disclose your PHI without consent or
authorization in the following circumstances:
When
required by law:
We may disclose PHI when a law requires that we report information
about suspected abuse, neglect or domestic violence, or relating to
suspected criminal activity, or in response to a court order.
We must also disclose PHI to authorities that monitor compliance
with these privacy requirements.
For
public health activities:
We may disclose PHI when we are required to collect information
about disease or injury, or to report vital statistics to the public
health authority.
For
health oversight activities:
We may disclose PHI to our central office, or another agency
responsible for monitoring the health care system for such purposes as
reporting or investigation of unusual incidents.
Relating
to decedents:
We may disclose PHI relating to an individual’s death to
coroners, medical examiners or funeral directors, and to organ procurement
organizations relating to organ, eye, or tissue donations or transplants.
For
research purposes:
In certain circumstances, and under supervision of a privacy board,
we may disclose PHI to our research staff and their designees in order to
assist medical/psychiatric research.
To
avert threat to health or safety:
In order to avoid a serious threat to health or safety, we may
disclose PHI as necessary to law enforcement or other persons who can
reasonably prevent or lessen the threat of harm.
For
specific government functions:
We may disclose PHI of military personnel and veterans in certain
situations, to correctional facilities in certain situations, to
government benefit programs relating to eligibility and enrollment, and
for national security reasons, such as protection of the President.
For
Worker’s Compensation purposes:
We may disclose PHI in relation to workers’ compensation programs,
established by law, that provide benefits for work-related injuries or
illnesses.
Uses
and Disclosures of PHI from Alcohol and Other Drug Records Not Requiring
Consent or Authorization
The
law provides that we may use/disclose your PHI from alcohol and other drug
records without consent or authorization in the following circumstances:
When
required by law:
We may use/disclose PHI when a law requires that we report
information about suspected child abuse and neglect, or when a crime has
been committed on the premises or against personnel, or in response to a
court order.
Relating
to decedents:
We may disclose PHI relating to an individual’s death if state or
federal law requires the information for collection of vital statistics or
inquiry into cause of death.
For
research, audit or evaluation purposes:
In certain circumstances, we may disclose PHI for research, audit
or evaluation purposes.
To
avert threat to health or safety:
In order to avoid a serious threat to health or safety, we may
disclose PHI as necessary to law enforcement when a threat is made to
commit a crime on the premises or against personnel.
Uses
and Disclosures Requiring You to have an Opportunity to Object
In
the following situations, we may disclose a limited amount of your PHI if
we inform you about the disclosure in advance and you do not object, as
long as the disclosure is not otherwise prohibited by law.
Patient
Directories: Your
name, location, and general condition my be disclosed to callers or
visitors who ask for you by name. Additionally,
your religious affiliation may be shared with clergy.
To
families, friends or others involved in your care:
We
may share with these people information directly related to their
involvement in your care, or payment for your care.
We may also share PHI with these people to notify them about your
location, general condition, or death.
Your
Rights Regarding Your Protected Health Information
You
have the following rights relating to your protected health information:
To
request restrictions on uses/disclosures:
You have the right to ask that we limit how we use or disclose your
PHI. We will consider your
request, but are not legally bound to agree to the restriction.
To the extent that we do agree to any restrictions on our
use/disclosure of your PHI, we will put the agreement in writing and abide
by it except in emergency situations.
We cannot agree to limit uses/disclosures that are required by law.
To
choose how we contact you:
You have the right to ask that we send your information to an
alternative address or by an alternative means.
We must agree to your request as long as it is reasonably easy for
us to do so.
To
inspect and request a copy of your PHI:
Unless your access to your records is restricted for clear and
documented treatment reasons, you have a right to see your protected
health information upon your written request.
We will respond to your request within 30 days.
If we deny your access, we will give you written reasons for the
denial and explain any right to have the denial reviewed.
If you want copies of your PHI, a charge for copying may be
imposed, depending on your circumstances.
You have a right to choose what portions of your information you
want copied and to have prior information on the cost of copying.
To
request amendment of your PHI:
If you believe that there is a mistake or missing information in
our record of your PHI, you may request, in writing, that we correct or
add to the record. We will
respond within 60 days of receiving your request.
We may deny the request if we determine that the PHI is (i) correct
and complete; (ii) not created by us and/or not part of our records, or;
(iii) not permitted to be disclosed.
Any denial will state the reasons for denial and explain your
rights to have the request and denial, along with any statement in
response that your provide, appended to your PHI.
If we approve the request for amendment, we will change the PHI and
so inform you, and tell others that need to know about the change in PHI.
To find
out what disclosures have been made:
You have a right to get a list of when, to whom, for what purpose,
and what content of your PHI has been released other than instances of
disclosure for treatment, payment, and operations; to you, your family, or
the facility directory; or pursuant to your written authorization.
The list also will not include any disclosures made for national
security purposes, to law enforcement officials or correctional
facilities, or disclosures made before April 14, 2003.
We will respond to your written request for such a list within 60
days of receiving it. Your
request can relate to disclosures going as far back as six years.
There will be no charge for up to one such list each year.
There may be a charge for more frequent requests.
To
receive this notice
You have a right to receive a paper copy of this Notice and/or an
electronic copy by email upon request.
How to
Complain about our Privacy Practices
If you
have questions about this Notice or any complaints about our privacy
practices, please contact the Compliance Office listed below.
If you think we may have violated your privacy rights, or you
disagree with a decision we made about access to your PHI, you may request
information or file a complaint by contacting:
Attn: Privacy Officer
1202 Farm Road
Stillwater, OK 74078
405-744-7013
You also may file a written complaint with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington D.C., 20201 or call 1-877-696-6775. We will take no retaliatory action against you if you make such complaints.
Effective April 14, 2003
