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Effective Date:
GUTHRIE
HEALTH
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU
Guthrie Health refers to Guthrie Health and its affiliated entities such
as Robert Packer Hospital, Guthrie Clinic Ltd., Guthrie Medical Group, P.C.,
Corning Hospital and Troy Community Hospital.
Guthrie Health also includes other entities affiliated with Guthrie
Health. If you have a question about whether an entity is affiliated with
Guthrie Health, please contact us using the information listed at the end of
this Notice. This Notice applies to information and records regarding your
health care maintained at Guthrie Health. Guthrie
Health entities and their employees, staff, students, volunteers and others
involved in patient care to which this Notice applies (referred to as “we,”
“our,” and “us”) have agreed to abide by its terms.
We may share your information with each other for purposes of treatment,
and as necessary for payment and operations activities as described below.
SUMMARY
In the course of receiving services from Guthrie Health (“Guthrie”), you will provide us with personal information about your health, with the understanding that this information will be kept confidential. We may also obtain information about your health from examinations, tests, or from others who have provided you with care. This notice of our privacy practices is intended to inform you of the ways we may use your information and the occasions on which we may disclose this information to others.
We use patients’ information when providing
treatment. We disclose patients’ information to other health care providers to
assist them to provide you with treatment. We
may disclose information to insurance companies as necessary to receive payment.
We may use the information within our organization to evaluate quality
and improve health care operations, and we may make other uses and disclosures
of patients’ information as required by law or as permitted by Guthrie
policies.
Guthrie is committed to protecting medical information about you. We
create a record of the care and services you receive at Guthrie for use in your
care and treatment.
This Notice tells you about the ways in which we may use and disclose
medical information about you. It also describes your rights and certain
obligations we have regarding the use and disclosure of your medical
information.
We are required by law to:
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make sure that your medical
information is protected;
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give you this Notice
describing our legal duties and privacy practices with respect to medical
information about you; and
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follow the terms of the Notice
that is currently in effect.
HOW WE
The following sections describe
different ways that we may use and disclose your medical information. For each
category of uses or disclosures, we will describe them and give some examples.
Some information such as certain drug and alcohol information, HIV information
and mental health information is entitled to special restrictions related to its
use and disclosure. Guthrie abides by all applicable state and Federal laws
related to the protection of this information. Not every use or disclosure will
be listed. All of the ways we are permitted to use and disclose information,
however, will fall within one of the following categories.
Treatment.
We may use medical information about you to provide you with medical
treatment or services. We may disclose medical information about you to doctors,
nurses, technicians, students, or others who are involved in taking care of you
in our system. 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. In
addition, the doctor may need to tell the hospital's food service if you have
diabetes so that we can arrange for appropriate meals. We may also share medical
information about you with other Guthrie personnel or non-Guthrie providers,
agencies or facilities in order to provide or coordinate the different things
you need, such as prescriptions, lab work and x-rays. We also may disclose
medical information about you to people outside Guthrie who may be involved in
your continuing medical care after you leave Guthrie such as other health care
providers, transport companies, community agencies and family members.
Payment.
We may use and disclose medical information about you so that the
treatment and services you receive at Guthrie or from other entities, such as an
ambulance company, may be billed and payment may be collected from you, an
insurance company or a third party. For
example, we may need to give information to your health plan about surgery you
received at Guthrie so your health plan will pay us or reimburse you for the
surgery. We may also tell your health plan about a proposed treatment to
determine whether your plan will cover the treatment.
We will use your health information, and disclose it to others, as
necessary to obtain payment for the services we provide to you.
For instance, an employee in our business office may use your health
information to prepare a bill. We
may send that bill, and any health information it contains, to your insurance
company. We may also disclose some
of your health information to companies with whom we contract for
payment-related services. For
instance, we may give information about you to a collection company that we
contract with to collect bills for us. We
will not use or disclose more information for payment purposes than is
necessary.
Health Care Operations.
We may use and disclose medical information about you for Guthrie
operations. These uses and disclosures include but are not limited to quality of
care and medical staff activities, health sciences education within Guthrie, and
teaching programs with affiliates and within other health care arrangements.
Your medical information may also be used or disclosed to comply with law
and regulation, to assess your satisfaction with our services, for population
based activities relating to improving health or reducing health care costs, for
contractual obligations, patients' claims, grievances or lawsuits, health care
contracting, legal services, business planning and development, business
management and administration, underwriting and other insurance activities and
to operate the Guthrie enterprise system. For example, we may review medical
information to find ways to improve treatment and services to our patients. We
may also disclose information to doctors, nurses, technicians, medical and other
students, and other Guthrie personnel for performance improvement and
educational purposes.
Public Health Risks.
We will disclose your health information when required to do so for public
health purposes. These purposes
generally include the following:
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reporting vital events such as
births and deaths;
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reporting child abuse or
neglect;
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reporting adverse events or
reactions to certain medications or defects or problems with products;
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notifying persons of recalls,
repairs or replacements of products they may be using;
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notifying a person who may
have been exposed to a disease or may be at risk of contracting or spreading a
disease or condition.
To
Report Abuse.
We may disclose your health information when the information relates to a
victim of abuse, neglect or domestic violence.
We will make this report only in accordance with laws that require or
allow such reporting, or with your permission.
Law Enforcement.
We may disclose your health information for law enforcement purposes:
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About a suspected victim of a
crime if, under certain limited circumstances, we are unable to obtain the
person's agreement;
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About a death suspected to be
the result of criminal conduct;
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About criminal conduct at
Guthrie;
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In case of a medical
emergency, to report a crime; the location of the crime or victims; or
the
identity, description or location of the person who committed the crime; and
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to a Federal agency
investigating our compliance with Federal privacy regulations.
Appointment Reminders.
We may contact you to remind you that you have an appointment at Guthrie.
Treatment Alternatives.
We may communicate to you via newsletters, mailings or other means to
tell you about or recommend possible treatment options or alternatives that may
be of interest to you.
Health-Related Benefits and Services.
We may contact you to tell you about benefits or services that we provide
that may be of interest to you.
Fundraising Activities.
We may contact you to provide information about Guthrie sponsored
activities, including fundraising programs and events. We would only use contact
information, such as your name, address and phone number and the dates you
received treatment or services at Guthrie.
News Gathering Activities.
We may contact you or one of your family members when a news reporter has
requested an interview with you. News reporters often seek interviews with
patients injured in accidents or experiencing particular medical conditions or
procedures. For example, a reporter working on a story about a new cancer
therapy may ask whether any of the patients undergoing that therapy might be
willing to be interviewed. In such cases, a member of our staff would contact
you to discuss whether or not you want to participate in the story.
Facility Directory.
We may list you in our directory if you are admitted to one of our
facilities. This is so your family,
friends and clergy can visit you in the hospital and generally know how you are
doing. This information may include your name, location in the hospital, your
general condition (e.g., fair, stable, etc.) and your religious affiliation. The
directory information, except for your religious affiliation, may also be
released to people who ask for you by name. Your religious affiliation may be
given to members of the clergy even if they don't ask for you by name. If you
request, we will not list you in the directory.
You can make your request to the admission staff at the appropriate
entity.
Your Family and Friends:
We may disclose to a family member, a friend, or other persons you
indicate are involved in your care or payment for your care, your medical
information that is directly relevant to their involvement.
We may use or disclose your name, location and general condition or death
to notify, or help with notification, of a family member, your personal
representative, or other persons involved in your care about your situation.
If you are present, we will give you the opportunity to object before we
disclose your medical information to these persons.
If you are incapacitated or in an emergency, we may disclose your medical
information to these persons if we determine that the disclosure is in your best
interest.
Disaster Relief Efforts.
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.
Guthrie is a research institution. All research projects conducted by Guthrie
are approved through a special review process to protect patient safety, welfare
and confidentiality. Your medical information may be important to further
research efforts and the development of new knowledge. We may use and disclose
medical information about our patients for research purposes, subject to the
confidentiality provisions of state and Federal law.
On occasion, researchers contact
patients regarding their interest in participating in certain research studies.
Enrollment in those studies can only occur after you have been informed about
the study, had an opportunity to ask questions, and indicated your willingness
to participate by signing a consent form. Other studies may be performed using
your medical information without requiring your consent. These studies will not
affect your treatment or welfare, and your medical information will continue to
be protected. For example, a research study may involve a chart review to
compare the outcomes of patients who received different types of treatment.
Required by Law:
We may use or disclose your medical information when we are required to do
so by law. For example, we must
disclose your medical information to the U.S. Department of Health and Human
Services upon request for purposes of determining whether we are in compliance
with Federal privacy laws. We may
also use and disclose your medical information for the following types of
entities, including but not limited to:
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Public Health or Legal
Authorities charged with preventing or controlling disease, injury, or
disability
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Organ and Tissue Donation
Organizations
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Military Command Authorities
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Workers’ Compensation Agents
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Health Oversight Agencies
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Coroners, Medical Examiners
and Funeral Directors
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Protected Services for the
President and Others
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National Security and
Intelligence Agencies
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Correctional Institutions
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Food and Drug Administration
Lawsuits and Other Legal Actions.
In connection with lawsuits or other legal proceedings, we may disclose medical
information about you in response to a court or administrative order, or in
response to a subpoena, discovery request, warrant, summons or other lawful
process.
Business Associate.
We provide some services through contracts with business associates, for
example, a copy service we use when making copies of your health record.
When these services and other services with business associates are
contracted, we may disclose your health information to our business associates
so 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.
Health Benefits Information.
Your health information may be disclosed by the Guthrie Network Advantage
Health Plan to Guthrie Health employees, as necessary for the administration of
the health benefit program. Employees
who receive this information have special rules to prevent the misuse of your
information for other purposes.
Your medical information is the
property of Guthrie; however, you have the following rights regarding medical
information we maintain about you:
Right to Inspect and Copy.
With certain exceptions, you have the right to inspect and/or receive a
copy of your medical information. To
inspect and/or to receive a copy of your medical information, you must submit
your request in writing to the Medical Record Custodian at the appropriate
Guthrie entity. If you request a copy of the information, we may charge a fee
for copying and mailing the records.
We may deny your request to inspect and/or to receive a copy of certain
information in certain limited circumstances. If we do, we will give you the
reason in writing. In some cases you
may have the denial reviewed. We
will also explain how you may appeal the decision.
Right to Request an Amendment.
If you feel that medical information we have about you is incorrect or
incomplete, you may ask us to amend the information.
To request an amendment, your request must be made in writing and
submitted to the Guthrie Health Privacy Office using the contact information
listed at the end of this Notice. In addition, you must provide a reason that
supports your request.
We may deny your request for an
amendment if it is not in writing or does not include a reason to support the
request. In addition, we may deny your request if you ask us to amend
information that:
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Was not created by Guthrie;
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Is not part of the medical
information we use to make decisions about you;
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Is not part of the information
which you would be permitted to inspect and copy;
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Is accurate and complete in
the record.
Right to an Accounting of
Disclosures.
You have the right to receive a list of the disclosures we have made of
medical information about you that were for purposes other than treatment,
payment, health care operations and certain other purposes.
To request this accounting of
disclosures, you must submit your request in writing to the Guthrie Health
Privacy Office. Please refer to the
Privacy Office contact information at the end of this Notice. Your request must
state a time period that may not be longer than the six previous years and may
not include dates before April 14, 2003. You are entitled to one accounting
within any 12-month period at no cost. If you request a second accounting within
that 12-month period, there will be a charge for the cost of compiling
the accounting. We will notify you of the cost involved and you may choose to
withdraw or modify your request at that time before any costs are incurred.
Right
to Request Restrictions. You
have the right to ask us to restrict how we use or disclose your health
information. We will consider your
request, but we are not required to agree. If
we do agree, our agreement must be in writing and we will comply with the
request unless the information is needed to provide you with emergency
treatment. We cannot agree to
restrict disclosures that are required by law.
To request a restriction, you must make your request in writing to the
Guthrie Health Privacy Office using the contact information listed at the end of
this Notice. In your request, you
must tell us what information you want to limit.
Right to 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 instead of your
home. We will grant reasonable
requests for confidential communications at alternative locations and/or via
alternative means only if the request is submitted in writing and the written
request includes a mailing address where the individual will receive bills for
services rendered by us 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.
Right to 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. Even if you have agreed to receive this
Notice electronically, you are still entitled to a paper copy of this Notice.
Copies of this Notice shall be available throughout Guthrie, or you may
obtain a copy at our website, www.guthrie.org.
OTHER USES OF MEDICAL INFORMATION
We may use or disclose your health information for any purpose that is
covered by this Notice without your written authorization.
Other uses and disclosures of medical information not covered by this
Notice will be made only with your written authorization. If you provide us
authorization to use or disclose medical information about you, you may revoke
that authorization, in writing, at any time. If you revoke your authorization,
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 authorization, and that we
will retain our records of the care provided to you as required by law.
If the authorization is to permit disclosure of your information to an
insurance company, as a condition of obtaining coverage, other law may allow the
insurer to continue to use your information to contest claims or your coverage,
even after you have revoked the authorization.
To revoke a written authorization, send a written statement to the Guthrie
Health Privacy Office using the contact information listed at the end of this
Notice. The statement must include
the date on which the authorization is no longer in force.
CHANGES TO GUTHRIE’S' PRIVACY
PRACTICES
We reserve the right to change our privacy practices and this Notice at
any time. We reserve the right to apply these changes to any medical information
we already have about you as well as any information we receive in the future.
We will post a copy of the current Notice at Guthrie facilities. The Notice will
contain the effective date on the first page in the top right-hand corner. In
addition, at any time you may request a copy of the current Notice in effect.
QUESTIONS OR COMPLAINTS
If you have any questions about this Notice, please contact us using the
information listed at the end of this Notice.
If you believe your privacy rights have been violated, you may file a
complaint with Guthrie or with the Secretary of the Department of Health and
Human Services. To file a complaint with Guthrie, the contact information is
listed below. All complaints must be
submitted in writing. We support your right to protect the privacy of your
medical information. We will not
retaliate in any way if you choose to file a complaint with us or with the U.S.
Department of Health and Human Services.
Click here to Download Guthrie Health's
Notice of Privacy Practice Acknowledgement Form
CONTACT OFFICE:
Privacy Office
Guthrie Health
One Guthrie Square
Sayre, Pennsylvania 18840
Telephone: 1-866-265-9974
E-Mail:
privacy@guthrie.org
We comply with the HONcode standard for trustworthy health information. |
For more information please call toll-free 1-888-4GUTHRIE (1-888-448-8474) or click here to Contact Us Website Privacy Guidelines Notice of Privacy Practices |