This notice describes how medical
information about you may be used
and disclosed and how you may have
access to this information.
This notice applies to all of your
records of care generated by the
practice, whether made by OCHC or an
OCHC business associate.
This notice describes our practice’s
policies, which extend to:
Any health care professional
authorized to enter information into
your chart (including physicians,
NPs, PAs, RNs, Dentist, Hygienist,
Dental Assistants, Psychologist,
psychiatrist, Case Managers,
Outreach Workers, etc. All areas of
OCHC (front desk, administration,
billing and collection, etc. All
employees, staff and other personnel
that work for or with our practice;
Our business associates (including a
billing service, or facilities to
which we refer patients), on-call
physicians, and so on.
Protecting Your
Private Health Information:
We understand that medical
information about you and your
health is personal and private and
we are committed to protecting and
safeguarding your medical
information. Individually
identifiable information about your
past, present, or future health or
condition, the provision of health
care to you, or payment for your
health care is considered "Protected
Health Information" ("PHI"). We are
required by law to make sure that
your PHI is kept private and to make
available this Notice about our
legal duties and 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
purpose of the use or disclosure. If
we discover a breach (as defined in
42 U.S.C. 201 et seq.) of the
privacy or security of your PHI, we
are required to notify you of the
breach. We are also required by law
to abide by the terms of our current
Notice of Privacy Practices.
The Practice provides this Notice to comply with
the Privacy Regulations issued by
the Department of Health and Human
Services in accordance with the
Health Insurance Portability and
Accountability Act of 1996
(HIPAA).
Effective Date: April 1, 2003
Revised July 28, 2010
HOW WE MAY USE AND DISCLOSE
MEDICAL INFORMATION ABOUT YOU
We use and disclose Protected Health
Information ( PHI) for a variety of
reasons. For certain uses or
disclosures we must get your written
authorization. However, the law
does permit some uses/disclosures of
your PHI without your authorization.
Disclosures and restrictions of
PHI include but are not limited to
the uses listed in this Notice.
Other uses may apply as permitted by
law.
Uses and Disclosures Not
Requiring Your Authorization: The law provides that we may
use/disclose your PHI without your
authorization in the following
circumstances:
Medical Treatment.
Information obtained by a provider,
a nurse, or other member of your
health care team will be recorded in
your medical record and used to
determine the course of treatment,
care and services. Health care team
members will communicate with one
another personally and through the
health record to coordinate care
provided. We will also provide your
physician or subsequent health care
provider with copies of various
reports that should assist him or
her in treating you in the future.
Payment.
We may use and disclose medical
information about you for services
and procedures provided at OCHC for
billing to you, your health plan or
any other third party payor. Your
health care information may be used
to obtain prior authorization of
payment for treatment and care.
Operational Uses.
Members of the medical staff, the
risk and quality improvement staff
may use information in your health
record to assess the care, treatment
and services you have received. This
information will then be used in an
effort to continually improve the
quality and effectiveness of health
care we provide. In some cases, we
will furnish your health information
to other qualified parties for their
health care operations such as your health plan and/or our
business associates.
Business Associates
OCHC may use and disclose certain
medical information about you to our
business associates. A business
associate is an individual or entity
under contract with OCHC to perform
or assist us in a function or
activity that necessitates the use
or disclosure of your medical
information. Examples of business
associates, include, but are not
limited to, a copy service used by
the OCHC to copy medical records,
consultants, accountants, lawyers,
medical transcriptionists, and
third-party billing companies. OCHC
requires the business associate to
protect the confidentiality of your
medical information.
Teaching
Programs; OCHC facilitates
the training of
graduates and students from
medical, dentistry, nursing,
pharmacy, and other allied health
programs and they may be assisting
with your care under the supervision
of a licensed health care provider
as a part of their professional
health care training program.
Appointment
and Patient Recall Reminders.
Unless you provide us with
alternative instructions, we may
use and disclose only minimally
necessary medical information to
contact you as a reminder that you
have an appointment for medical care
with OCHC or that you are due to
receive periodic care from the
Practice. This contact may be by
phone, in writing, e-mail, or
otherwise and may involve the
leaving an e-mail, a message on an
answering machines, or otherwise
which could (potentially) be picked
up by others.
Others Involved in 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.
Research at OCHC is
conducted under strict Institutional
Review Board (IRB) guidelines
designed to safeguard and protect
you and health information used for
research. We would obtain your
specific authorization prior to
using your health information if the
disclosure of that information
directly identifies you. The only
exception would be granted under
rare circumstances when the IRB is
permitted by federal regulations to
grant a waiver of authorization.
Required By Law.
We will disclose medical information
about you when required to do so by
federal, state or local law.
To Avert a Serious Threat to Health
or Safety.
We may use and disclose medical
information about you when necessary
to prevent a serious threat either
to your specific health and safety
or the health and safety of the
public or another person. Any
disclosure, however, would only be
to someone able to help prevent the
threat.
Organ and Tissue Donation. If you are an organ donor, we may release medical
information to organizations that
handle organ procurement or organ,
eye or tissue transplantation or to
an organ donation bank, as necessary
to facilitate organ or tissue
donation and transplantation.
Workers' Compensation.
We may release medical information
about you for workers' compensation
or similar programs. These programs
provide benefits for work-related
injuries or illness.
Lawsuits and Disputes.
If you are involved in a lawsuit or
a dispute, we may disclose medical
information about you in response to
a court or administrative order.
This is particularly true if you
make your health an issue. We may
also disclose medical information
about you in response to a subpoena,
discovery request, or other lawful
process by someone else involved in
the dispute. We shall attempt in
these cases to tell you about the
request so that you may obtain an
order protecting the information
requested if you so desire. We may
also use such information to defend
ourselves or any member of our
practice in any actual or threatened
action.
Public Health Risks.
Law or public policy may require us
to disclose medical information
about you for public health
activities. These activities
generally include the following: to
prevent or control disease, injury
or disability, to report births and
deaths, to report child abuse or
neglect, to report reactions to
medications or problems with
products, to notify people of
recalls of products they may be
using and to notify persons of
possible exposure to a disease or
may be at risk for contracting or
spreading a disease or condition, to
notify the appropriate government
authority if we believe a patient
has been the victim of abuse,
neglect or domestic violence. We
will only make this disclosure if
you agree or when required or
authorized by law.
Investigation and Government
Activities We may disclose medical information
to a local, state or federal agency
for activities authorized by law.
These oversight activities include,
for example, audits, investigations,
inspections, and licensure. These
activities are necessary for the
payor, the government and other
regulatory agencies to monitor the
health care system, government
programs, and compliance with civil
rights laws.
Military and Veterans
If you are a member of the armed
forces, we may release medical
information about you as required by
military command authorities. We may
also release medical information
about foreign military personnel to
the appropriate foreign military
authority.
Law Enforcement
We may release medical information
if asked to do so by a law
enforcement official: In response to
a court order, subpoena, warrant,
summons or similar process; To
identify or locate a suspect,
fugitive, material witness, or
missing person; About the victim of
a crime if, under certain limited
circumstances, we are unable to
obtain the person's agreement; About
a death we believe may be the result
of criminal conduct; About criminal
conduct at the Practice; and In
emergency circumstances to report a
crime; the location of the crime or
victims; or the identity,
description or location of the
person who committed the crime.
Coroners, Medical Examiners and
Funeral Directors
We may release medical information
to a coroner or medical examiner and
funeral directors as necessary by
law or to perform and carry out
their duties.
Inmates
Medical information can be
released about inmates in
correctional institutions or under
the custody of a law enforcement
official, This release would help
facilitate (1) the institution in
providing you with health care; (2)
protecting your health and safety or
the health and safety of others and
(3) the overall safety and security
of the correctional institution.
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. We are required
to retain records of the care we
provided to you for a minimum period
specified by law.
PATIENT RIGHTS
Your Rights Regarding Your Protected
Health Information (PHI):
This section describes your rights
and the obligations of OCHC
regarding the use and disclosure of
your PHI. You have the following
rights regarding medical information
we maintain about you:
Right to Inspect and Copy.
You have the right to inspect and
copy medical information that may be
used to make decisions about your
care. This includes your own medical
and billing records, but does not
include psychotherapy notes. Upon
proof of an appropriate legal
relationship, records of others
related to you or under your care
(guardian or custodial) may also be
disclosed. Medical information
protected under the Minnesota Minor
Consent Law is excluded from your
right to access, inspect, amend or
copy medical information regardless
of legal or guardianship status
without the written permission of
the minor. To inspect and copy your
medical record, you must submit your
request in writing to our HIPAA
Compliance Officer. Ask the front
desk person for the name of the
HIPAA Compliance Officer. If you
request a copy of the information,
we may charge a fee for the costs of
copying, mailing or other supplies
(tapes, disks, etc.) associated with
your request. 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
our Compliance Committee review the
denial. Another licensed health care
professional chosen by OCHC 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 and recommendations from
that review.
Right to Amend.
If you feel that the medical
information we have about you in
your record is incorrect or
incomplete, then you may ask us to
amend the information, following the
procedure below. You have the right
to request an amendment for as long
as OCHC maintains your medical
record. To request an amendment,
your request must be submitted in
writing, along with your intended
amendment and a reason that supports
your request to amend. The
amendment must be dated and signed
by you and notarized. 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: Was not created by
us, unless the person or entity that
created the information is no longer
available to make the amendment; Is
not part of the medical information
kept by or for the Practice; Is not
part of the inaccurate and
incomplete medical information in your record.
Right to Revoke Disclosure.
You may at any time in writing,
revoke your permission to use or
disclose your medical information
that requires your written
authorization. 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.
Right to an Accounting of
Disclosures.
You may request an accounting of
certain disclosures of your health
information showing with whom your
health information has been shared
(does not apply to disclosures to
you, with your authorization, for
treatment, payment or health care
operations, and in certain other
cases). To request an accounting of
disclosures, you must send a written
request to the Medical Records
Department. Your request must state
a time period that may not be longer
than six years and may not include
dates before April 14, 2003.
Your request should indicate in
what form you want the list (for
example, on paper, electronically).
The first list you request within a
twelve (12) month period will be
free. For additional lists, there
may be charge for the costs of
providing the list. You will be
notified in advance of any costs and
you may choose to withdraw or modify
your request at that time.
Right to 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.
You also have the right to request a
limit on the medical information we
disclose about you to someone who is
involved in your care or the payment
for your care (a family member or
friend). For example, you could ask
that we not use or disclose
information about treatment you
received. We are not required to
agree to your request and we may not
be able to comply with your
request. If we do agree, we will
comply with your request except that
we shall not comply, even with a
written request, if the information
is needed to provide emergency
treatment to you. We cannot agree
to limit uses or disclosures that
are required by law. To request
restrictions, you must make your
request in writing and state what
information you want to limit;
whether you want to limit our use,
disclosure or both; and to whom you
want the limits to apply, (e.g.,
disclosures to your children,
parents, spouse, etc.)
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
can ask that we only contact you at
work or by mail, that we not leave
voice mail or e-mail, or the like.
To request confidential
communications, you must make your
request in writing. We will not ask
you the reason for your request. We
will attempt to accommodate all
reasonable requests. Your
request must specify how or where
you wish us to contact you.
Right to a 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.
CHANGES TO THIS NOTICE
We reserve the right to change this
notice at any time. We reserve the
right to make the revised or changed
notice effective for medical
information we already have about
you as well as any information we
may receive from you in the future.
We will post a copy of the current
notice in the Practice. The notice
will contain on the first page, in
the lower left corner, the date of
last revision and effective date.
In addition, each time you visit
OCHC for treatment or health care
services you may request a copy of
the current notice in effect.
COMPLAINTS
If you believe your privacy rights have been
violated, you may file a complaint
with OCHC or with the Secretary of
the Department of Health and Human
Services. To file a complaint with
the Practice, contact our office
manager, who will direct you on how
to file an office complaint. All
complaints must be submitted in
writing, and all complaints shall be
investigated, without repercussion
to you. There will be no retaliation
for filing a complaint.
For more information or to file a compliant please
call the Compliance Officer at
651-290-9200. Or write to:
OCHC
Compliance Officer
409 Dunlap Street
St Paul, MN 55104
