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Dear Patients and Visitors,
Protecting the privacy of your health information is important. We are pleased to provide the information below to inform you about a federal law that is designed to help protect the privacy of that health information. This law is known as the HIPAA Privacy Rule.
The Privacy Rule requires us to give you a copy of our Notice of Privacy Practices ("the Notice"). This Notice explains our use of your medical or health information. The Rule also requires us to ask you to sign a form called the Acknowledgment. By signing this form you are confirming that you received a copy of the Notice.
We hope that the Notice of Privacy Practices helps you to understand the ways we use and protect your health information. If you have any questions about this Notice or our privacy practices, please feel free to contact the HIPAA Program Office at 773-834-9716.
Chief Compliance Officer
THIS NOTICE OF PRIVACY PRACTICES IS BEING PROVIDED TO YOU AS REQUIRED BY THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT ("HIPAA"). IF YOU WISH TO RECEIVE A PAPER COPY OF THIS NOTICE AT ANY TIME CONTACT THE HIPAA PRIVACY PROGRAM IN THE OFFICE OF CORPORATE COMPLIANCE.
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.
This Notice describes the privacy practices of the University of Chicago Organized Health Care Arrangement. It applies to services you receive at:
A list of our care sites is listed at the end of this Notice. Collectively, these entities will be referred to as “we” or “us” in this Notice. We will share your medical information with each other to treat you, obtain payment for our services and operate our hospitals and clinics as permitted by HIPAA.
If you are under 18 years of age, usually your parent(s) or guardian(s) handle your privacy and your medical information for you, although there are a few exceptions.
If you are an adult with others who make decisions for you, such as your health care surrogate, they may make decisions about your privacy and your medical information.
We respect the privacy of your medical information. Each time you visit us, we record information about the care you receive, including external information we receive about your health care and information to seek payment for our services (your “medical information”). This medical information is also called your “Protected Health Information” (“PHI”). These records may be kept on paper, electronically on a computer, or stored by other media.
UCMC is required by law to:
We reserve the right to make changes to this Notice at any time and to apply new privacy or security practices to medical information we maintain. Our website will contain the most current version of our Notice. You can access the Notice that is current at any time at http://hipaa.bsd.uchicago.edu/npp.html. You can also request a paper copy of this notice from our HIPAA Privacy Program in the Office of Corporate Compliance.
This Notice explains how we may use and share medical information about you in order to provide health care, obtain payment for that health care, and operate our business. This Section also describes several other circumstances in which we may use and share your medical information. We do not need your authorization (permission) to use your medical information in the following circumstances:
We keep records of the care and services we provide to you. We may use and share your information with doctors, nurses, technicians, medical or nursing students, or anyone else who needs the information to take care of you.
Example 1: A doctor treating a patient for a broken leg may need to ask another doctor if the patient has diabetes, because diabetes may slow the leg’s healing process. This may involve talking to doctors and others not employed by us. If they are involved in the patient’s health care, we may disclose the patient’s medical information to them for purposes of the patient’s treatment.
Example 2: We use medical information to notify you about products or services we provide that are related to your health, recommend treatment alternatives and to provide information about health-related benefits or services that may be of interest to you.
We may use and share information about you so that we and other health care providers that have provided services to you, such as an ambulance company, may bill and collect payment for those services. Your information may be used to obtain payment from you, your insurance company, or another person you identify.
Example: We submit claims for services rendered using medical information about the services provided to obtain payment from insurance companies, including Medicare, and family members or others who are responsible for paying the patient’s bill.
3. Health Care Operations
We may use and share information about you for business tasks necessary for our operations, including, for example, to improve the quality of care, train staff and students, provide customer services, or conduct any required business duties to better serve our patients and community. Also, we may share your medical information with others we hire to help us provide services and programs.
4. Relatives, Close Friends, and Caregivers
We may share your medical information with your family member or relative, a close personal friend, or another person you identify if you do not object to the disclosure or you agree to share your information with them. If, for some reason such as medical emergency, you are not able to agree or disagree, we may use our professional judgment to decide whether sharing your information is in your best interest. This includes information about your location and general condition.
5. Contacting You
We may use and share your medical information to contact you about appointments and other matters by mail, telephone, or email. When calling you at the number you give us to remind you of your appointment, we may include your name, the clinic, the location, and the physician or other health care provider you have the appointment with in any message left on an answering machine or with an individual who answers the phone. We will honor any reasonable request you make to receive an appointment reminder in a different way. We may also contact you to follow up regarding test results, care received, or to notify you about treatment options or health-related products or services that may interest you.
6. Patient Directory
We may automatically include your name, location in the hospital, general health condition and religious affiliation in a directory of patients in our hospital unless you tell us you do not want your information in the directory. Information in the directory may be shared in emergency situations and to members of the clergy. Directory information other than religious affiliation may also be shared with anyone who asks for you by name.
We may use limited information about you (e.g., your name, address, phone number, date of birth, gender, dates on which we provided health care to you, your treating physician, outcome information, and health insurance status) to contact you to raise money for our programs and services. You can opt out of these communications at any time by contacting our Development Office by phone at (773) 834-9166 or by e-mail at supportUCMC@bsd.uchicago.edu.
We perform research at UCMC. Our researchers may use or share your information without your authorization (a) if the group that oversees research gives them permission to do so, (b) if the patient data is being used to prepare for a research study, or (c) if the research is limited to data of deceased patients.
9. Permitted and Required by Law
We are required and permitted by federal, state and local laws to share medical information to certain government agencies and others. For example, we may share your medical information to:
We may also share your medical information:
10. Organ and Tissue Donation
We may release your medical information to organizations that manage organ, tissue, and eye donation and transplantation.
11. Deceased Patients
We may share medical information about deceased patients to the coroner, medical examiner or funeral director.
We will not use or share your medical information for any reason other than those described in this Notice without a written authorization signed by you or your personal representative. An authorization is a document that you sign that directs us to use or disclose specific information for a specific purpose. For example, if you want your medical information sent to a family member, we will ask you to sign an authorization.
We will obtain your written permission:
Psychotherapy notes (your mental health provider’s written notes) will only be disclosed with your written permission and the consent of your mental health provider.
You may change your mind about your authorization at any time by sending a written “revocation statement” to the HIPAA Privacy Program in the Office of Corporate Compliance. The revocation will not apply if we have already taken action for which we relied on your permission.
1. Inspect and Receive a Copy Your Medical Information
You may access and receive a copy your medical record file, billing records, and other similar records used to make decisions about your treatment and obtain payment for our services. We may deny access to a portion of your records under limited circumstances. If you want to see your records or receive a copy, call Health Information Management (Medical Records) at (773) 702-1637. We will expect you to complete, sign, and return a Record Request form. We will charge you for the reasonable cost of the copy and postage costs to the extent state law allows it.
2. Receive Confidential Communications
You may ask us to send papers that contain your PHI to a different location than the address that you gave us, or in a special way. You will need to ask us in writing. We will try to grant any reasonable request. For example, you may ask us to send a copy of your medical records to a different address than your home address.
3. Amend Certain Records
You have the right to request an amendment (correct or add to) to your medical information that we maintain. If you believe that the information is either inaccurate or incomplete and you would like to amend your information, you may obtain an Amendment Request Form from the HIPAA Privacy Program in the Office of Corporate Compliance. We will decide if we will grant your request or, under limited circumstances, deny your request.
4. Receive an Accounting of Disclosures
You may request a list (accounting) of people or organizations, outside of UCMC, with whom we have shared (disclosed) your medical information. This list will not include disclosures:
We will not go back more than six (6) years before the date of your request. If you request more than one accounting during a twelve-month period, we will charge you a reasonable cost for the accounting. Direct your request for an accounting to the HIPAA Privacy Program in the Office of Corporate Compliance.
5. Request Restrictions
You have the right to ask us to restrict or limit the medical information we use or disclose about you for treatment, payment, or health care operations. We are not required to agree to your request with one exception specified below. If we do agree, we will comply unless the information is needed to provide emergency treatment. Your request for restrictions must be made in writing and submitted to the HIPAA Privacy Program in the Office of Corporate Compliance. By law, we must agree to your request to restrict disclosure of your medical information to a health plan if the disclosure is a) for the purpose of carrying out payment or health care operations, b) is not otherwise required by law, and c) for an item or service you have paid for in full, out-of-pocket.
6. Breach Notification
You may have the right to be notified in the event of unpermitted access or use of unsecured medical information. If the law requires us to notify you of this type of access or use, then we will notify you promptly with the following information:
Our original Notice was effective in April, 2003. It was revised in May, 2012 and September, 2013. This version is effective January, 2017.
We have numerous locations in and around Chicago. The on-campus and off-site locations that follow this Notice include:
If you would like more information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we made about access to your PHI, you may contact the HIPAA Privacy Program in our Office of Corporate Compliance. You may also file written complaints with the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services. When you ask, the HIPAA Privacy Program will provide you with the correct address for the OCR. We will not take any action against you if you file a complaint with us or with the OCR.
You may contact the HIPAA Privacy Program at:
The University of Chicago Medicine
Office of Corporate Compliance, HIPAA Privacy Program
5841 South Maryland Avenue, MC1000
Chicago, IL 60637
Telephone Number: (773) 834-9716
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