Notice of Privacy Practices Wyoming Medical Center by celeste.bertha


									                                                                              Effective Date: April 14, 2003
                                                                                      Updated July 18, 2012

                                 Notice of Privacy Practices


                            PLEASE REVIEW IT CAREFULLY

                       Wyoming Medical Center and Affiliated Facilities

At Wyoming Medical Center, we believe that your health information is personal. We keep records of the
care and service that you receive at our facilities. We are committed to keeping your Health information
private and we are also required by law to respect your confidentiality.

This Notice describes the privacy practices of Wyoming Medical Center and its affiliated facilities,
Wyoming Health Medical Group. This notice applies to all of the health records that identify you and the
care you receive at all facilities.

Wyoming Medical Center and Wyoming Health Medical Group follow the terms of this notice. Wyoming
Medical Center and Wyoming Health Medical Group may share your health information with each other
for reasons of treatment, payment, and health care operations.

                                       Our Legal Responsibility
Wyoming Medical Center and affiliated facilities           required to follow the privacy practices that are
are legally required to protect the privacy of your        described in this notice.
health information. This information is called
"protected health information" (PHI). PHI                  However, we reserve the right to change the
includes information that can be used to identify          terms of this notice and our privacy policies at
you that we have created or received about your            any time. Any changes will apply to the PHI we
past, present, or future health or condition, the          already have. Before we make an important
provision of health care to you, or the payment            change to our policies, we will promptly change
of this health care. We have an obligation to              this notice and post a new notice. You can view
provide you with this notice about our privacy             or print a copy of this notice from our web site at
practices that explains how, when, and why we    
use and disclose your PHI. We are legally

  How Wyoming Medical Center and Affiliated Facilities may Use or Disclose Your
                              Health Information
Wyoming Medical Center and affiliated facilities uses and discloses health information for many different
reasons, which are listed below:
    1. For treatment, payment, or healthcare                  involved with your care. For example, your
    operations. Treatment includes sharing                    physician may share information about your
    information among health care providers                   condition with the pharmacist to discuss

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                                                                         Effective Date: April 14, 2003
                                                                                 Updated July 18, 2012

appropriate medications or with radiologists              investigations, inspections, licensure and
or other consultants in order to make a                   other proceedings.
diagnosis. We ay disclose your medical                    7. Judicial and administrative
information as required by your insurance or              proceedings. We may disclose your health
other payment sources to receive payment                  information in the course of any
for treatment. We may use your health                     administrative or judicial proceeding.
information for healthcare operations, such               8. Law enforcement. We may disclose
are to improve the quality of care, or to                 your health information to a law
contracted accountants, attorneys, or                     enforcement official for purposes such as
consultants.                                              identifying or locating a suspect, fugitive,
2. The Hospital Directory. With your                      material witness or missing person,
verbal or written permission, we may                      complying with a court order or subpoena
include certain limited information about                 and other law enforcement purposes,
you in the hospital directory while you are a             regardless of hospital directory preference.
patient at the hospital. This information                 9. Deceased person information. We may
may include your name, location in the                    disclose your health information to coroners,
hospital, and your religious affiliation. The             medical examiners and funeral directors.
directory information, except for your                    10. Organ donation. We may disclose
religious affiliation, may also be released to            your health information to organizations
people who ask for you by name. 3.                        involved in procuring, banking, or
Notification and communication with                       transplanting organs and tissues.
family or patient representative. We may                  11. Research. In certain circumstances, we
disclose your health information to notify or             may provide PHI in order to conduct
assist in notifying a family member, your                 medical research.
personal representative, or another person                12. Public Safety. We may provide PHI to
responsible for your care about your                      law enforcement or persons able to prevent
location, your general condition or in the                or lessen harm in order to avoid a threat to
event of your death. If possible, we will                 the health or safety of a person or the public.
give you the opportunity to agree or                      13. Military & National Security. If you
object prior to making this notification.                 are a member of the armed forces, we may
4. As Required by Law.                                    release medical information about you as
5. Public Health Activities. We may                       required by military command authorities.
disclose medical information about you for                We may also disclose your PHI for reasons
public health activities. These activities                of national security.
generally include the following:                          14. Worker’s Compensation. We may
     to prevent or control disease, injury or             provide PHI in order to comply with
 disability                                               worker’s compensation laws.
               to report births and deaths;               15. Appointment Reminders and Health
               to report child abuse or                   Benefits or Services. We may use PHI to
 neglect;                                                 provide appointment reminders or give you
               to report reactions to                     information about treatment alternatives, or
 medications or problems with products;                   other health care services or benefits we
               to notify people of recalls of             offer.
 products they may be using;                              16. Inmates. If you are an inmate of a
               to notify a person who may                 correctional institution or under the custody
 have been exposed to a disease or may be at              of a law enforcement official, we may
 risk for contracting or spreading a disease              release medical information about you to the
 or condition;                                            correctional institution or law enforcement
     To notify the appropriate government                 official.
 authority if we believe a patient has been               17. Change of Ownership. In the event
 the victim of abuse or neglect. (If you agree            that Wyoming Medical Center and affiliated
 or as required by law).                                  facilities is sold or merged with another
6. Health oversight activities. We may                    organization, your health information/record
disclose your health information to health                will become the property of the new owner.
agencies during the course of audits,

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                                                                                         Updated July 18, 2012


  When Wyoming Medical Center and affiliated facilities May Not Use or Disclose
                          Your Health Information
In any other situation not described above, we  If you choose to sign an authorization to disclose
will ask for your written authorization before  your PHI, you can later revoke that authorization
using or disclosing any of your PHI.            in writing to stop any future uses and
Authorization forms are available upon request. disclosures.

                   Your Rights Regarding Medical Information About You

    Right to Inspect and Copy. You have the                  support the request. In addition, we may deny
    right to inspect and copy medical                        your request if you ask us to amend information
    information that may be used to make                     that:
    decisions about your care. Usually, this                                   Was not created by us, unless
    includes medical and billing records, but                      the person or entity that created the
    does not include psychotherapy notes.                          information is no longer available to make
                                                                   the amendment;
To inspect and copy medical information that
may be used to make decisions about you, you                                  Is not part of the medical
must submit your request in writing to: Release                   information kept by or for the hospital;
of Information, Wyoming Medical Center
1233 E. 2nd St. Casper, WY 82601. If you                                       Is not part of the information
request a copy of the information, we may                         which you would be permitted to inspect
charge a fee for the costs of copying, mailing or                 and copy; or
other supplies associated with your request.
                                                                                Is accurate and complete.
We may deny your request to inspect and copy in
certain very limited circumstances. If you are                    Right to an Accounting of Disclosures.
denied access to medical information, you may                     You have the right to request an "accounting
request that the denial be reviewed. Another                      of disclosures." This is a list of the
licensed health care professional chosen by the                   disclosures we made of medical information
hospital will review your request and the denial.                 about you.
The person conducting the review will not be the
person who denied your request. We will                      To request this list or accounting of disclosures,
comply with the outcome of the review.                       you must submit your request in writing to The
                                                             Privacy Officer, Wyoming Medical Center
    Right to Amend. If you feel that medical                 1233 E. 2nd St. Casper, WY 82601. Your
    information we have about you is incorrect               request must state a time period which may not
    or incomplete, you may ask us to amend the               be longer than six years and may not include
    information. You have the right to request               dates before April 14, 2003. Your request should
    an amendment for as long as the information              indicate in what form you want the list (for
    is kept by or for the hospital.                          example, on paper, electronically). The first list
                                                             you request within a 12 month period will be
To request an amendment, your request must be                free. For additional lists, we may charge you for
made in writing and submitted to The Privacy                 the costs of providing the list. We will notify
Officer, Wyoming Medical Center                              you of the cost involved and you may choose to
1233 E. 2nd St. Casper, WY 82601. In addition,               withdraw or modify your request at that time
you must provide a reason that supports your                 before any costs are incurred.
We may deny your request for an amendment if                      Right to Request Restrictions. You have
it is not in writing or does not include a reason to              the right to request a restriction or limitation

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                                                                                 Effective Date: April 14, 2003
                                                                                         Updated July 18, 2012

    on the medical information we use or                           medical matters in a certain way or at a
    disclose about you for treatment, payment,                     certain location.
    or health care operations. You also have the
    right to request a limit on the medical                   To request confidential communications, you
    information we disclose about you to                      must make your request in writing to the Privacy
    someone who is involved in your care or the               Officer. You may ask for a confidential
    payment for your care.                                    communication form at the registration desk. We
                                                              will not ask you the reason for your request. We
We are not required to agree to your request. If              will accommodate all reasonable requests. Your
we do agree, we will comply with your request                 request must specify how or where you wish to
unless the information is needed to provide you               be contacted.
emergency treatment.
                                                                  Right to a Paper Copy of This Notice.
To request restrictions, you must make your                       You have the right to a paper copy of this
request in writing to: The Privacy Officer,                       notice. You may ask us to give you a copy
Wyoming Medical Center, 1233 E. 2nd St.                           of this notice at any time. Even if you have
Casper, WY 82601. You may ask for a                               agreed to receive this notice electronically,
restriction of PHI form at the registration desk.                 you are still entitled to a paper copy of this
In your request, you must tell us (1) what                        notice.
information you want to limit; (2) whether you                You may obtain a copy of this notice at our
want to limit our use, disclosure or both; and (3)            website,
to whom you want the limits to apply.                         To obtain a paper copy of this notice, write to
                                                              Release of Information,
    Right to Request Confidential                             Wyoming Medical Center
    Communications. You have the right to                     1233 E. 2nd St. Casper, WY 82601.
    request that we communicate with you about

                                Other Uses of Medical Information
Other uses and disclosures of medical                         or disclose medical information about you for
information not covered by this notice or the                 the reasons covered by your written
laws that apply to us will be made only with your             authorization. You understand that we are
written authorization. If you provide us                      unable to take back any disclosures we have
authorization to use or disclose medical                      already made with your authorization, and that
information about you, you may revoke that                    we are required to retain our records of the care
authorization, in writing, at any time. If you                that we provided to you.
revoke your authorization, we will no longer use


                                         Changes to this Notice
    We reserve the right to change this notice.                    contain on the first page, in the top right-
    We reserve the right to make the revised or                    hand corner, the effective date. In addition,
    changed notice effective for medical                           each time you register at or are admitted to
    information we already have about you as                       the hospital for treatment or health care
    well as any information we receive in the                      services as an inpatient or outpatient, we
    future. We will post a copy of the current                     will offer you a copy of the current notice in
    notice in the hospital. The notice will                        effect.

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                                                                              Effective Date: April 14, 2003
                                                                                      Updated July 18, 2012

                                       How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint in writing with the hospital
or with the Office of Civil Rights. To file a complaint with the hospital, write to:

The Privacy Officer                             or                  Office for Civil Rights, DHHS
1233 E. 2nd Street                                                  1961 Stout Street - Room 1426
Casper, WY 82601                                                    Denver, CO 80294                                 (303) 844-2024; (303) 844-3439 (TDD)
                                                                    (303) 844-2025 FAX

                      You Will Not Be Penalized for Filing a Complaint
Wyoming Medical Center and affiliated facilities           you have received undue treatment for filing a
considers the protection of your health                    complaint, please use the above contact
information a high priority, and you will not be           information to report the incident.
penalized for filing a complaint. If you feel that


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