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University of Iowa Health Care Privacy Notice
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.
Our Legal Responsibility
As your health care provider, we are legally required to protect
the privacy of your health information, and to provide you with this
notice about our legal obligations and privacy practices. This
requirement applies to all patients served by University of Iowa
Health Care and University of Iowa Student Health Service.
University of Iowa Health Care describes the partnership between
University of Iowa Hospitals and Clinics and the Roy J. and Lucille
A. Carver College of Medicine. Student Health Service provides health
services to University of Iowa students. This notice applies to
health information held by both entities.
University of Iowa Heath Care and Student Health Service are
legally required to follow the privacy practices described in this
notice. If you have any questions or want more information about this
notice, please contact our Privacy Officer listed at the end of this
notice.
Your Protected Health Information (PHI)
Throughout this notice we will refer to your protected health
information as PHI. Your PHI includes data that identifies you and
reports about the care and services you receive at the hospital, in
the clinics, or at Student Health Service.
This notice applies to all of the records, both electronic and
paper, about your care. It includes all information created by
University of Iowa Health Care or Student Health Service staff. This
staff includes physicians, other health care professionals, health
care students and other departmental staff.
This notice about our privacy practices explains how, when, and
why we use and share your PHI. We may not use or disclose any more of
your PHI than is necessary, with some exceptions. If state law is
more protective of your privacy, we will follow state law.
Changes to This Notice
We reserve the right to change the terms of this notice and our
privacy policies. Any changes will apply to your past, current, or
future PHI. When we make an important change to our policies, we will
change this notice and post a new notice on our Web site,
www.uihealthcare.com/hipaa. You may also request a copy of our
current notice at any time from the University of Iowa Hospitals and
Clinics registration desks, or the Student Health Service
registration desk.
Uses of Protected Health Information
University of Iowa Heath Care and Student Health Service collect
health information about you and store it in a chart and on a
computer. This is your medical record. The medical record is the
property of University of Iowa Hospitals and Clinics or Student
Health Service, but the information in the medical record belongs to
you.
We use and disclose health information for many reasons. The
following examples describe some of the categories of our uses and
disclosures. Please note that not every use or disclosure in a
category is listed.
- Treatment. We may use and disclose medical information
about you to physicians, nurses, technicians, physicians in
training, or other health care professionals who are involved with
your care. For example, if you are being treated for a knee
injury, we may disclose your PHI to the Department of
Rehabilitation Therapies. Different health care professionals,
such as pharmacists, lab technicians, and x-ray technicians, also
may share information about you in order to coordinate your care.
In addition, we may send information to the physician who referred
you to University of Iowa Health Care.
- Payment. We may use and disclose your PHI in order to
bill and collect payment for the treatment and services we
provided to you. For example, we may provide PHI to an insurance
company or other third party payor in order to obtain approval for
treatment or admission to the hospital.
If you are a University of Iowa student and incur a charge at
Student Health Service, and you choose to place that charge on
your University bill, the University of Iowa Business Office will
receive notice that a visit occurred at Student Health Service and
the charge for that visit.
- Appointment reminders and health-related benefits or
services. We may use your PHI to provide appointment reminders
or give you information about treatment alternatives or other
health care services.
- Public health activities. We report information about
births, deaths, and various diseases to government officials in
charge of collecting that information. We provide coroners,
medical examiners, and funeral directors with information about an
individual's death.
- Law enforcement. We may disclose PHI to government
agencies and law enforcement personnel when the law requires it.
For example, we report about victims of abuse, neglect, domestic
violence, and gunshots, or when ordered to do so in judicial or
administrative proceedings.
- Health oversight activities. We may disclose PHI to a
health oversight agency for audits, investigations, inspections,
and licensure, as authorized by law. For example we may disclose
PHI to the Food and Drug Administration, state Medicaid fraud
control, or the Department of Health and Human Services Office for
Civil Rights.
- Research studies. We may disclose your PHI to help
conduct research. Research may involve finding a cure for an
illness or helping to determine the effectiveness of a treatment.
All research studies are subject to a specific approval process by
a Privacy Board or Institutional Review Board. This process
evaluates a proposed research study to determine that measures are
in place to balance research needs with the need for the privacy
of your health information. For some research activities you may
be asked to participate in a study, and if you agree, the
researcher will be required to obtain your permission to use your
PHI for that study.
- Organ donation. We may use your PHI to notify organ
donation organizations, and to assist them in organ, eye or tissue
donation and transplants.
- Workers' compensation purposes. We may disclose PHI to
your employer or your workers' compensation carrier.
- National security and intelligence activities. We may
release PHI to authorized federal officials when required by law.
This information may be used to protect the President, other
authorized persons or foreign heads of state, to conduct special
investigations, for intelligence and other national security
activities authorized by law.
Uses and Disclosures for which You Have the Opportunity to
Object
- Hospital Directory. We will use your name, the location
at which you are receiving care, your general condition, and your
religious affiliation for directory purposes. All of this
information, except religious affiliation, will be disclosed to
people who ask for you by name. If you object to this use, we will
not include this information in the directory. You will need to
express your objection for each inpatient stay. To object, please
notify a member of your nursing staff.
- Fundraising. We may use your PHI in efforts to raise
money for University of Iowa Health Care. We may provide your PHI
to the University of Iowa Foundation for this purpose. We would
release contact information only, such as your name, address and
phone number, the dates that health care was provided to you, and
your insurance status. If you do not want University of Iowa
Health Care to contact you for fundraising efforts, you must
notify our Privacy Officer in writing at the address listed at the
end of this notice.
Your Rights Regarding PHI
You have the right to:
- Request Restrictions. You have the right to ask that we limit
how we use and disclose your PHI. We will consider your request,
but we are not legally required to accept it. If we accept your
request, we will honor that request except in emergency
situations. You may not limit the uses and disclosures that we are
legally required or allowed to make. To request a restriction,
contact the Privacy Officer listed at the end of this
notice.
- Request Confidential Communications. You have the right
to ask that we send PHI to you at an alternate address. For
example, you may wish to have appointment reminders and test
results sent to a P.O. Box or an address different from your home
address. We will accommodate reasonable requests. To make a
request, contact Joint
Office for Patient Financial Services listed
at the end of this notice.
- Inspect and Copy. You have the right to inspect and
obtain a copy of medical information that may be used to make
decisions about your care. Usually this includes the medical
record and billing records. To inspect and obtain a copy of
medical information, you must submit your request in writing to
either:
1. Release of Information (for medical information) or
2. Joint
Office for Patient Financial Services (for billing)
Both listed at the end of this notice.
We will make every effort to respond to your request within a
reasonable period of time. You may be charged a fee to cover the
costs of copying, mailing, or other supplies associated with your
request.
- Accounting of Disclosures. You have the right to obtain
a list of instances in which we have disclosed your PHI. Your
request must state a time period not longer than six years and
your request may not include dates before April 14, 2003. The list
will not include uses or disclosures made for treatment, payment,
or health care operations. In addition, the list will not include
uses or disclosures that you have specifically authorized in
writing, such as copies of records to your attorney or to your
employer. To request an accounting of disclosures, contact the
Privacy Officer listed at the end of this notice.
- Amend. You have the right to request an amendment of
your PHI if you think that information is inaccurate or incomplete
in your medical record or in a billing record. You may request an
amendment for as long as that record is maintained. You may submit
a written request for an amendment to either:
1. Release of Information (for amendment to your medical
record) or
2. Joint
Office for Patient Financial Services (for amendment to your
billing record)
Both are listed at the end of this notice.
UI Health Care may deny your request for an amendment if:
- it is not in writing
- it relates to information not created or produced by UI
Health Care staff
- we decide that the information is accurate and
complete
- Paper copy of this notice. You have the right to
request a paper copy of this notice. You may pick up a copy at any
check-in point throughout the hospitals and clinics; at the
registration desk; at Student Health Service; or request that a
copy be sent to you. The notice also can be downloaded from
www.uihealthcare.com/hipaa.
Revocation of Permission
If you provide us with permission to use or disclose medical
information about you, you may revoke that permission at any time. To
request revocation of permission, contact Release of Information
listed at the end of this notice.
If you revoke your permission, we will no longer use or disclose
medical information about you for the reasons covered by your written
revocation. We are unable to take back any disclosures previously
made with your permission. Also, we are required to keep all records
of the care that we provided to you.
Complaints and Questions
If you believe your privacy rights have been violated, you may
file a complaint with University of Iowa Community Medical Services
or with the Secretary of the U.S. Department of Health and Human
Services.
To file a complaint with University of Iowa Community Medical
Services, contact the University of Iowa Community Medical Services
Privacy Officer. The address and phone number are listed at the end
of this notice. You will not be penalized for filing a complaint and
your care will not be compromised.
The University of Iowa Community Medical Services is affiliated
with the University of Iowa Hospitals and Clinics. The contact
information for University of Iowa Community Medical Services is as
listed below. Please refer to these contacts for your questions,
complaints, or contact's phone numbers and addresses.
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Contact Information
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For:
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Contact:
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Filing a complaint
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University of Iowa Community Medical Services
ATTN: Privacy Officer
2941 Sierra Court SW
Iowa City, IA 52246
319-337-7642
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Requesting a restriction
Requesting an accounting of disclosures
Opting out of a fundraiser
Amending your medical record (Release of Information)
Revoking your permission to disclose your medical
information (Release of Information)
Filing a complaint
Questions
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University of Iowa Community Medical Services
ATTN: Privacy Officer
2941 Sierra Court SW
Iowa City, IA 52246
319-337-7642
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Confidential communications (Joint
Office for Patient Financial Services)
Amending your billing records (Joint
Office for Patient Financial Services)
Inspection and copying of your medical and/or billing
records (Release of Information or Joint
Office for Patient Financial Services)
Obtaining a copy of the University of Iowa Health Care
Privacy Notice
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Practice Administrator at the specific University
of Iowa Community Medical Services clinic you were seen at
for your care.
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If you have any questions about this notice, any complaints about
our privacy practices or you would like to have more information,
please contact the Privacy Officer listed above.
This notice is in effect April 14, 2003.
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