Patients’ Rights & Responsiblities
This notice describes ways in which we may use or disclose our patients’ information. It also lists patient rights regarding the privacy of their health information and tells how to fulfill those rights. Additionally, it describes how medical information about you may be used and disclosed and how you can get access to this information.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:
All medical professionals involved in your care will use your medical information to treat you. This includes referral services.
We may use and disclose your medical information to receive payment for services.
For Health Care Operations
We may use and disclose your medical information to review our treatment/services and compare our services to those offered by other organizations in an effort to improve quality of care.
FOR CONTRACTED SERVICES
We may use and disclose your medical information to contracted companies or individuals providing services for IHC. These contractors are held to the same confidentiality standards as IHC employees.
We may use and disclose your medical information to provide you with appointment or treatment reminders.
We may use and disclose medical information to tell you about treatment options.
For Health Benefits and Services
We may use and disclose your medical information to provide you with health benefits and services, including special programs or discounts that might apply to you.
Individuals Involved in Your Care or Payment for Your Care
As our patient, it is your right to designate a friend or family member that may receive information on your health status. However, if you are unable to make this decision, we may use or disclose this information to a friend or family member involved in your care. Additionally, we may disclose this information in cooperation with disaster relief efforts.
REASONS REQUIRED OR ALLOWED BY LAW
To Avert a Serious Threat to Health or Safety
Military and Veterans: If you are a member of the armed forces or separated/discharged from military services, we may release your health information as required by the military, including foreign military.
Workers’ Compensation: We may release your health information for workers’ compensation or such programs.
Public Health Risks and Patient Safety Issues: We may disclose your health information for public health programs or to ensure your safety.
Health Oversight Activities: We may disclose your health information to a health group that oversees activities allowed by law, including audits.
Grants: Funding sources can review health information to ensure IHC’s compliance.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose your health information as required by law.
Law Enforcement: We may release health information if asked by law enforcement.
Coroners, Medical Examiners and Funeral Directors: We may release health information to a coroner, medical examiner, or funeral director.
National Security and Intelligence Programs: We may release your health information to federal officials for security activities authorized by law.
Protective Services for the President and Others: We may disclose your health information to federal officials so they can protect the President, or to other persons involved with special investigations.
Inmates: If you are in custody, we may release your health information to law enforcement to treat you, and for the health safety of yourself and others. The rights listed in this notice will not apply to inmates.
Your rights about your health information:
Although your health record belongs to IHC, the information belongs to you. You have the:
Right to Look Over and Copy. You have the right to request, in writing, to look over and/or copy your health information. If there is a fee for these services, you will be told in advance. We may deny your request to look over and copy. If you are denied access to health information, you may ask that the denial be reviewed. A manager chosen by Indiana Health Centers, Inc. will review your request and the denial. The person doing the review will not be the person who denied your request.
Right to Amend. You may ask, in writing, for an amendment to your health information. This request must include a reason.
Right to an Accounting of Disclosures. You have the right to request, in writing, a list of the disclosures we made that are not related to treatment, payment for services, or health care operations. This request must include a time period. If there is a fee associated with the list, you will be told in advance.
Right to Request Restrictions. You have the right to request, in writing, that we limit the health information disclosed to family members/friends.
Right to Request Confidential Communications. You have the right to request, in writing, that we communicate with you in a certain way. For example, you may request that we only contact you at a certain phone number. This request must specify your preferred contact information.
Right to a Paper Copy of This Notice. You have the right to request a paper copy of this notice at any time.
If you have a complaint about your privacy rights, please report it to the IHC Alert Line. This Alert Line is an anonymous compliance hotline that can be reached 24/7, 365 days a year. The Alert Line is available online at https://ihcinc.alertline.com or by phone at 1-866-813-9158.
You may also complain to the Office of Civil Rights. The law requires your complaint be submitted in writing (on paper or electronically) , name the person/company, and describe the situation. The complaint also must be filed within 180 days of when the incident occurred, unless you can state a reason for waiving the time limit.
Send your complaint to:
Robinsue Frohboese, Acting Director
200 Independence Avenue, SW
Room 509F HHH Building
Washington, DC 20201
Region V: CHICAGO
Lisa Simeone, Regional Manager
233 N. Michigan Avenue, Suite 240
Chicago, IL 60601
(312) 886-1807 fax
(312) 353-5693 TDD
You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION. Other uses and disclosures of health information not in this notice or law will be made only with your written consent. This consent may be canceled in writing at any time. If you cancel your consent, we will no longer use or disclose your health information for the reasons listed in your consent. This does not apply to any disclosures we have already made. We are required to keep your original records.