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ARHS Notice of Privacy Practices (download)
Servicios de salud de Athens
Regional aviso de practicas de la privacidad
ARHS Authorization for the
Release of PHI (download)
Autorizacion para reveler
informacion protegida de salud
ARHS Privacy Complaint form
(download)
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ARHS Notice of Privacy Practices
THIS NOTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Athens Regional makes and keeps records of medical information. While you are a patient here, we will use and disclose your medical information:
- To provide treatment to you and to keep a record describing your care
- To receive payment for the care we provide
- To facilitate administrative functions at Athens Regional
- To comply with the law
This Notice
summarizes the ways we may use and disclose medical information about you.
It also describes your rights and our duties regarding the use and
disclosure of your medical information. This Notice applies to all records
of your care at Athens Regional, whether made by Athens Regional personnel
or by your personal doctor. Your doctor and other health care providers
may use a different Notice and policy regarding the use and disclosure of
your medical information in their offices.
When we use the word "we" or "Athens Regional" we mean the
hospital, home health agency, urgent care centers and Athens Regional
owned physician offices, medical professionals and other parties who
assist us in our business.
We are required by law:
- To keep your medical information confidential in accordance with legal requirements
- To give you this Notice of our legal duties and privacy practices with respect to your medical information
- To follow the terms of the Notice that are
currently in effect
PERSONS COVERED BY THIS NOTICE
All employees, staff and other Athens Regional personnel:
- The following entities, sites and locations: Athens Regional Medical Center, Athens Regional Physician Services and its individual physician offices, Regional FirstCare, and Athens Regional Home Health.
- Persons or entities performing services for Athens Regional under agreements containing privacy protections or to which disclosure of medical information is permitted by law
- Persons or entities with whom Athens Regional participates in managed care arrangements
- Our volunteers and medical, nursing and other health care students
- Members of the Athens Regional Medical Staff
and other medical professionals involved in your care or performing peer
review, quality improvement, medical education and other services for
Athens Regional
USES AND DISCLOSURES OF YOUR MEDICAL INFORMATION
We use and disclose medical information in the ways described
below.
Treatment. We may use your medical
information to provide medical treatment or services to you. We may
disclose medical information about you to doctors, nurses, technicians,
medical, nursing or other health care students, or other personnel taking
care of you. For example, a doctor treating you for a broken leg may need
to know if you have diabetes because diabetes may slow the healing
process. In addition, the doctor may need to tell the dietitian if you
have diabetes so you can have appropriate meals. Departments of Athens
Regional may share your medical information to schedule the tests and
procedures you need. We also may disclose your medical information to
health care facilities if you need to be transferred from Athens Regional
to another hospital, a nursing home, a home health provider or a
rehabilitation center. We also may disclose your medical information to
people outside Athens Regional such as family members or pharmacists who
are involved in your care after you leave Athens Regional.
Payment. We may use and disclose your
medical information so that the treatment and services you receive can be
billed and collected from you, an insurance company or another third
party. For example, we may give your health plan information about surgery
you received so your health plan will pay us for the surgery. We also may
tell your health plan about a treatment you are going to receive in order
to obtain prior approval from your plan to cover payment for the
treatment.
Health Care Operations. We may use and
disclose your medical information for Athens Regional operations, such as
for peer review, performance improvement, risk management, and our
compliance with licensure, accreditation or certification requirements.
For example, we may disclose your medical information to physicians on our
Medical Staff who review treatment of patients. We may disclose
information to doctors, nurses, technicians, medical, nursing or other
health care students, and Athens Regional personnel for teaching. We may
combine medical information about many patients to decide what services
Athens Regional should offer, and whether new services are cost-effective
and how we compare with other health care providers. Sometimes, we may
remove identifying information from this medical information so others may
use it to study health care and health care delivery without learning who
you are. We may disclose information to other health care providers
involved in your treatment to permit them to carry out the work of their
facility or to get paid. For example, we may provide information about
your treatment to an ambulance company that brought you to Athens Regional
so that the ambulance company can get paid for its services.
Activities of Our Affiliates. We may
disclose your medical information to our affiliates in connection with
your treatment at other Athens Regional facilities.
Activities of Organized Health Care Arrangements in Which We Participate. For certain activities, Athens
Regional, members of its Medical Staff and other independent professionals
are called an Organized Health Care Arrangement. We may disclose
information about you to health care providers participating in our
Organized Health Care Arrangements, such as a managed care or
physician-hospital organization. Such disclosures would be made in
connection with our services, your treatment under a health plan
arrangement, and other activities of the Organized Health Care
Arrangement.
IMPORTANT NOTICE
Athens Regional may share your medical information with members of
the Medical Staff and other independent medical professionals in order to
provide treatment and perform other activities such as peer review,
quality improvement, medical education and other services for Athens
Regional. While those professionals may follow this Notice and otherwise
participate in the privacy program of Athens Regional, they are
independent professionals and Athens Regional expressly disclaims any
responsibility or liability for their acts or omissions.
Health Services, Treatment Alternatives and Health-Related Benefits. We may use and disclose your medical
information to tell you about (1) health-related products or services that
we offer, (2) other providers participating in a health care network that
we participate in, (3) possible treatment options or alternatives, or (4)
health-related benefits or services that may be of interest to you. We
also may use that information to communicate with you to coordinate your
care. We may use and disclose your medical information to contact and
remind you of an appointment for treatment or medical care.
Fundraising. We may use your medical
information to raise money for Athens Regional. We may disclose
information such as your name, address, telephone number, gender, age and
the dates you received treatment at Athens Regional to an affiliated
foundation so it can contact you. If you do not want Athens Regional to
contact you for fundraising, please notify the Contact Person listed below
in writing.
Athens Regional Directory. We may
include certain information about you in the Athens Regional Directory
while you are a patient at Athens Regional. This information may include
your name, your room number, your general condition (fair, stable, etc.)
and your religious affiliation. Your religious affiliation may be given to
a member of the clergy, such as a priest or rabbi, even if they don't ask
for you by name. Disclosure of your room will not reveal that you are in a
specific unit or area of Athens Regional, if such information would reveal
that you are at Athens Regional for treatment of rape or attempted rape,
HIV/AIDS, or alcohol/drug abuse. Directory information, except for your
religious affiliation, may be released to people who ask for you by name.
This is so your family, friends and clergy can visit you at Athens
Regional and generally know how you are doing. If you do not want this
information given out, please tell the Preadmission Counselor.
Individuals Involved in Your Care or Payment for Your Care. We may release your medical information to the
person you named in your Durable Power of Attorney for Health Care (if you
have one), or to a friend or family member who is your personal
representative (i.e., empowered under state or other law to make
health-related decisions for you). We may give information to someone who
helps pay for your care. In addition, we may disclose your medical
information to an entity assisting in disaster relief efforts so that your
family can be notified about your condition.
Research. We may use and disclose your
medical information for research purposes. Most research projects,
however, are subject to a special approval process. Most research projects
require your permission if a researcher will be involved in your care or
will have access to your name, address or other information that
identifies you. However, the law allows some research to be done using
your medical information without requiring your authorization.
Required By Law. We will disclose your
medical information when federal, state or local law requires it. For
example, Athens Regional must comply with child abuse reporting laws and
laws requiring us to report certain diseases or injuries to state or
federal agencies.
Serious Threat to Health or Safety. We
may use and disclose your medical information when necessary to prevent a
serious threat to your health and safety or the health and safety of the
public or another person.
Note: Georgia and Federal Law provide
protection for certain types of health information, including information
about alcohol or drug abuse, mental health and AIDS/HIV, and may limit
whether and how we may disclose information about you to others.
SPECIAL SITUATIONS
Organ and Tissue Donation. If you are
an organ donor, we may release your medical information to organizations
that handle organ procurement or organ, eye or tissue transplantation or
to an organ donation bank, as necessary to aid in its organ or tissue
donation and transplantation process.
Military and Veterans. If you are a
member of the U.S. or foreign armed forces, we may release your medical
information as required by military command authorities.
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.
Minors. If you are a minor (under 18
years old), Athens Regional will comply with Georgia law regarding minors.
We may release certain types of your medical information to your parent or
guardian, if such release is required or permitted by law.
Public Health Risks. We may disclose your medical information for
public health purposes:
- To prevent or control disease, injury or disability
- To report births and deaths
- To report child or adult abuse, neglect or violence
- To report reactions to medications or problems with products
- To notify people of recalls of products they may be using
- To notify a person who may have been exposed to
a disease or may be at risk for getting or spreading a disease or
condition
Health Oversight Activities. We may disclose your medical information to a federal or
state agency for health oversight activities such as audits,
investigations, inspections, and licensure of Athens Regional and of the
providers who treated you at Athens Regional. These activities are
necessary for the government to monitor the health care system, government
programs, and compliance with laws.
Lawsuits and Disputes. We may disclose
your medical information to respond to a court or administrative order or
a search warrant. We also may disclose your medical information in
response to a subpoena, discovery request, or other lawful process by
someone else involved in a dispute, but only if efforts have been made to
tell you about the request and you have been provided an opportunity to
object or to obtain an appropriate court order protecting the information
requested.
Law Enforcement. Subject to certain
conditions, we may disclose your medical information for a law enforcement
purpose upon the request of a law enforcement official.
Medical Examiners and Funeral Directors. We may disclose your medical information to a medical
examiner or funeral director so they may carry out their duties.
National Security. We may disclose your
medical information to authorized federal officials for national security
activities authorized by law.
Protective Services. We may disclose
your medical information to authorized federal officials so they may
provide protection to the President and other persons.
Inmates. If you are an inmate of a
correctional institution or under the custody of a law enforcement
officer, we may release your medical information to the correctional
institution or a law enforcement officer. This release would be necessary
for Athens Regional to provide you with health care, to protect your
health and safety or the health and safety of others, or for the safety
and security of the law enforcement officer or the correctional
institution.
YOUR PRIVACY RIGHTS
Right to Review and Right to Request a Copy. You have the right to review and copy medical information in
your medical and billing records. The Medical Records Department of Athens
Regional has a form you can fill out to request to review or copy your
medical information, and to tell you how much it will cost. Athens
Regional will tell you if it cannot fulfill your request. If you are
denied the right to see or copy your medical information, you may ask us
to reconsider our decision. Depending on the reason for the decision, we
may ask a licensed health care professional to review your request and its
denial. We will comply with this person's decision.
Right to Amend. If you feel your
medical information in our records is incorrect or incomplete, you may ask
us in writing to amend the information. You must provide a reason to
support your requested amendment. We will tell you if we cannot fulfill
your request. The Contact Person listed below can help you with your
request.
Right to an Accounting of Disclosures.
You have the right to make a written request for a list of certain
disclosures Athens Regional has made of your medical information. This
list is not required to include all disclosures we make. Disclosure for
treatment, payment, or Athens Regional administrative purposes,
disclosures made before April 14, 2003, disclosures made to you or which
you authorized, and other disclosures are not required to be listed. The
Contact Person listed below can help you with this process, if needed, and
can tell you how much it will cost.
Right to Request Restrictions on Disclosures. You have the right to make a written request to restrict
or put a 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 your medical information that we disclose to
someone involved in your care or the payment for your care, like a family
member or friend. We are not required to agree to your request. However,
if we do agree, we will comply with your request unless the information is
needed to provide you with emergency treatment or to make a disclosure
that is required under law. In your request, you must tell us (1) what
information you want to limit; (2) whether you want to limit our use,
disclosure or both; and (3) to whom you want the limits to apply, for
example, disclosures to your adult children.
Right to Request Confidential Communications. You have the right to make a written 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 contact you only at
work or by mail. We will not ask you the reason for your request. We will
accommodate all reasonable requests. Your request must specify how or
where you wish to be contacted. The Contact Person listed below can help
you with these requests if needed.
Right to a Paper Copy of This Notice.
You have the right to receive a paper copy of this Notice at any time even
if you have agreed to receive this Notice electronically. You may obtain a
copy of this Notice at our website, www.armc.org or a paper copy from the
Contact Person listed below.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to
make the revised or changed Notice effective for medical information we
already have about you as well as for any information we receive in the
future. We will post the current Notice in Athens Regional facilities and
on our website.
COMPLAINTS
If you believe your privacy rights have been violated, you may file
a written complaint with the Privacy Officer or Guest Services/Patient
Representative at Athens Regional or with the Secretary of the Department
of Health and Human Services or HHS. Generally, a complaint must be filed
with HHS within 180 days after the act or omission occurred, or within 180
days of when you knew or should have known of the action or omission. To
file a complaint with Athens Regional, contact:
Privacy Officer
Athens Regional Health Services
1199 Prince Avenue
Athens, GA 30606-2793
Phone: 706.475.4369
Privacy Officer
Athens Regional Health Services
1199 Prince Avenue
Athens, GA 30606-2793
Phone: 706.475.4369
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