Patients & Visitors

Notice of Patient Privacy Practices

This notice describes how information about you may be used and disclosed by Stevens Hospital and how you can get access to this information. Please review it carefully.

Understanding Your Health Information

Each time you visit our hospital, physicians, or other health care providers, a record of your visit is made. This record may contain personal identifying information about you and your health. It will also contain information related to your care. This may include your medical history, results of physical examinations, test results, diagnoses, treatments, instructions provided to you by your health care provider and plans for future health care services. This information is often referred to as your health or medical record. Your medical record serves as a:

Record for planning your care and treatment.
Way to communicate among the many health professionals who provide your care.
Legal document describing the care you received.
Resource you or your health care insurance company can use to check the accuracy of your bill.
Source for educating health professionals.
Source of information for medical research.
Source of information for public health officials responsible for improving the health of our nation.
Source of information for Stevens Hospital operations including the development of future plans, marketing our services, assessing the quality of your care and identifying ways to improve our services to you and the community.

Understanding what is in your record and how it is used helps you to:

Make sure it is accurate.
Better understand who, what, when, where and why others may use your health information.
Make decisions about allowing the information to be used by or shared with others.

Designated Record Set

In addition to your health record Stevens Hospital also maintains financial records and specialized documents such as radiographic films and digital recordings that are maintained separate from your health record. The combination of these records is referred to as your designated record set.

Your Health Information Rights

The paper and electronic medical record we keep on you is the property of Stevens Hospital. However, the information in the record belongs to you and you have the right to:

Receive, read and ask questions about this notice.
Request that we limit certain uses and releases of your information. You must make the request in writing. We are not required to agree to the request. But we will cooperate with any request we agree to.
Request and receive from us a paper copy of the most current notice of privacy practices for protected health information.
Request that you be allowed to see and get a copy of your medical record. You must deliver this request in writing. Forms for this purpose are available in the Stevens Hospital Health Information Management Department.
Request to have us review a denial of access to your medical record. The request may be denied for certain reasons.
Request corrections to your health records; the request must be given to us in writing. If the request is denied, you may submit a written statement of disagreement that will become part of your medical record and included when the related information is used or disclosed.
Obtain a report of certain disclosures of your health information.
Request that any or all communications of your health information be made by different means or to a different location. The request must be made in writing.
Rrevoke any authorization to use or disclose your health information except when the information has already been disclosed.

Our Responsibilities

Stevens Hospital is required to:

Protect the privacy of your health information.
Provide you with a notice about our legal duties and privacy practices.
Uphold the terms of this notice.
Inform you if we do not agree to a requested restriction.
Respect reasonable request to communicate health information by different means or to different locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will post a revised copy on the Stevens Hospital website.

We reserve the right to distribute a summary version of this notice (Summary of Privacy Practices). The summary notice will contain information about how to obtain the detailed Stevens Hospital Privacy Notice.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact the Stevens Hospital Privacy Officer at 425.640.4043.

If you believe your privacy rights have been violated, you may file a complaint through the privacy hotline or with the office of civil rights:

Stevens Hospital privacy hotline: 425.640.4043.
Region X, Office of Civil Rights, Department of Health & Human Services: 206.615.2290.

There will be no action taken against you for filing a complaint.

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment:

For example: Information received or recorded by a nurse, physician or other member of your health care team will be in your record and used to plan the course of treatment best for you.

We will use your health information for payment purposes:

For example:When you come in for services we will request permission to sendA bill to your insurance company.

We will use your health information for Stevens Hospital operations:

For example: Members of the medical staff, and our quality improvement team(s) may use information in your health record to evaluate the care we provide and the results of your case and others like it. This information is used to improve the quality and effectiveness of the health care services we provide.

Other Uses or Disclosures

Business Associates

There are some services provided to our organization by business associates, which are support services or other health service providers with whom we contract to assist us in our health care service or business operations. Examples include, but are not limited to, billing services and a copy service for making copies of requested health records. When these services are used, we may disclose your health information to our business associate so that they can perform the job we have asked them to do. To make sure your health information is protected, we require our business associates to keep your information confidential.

Notification

We may use or provide information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location and general condition.

Communication with Family

Health professionals, using their best judgment, may talk to a family member, other relative, close personal friend or any other person you identify, about health information that is important to the person's involvement in your care or payment related to your care.

Research

We may provide information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral Directors

We may provide health information to funeral directors as allowed by law to carry out their duties.

Organ Procurement Organizations

We may provide health information to companies engaged in procuring, banking, or transplanting organs for the purpose of tissue donation and transplant.

Marketing

We may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.

Fundraising

We may contact you as part of a fundraising effort.

Food and Drug Administration (FDA)

We may provide to the FDA health information related to adverse events regarding food, supplements, product and product defects or post marketing information to enable product recalls, repairs or replacement.

Workers Compensation

We may provide health information as authorized by law to workers compensation or other similar programs.

Public Health

We may provide your health information to public health or legal representatives responsible for preventing or controlling disease, injury or disability.

Correctional Institution

If you are an inmate of a correctional institution, we may provide to the institution or its agents, health information necessary for your health, and the health and safety of others.

Law Enforcement

We may provide health information for law enforcement purposes as required by law, or in response to a legal request such as a court order or subpoena.

Specialized Government Functions

We may provide information for national security purposes.

Health Care Oversight

We may provide information to external review agencies such as the Joint Commission or Department of Social Health Services that provide health care review and accreditation services.

Stevens Hospital has also entered into an arrangement with the members of the hospital medical staff. This arrangement allows the Stevens Hospital Privacy Notice to include individual members of the medical staff for services provided in the hospital.

October, 2007

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