Privacy Policy
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Pulmonary & Critical Care Associates
EFFECTIVE DATE OF THIS NOTICE: 3/14/2003
UPDATED: 11/4/2010
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Legal Duty To Protect Your Medical Information
The privacy of your medical information is important to Pulmonary & Critical Care Associates (“PCCA”). This Notice of Privacy Practices (“Notice”) explains how your medical information may be used by PCCA and shared with others. It also explains your privacy rights regarding this kind of information.
We (“PCCA”) are required by federal and state law to make sure that medical information that identifies you is kept private; to give you this Notice; and to abide by the terms of this Notice.
We reserve the right to change the terms of this Notice and to make new notice provisions effective for all of the medical information we maintain about you as well as any information we receive in the future. If the terms of this Notice change, we will post a revised Notice in our offices, make copies available to you upon request and post the revised Notice on our website.
Minnesota Patient Consent for Disclosures
For most disclosures of your medical information, PCCA is required by Minnesota law to obtain a written consent from you, unless the disclosure is authorized by law. This consent may be obtained at the beginning of your treatment, during the first delivery of health care service, or at a later point in your care, when the need arises to disclose your medical information to others outside of PCCA.
Uses and Disclosures of Your Medical Information
A. Your medical information may be used and disclosed for the following purposes:
Health Care Treatment. We may use and disclose medical information about you to provide, coordinate or manage your health care and related services. This may include communicating with other health care providers regarding your treatment and coordinating and managing the delivery of health services with others. For example, we may use and disclose medical about you when you need a prescription, lab work, x-ray, or other health care services. In addition, we may use and disclose medical information about you when referring you to another health care provider. We will get your written consent prior to making disclosures outside of PCCA for treatment purposes, except in emergency circumstances when it is not possible to get your consent.
Payment. We may use and disclose your medical information to others to bill and collect payment for the treatment and services provided to you. For example, a bill may be sent to you or a third party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used. Before you receive scheduled services, we may share information about these services with your health plan(s). Sharing information allows us to ask for coverage under your plan or policy and for approval of payment before we provide the services. We may also share portions of your medical information with the following: 1) Billing departments; 2) Collection departments or agencies; 3) Insurance companies, health plans and their agents which provide you coverage; 4) Utilization review personnel that review the care you received to check that it and the costs associated with it were appropriate for your illness or injury; and 5) Consumer reporting agencies (e.g., credit bureaus). We will get your written consent before making disclosures outside of PCCA for payment purposes.
Health Care Operations. We may use and disclose your medical information for PCCA’s health care operations. Health care operations are the uses and disclosures of information that are necessary to run PCCA and to make sure that all of our patients receive quality care. For example, members of our staff such as the risk or quality improvement manager, or members of the quality improvement team may use your medical information to assess the care and outcomes in your case and others like it. We will get your written consent before making disclosures outside of PCCA for health care operations purposes.
Our Business Associates. There are some services provided to PCCA through contracts with business associates. Examples include PCCA’s attorneys, consultants, collection agencies, copy services and accreditation organizations. We may disclose your medical information to our business associates so that they can perform the job we have contracted with them to do. To protect the information that is disclosed, we require each business associate to sign an agreement to appropriately safeguard your information.
Fundraising. Occasionally, PCCA may use limited information (your name, address, and the dates you were seen) for medical services to let you know about fund-raising or other charitable events.
To People Assisting in Your Care. PCCA will only disclose medical information to those taking care of you, helping you to pay your bills, or other close family members or friends if these people need to know this information to help you, and then only to the extent permitted by law. We may, for example, provide limited medical information to allow a family member to pick up a prescription for you. Generally, we will get your written consent prior to making disclosures about you to family or friends. If you are able to make your own health care decisions, PCCA will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, PCCA will disclose relevant medical information to family members or other responsible people if we feel it is in your best interest to do so, including in an emergency situation, to the extent permitted by law.
Research. Federal law permits PCCA to use and disclose medical information about you for research purposes, either with your specific, written authorization or when the study has been reviewed for privacy protection by an Institutional Review Board or Privacy Board before the research begins. In some cases, researchers may be permitted to use information in a limited way to determine whether the study or the potential participants are appropriate. Minnesota law generally requires that we get your consent before we disclose your medical information to an outside researcher. We will make a good faith effort to obtain your consent or refusal to participate in any research study, as required by law, prior to releasing any identifiable information about you to outside researchers.
To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure must be only to someone able to help prevent the threat. In addition, Minnesota law generally does not permit these disclosures unless we have your written consent to do so or when the disclosure is specifically required by law, including the limited circumstances in which PCCA health care professionals have a “duty to warn.”
B. Your medical information may be released in the following special situations:
Organ and Tissue Donation: 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 facilitate organ or tissue donation and transplantation. The information that PCCA may disclose is limited to the information necessary to make a transplant possible.
Military and Veterans: If you are a member of the armed forces, we will release medical information about you as requested by military command authorities if we are required to do so by law, or when we have your written consent. We may also release medical information about foreign military personnel to the appropriate foreign military authority as required by law or with written consent.
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. We are permitted to disclose this information to the parties involved in the claim without any specific consent, so long as the information is related to a workers’ compensation claim.
Public Health: We may disclose medical information to public health authorities about you for public health activities. These disclosures generally include the following:
- Preventing or controlling disease, injury or disability;
- Reporting births and deaths;
- Reporting child abuse or neglect, or abuse of a vulnerable adult;
- Reporting reactions to medications or problems with products;
- Notifying people of recalls of products they may be using;
- Notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; or
- Reporting to the FDA as permitted or required by law.
Health Oversight Activities: PCCA may disclose medical information to a health oversight agency for health oversight activities that are authorized by law. These oversight activities include, for example, government audits, investigations, inspections, and licensure activities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. Minnesota law requires that patient-identifying information (for example, your name, social security number, etc.) be removed from most disclosures for health oversight purposes, unless you have provided us with written consent for the disclosure.
Lawsuits and Disputes: If you are involved in a lawsuit, dispute, or other judicial proceeding, we will disclose medical information about you only in response to a valid court order, administrative order, or a grand jury subpoena, or with your written consent.
Law Enforcement: We may release medical information if asked to do so by a law enforcement official in response to a valid court order, grand jury subpoena, or warrant, or with your written consent. In addition, we are required to report certain types of wounds, such as gunshot wounds and some burns. In most cases, reports will include only the fact of injury, and any additional disclosures would require your consent or a court order.
We may also release information to law enforcement that is not a part of the health record (in other words, non-medical information) for the following reasons:
- To identify or locate a suspect, fugitive, material witness, or missing person;
- If you are the victim of a crime, if, under certain limited circumstances, we are unable to obtain your agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at our facility; and
- In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners, and Funeral Directors: We will release medical information to a coroner or medical examiner in the case of certain types of death, and we must disclose health records upon the request of the coroner or medical examiner. This may be necessary, for example, to identify you or determine the cause of death. We may also release the fact of death and certain demographic information about you to funeral directors as necessary to carry out their duties. Other disclosures from your health record will require the consent of a surviving spouse, parent, a person appointed by you in writing, or your legally authorized representative.
National Security and Intelligence Activities: We will release medical information about you to authorized federal officials for intelligence, counter-intelligence, and other national security activities only as required by law or with your written consent.
Protective Services for the President and Others: We will disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or conduct special investigations only as required by law or with your written consent.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we will release medical information about you to the correctional institution or law enforcement official only as required by law or with your written consent.
Your Individual Rights
- A. Right to Request Restrictions on Uses and Disclosures.
You have the right to request that we restrict or limit the medical information we use or disclose about you. If you pay out-of-pocket in full for an item or service, then you may request that we not disclose information pertaining solely to such item or service to your health plan for purposes of payment or health care operations. We are required to agree with such a request. However, we are not required to agree to any other request. If we do agree, we will comply with your request, unless the information is needed to provide you emergency treatment or the disclosure of your information is specifically required by law. You may request a restriction by submitting your request in writing to us. You must tell us (1) the 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, if you want to prohibit disclosures to your spouse. We will notify you if we are unable to agree to your request.
- B. Right to Request Communications via Alternative Means or Disclosure to You at Alternative Locations.
Periodically, we will contact you by phone, email, postcard reminders, or other means to the location identified in our records with appointment reminders, results of tests or other health information about you. You have the right to request that we communicate with you through alternative means or disclose medical information to you at alternative locations. For example, you may request that we contact you at your work address or phone number or by email. While we are not required to agree with your request, we will make efforts to accommodate reasonable requests. You must submit your request in writing. Your request must specify how or where you wish to be contacted, and we may require you to provide information about how payment will be handled.
- C. Right to Inspect and Copy.
You have the right to request to see and receive a copy of your medical information contained in clinical, billing and other records used to make decisions about you. Your request must be in writing. We may charge you fees for the costs of copying, mailing or other supplies associated with your request, to the extent permitted by state and federal law. Instead of providing you with a full copy of the medical information, we may give you a summary or explanation of the PHI about you, if you agree in advance to the form and cost of the summary or explanation. There are certain situations in which we are not required to comply with your request. For example, we may deny access if your physician believes it will be harmful to your health, or could cause a threat to others. In these cases, we may supply the information to a third party who may release the information to you. Under these circumstances, we will respond to you in writing, stating why we will not grant your request. You may request that the denial be reviewed. Another licensed health care professional chosen by PCCA will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
- D. Right to Request Amendment.
If you believe that medical information we have about you is incorrect or incomplete, you have the right to request that we make amendments to change the information. Your request must be in writing and must explain your reason(s) for the amendment and, when appropriate, provide supporting documentation. We may deny your request if: 1) the information was not created by us (unless you prove the creator of the information is no longer available to amend the record); 2) the information is not part of the medical information kept by or for PCCA; 3) the information is correct and complete; 4) the information is not part of the information which you would be permitted to inspect and copy; or 5) you did not include a reason to support your request for amendment. We will tell you in writing the reasons for the denial. You have the right to submit a written statement disagreeing with the denial. If we accept your request to amend the information, we will make reasonable efforts to inform others of the amendment, including persons you name who have received medical information about you and who needs the amendment.
- E. Right to Request and Accounting of Disclosures of PHI.
You have the right to request an “accounting of disclosures.” This is a list of disclosures we made of medical information about you. This list will not include disclosures for treatment, payment, and health care operations; disclosures that you have authorized or that have been made to you; disclosures for national security or intelligence purposes; disclosures to correctional institutions or law enforcement with custody of you; disclosures that took place before April 14, 2003; and certain other disclosures. Your request must be in writing. You may ask for disclosures made up to six (6) years before the date of your request (not including disclosures made prior to April 14, 2003). The list will include the date of the disclosure, the name (and address, if available) of the person or organization receiving the information, a brief description of the information disclosed, and the purpose of the disclosure. If, under permitted circumstances, your medical information has been disclosed for certain types of research projects, the list may include different types of information. If you request a list of disclosures more than once in 12 months, we can charge you a reasonable fee.
- F. Right to Receive a Copy of This Notice.
You have the right to request and receive a paper copy of this Notice at any time. We will provide a copy of this Notice no later than the date you first receive service from us (except for emergency services or when the first contact is not in person, and then we will provide the Notice to you as soon as possible). This Notice is available on our website.
Questions or Complaints
If you have questions about this Notice, please contact our Privacy Official (contact information below). If you believe we have not followed the terms of this Notice or that your privacy rights have been violated, you may file a complaint with our Privacy Official. All complaints must be in writing. You may also file a complaint with the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.
We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
Privacy Office Contact Information
Address: 225 North Smith Ave, Ste 300, St. Paul, MN 55102
Telephone: (651) 726-6200
Fax: (651) 726-6201
E-mail: mary.bloom@thelungclinic.com
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