Notice of Privacy Practices
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.
I. Who We Are
This Notice describes the privacy practices of West Tennessee Healthcare and its hospitals and affiliates (“WTH”), including members of its workforce (employees and volunteers), the physician members of the medical staff, and allied health professionals who practice at WTH. WTH and the individual health care providers together are sometimes called “us” or “we” in this Notice. While we engage in many joint activities and provide services in a clinically integrated care setting, we each are separate legal entities (physician members of the staff and some allied health professionals are not employees, joint venturers, or agents of WTH). This Notice applies to services furnished to you including but not limited to the following facilities or through the following services.
II. Our Privacy Obligations
Each of us is required by law to maintain the privacy of your health information (“Protected Health Information” or “PHI”) and to provide you with this Notice of our legal duties and privacy practices with respect to your Protected Health Information. When we use or disclose your Protected Health Information, we abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).
III. Permissible Uses and Disclosures Without Your Written Authorization
In certain situations, which we will describe in Section IV below, we must obtain your written authorization on our authorization form (“Your Authorization”) in order to use and/or disclose your PHI. However, we do not need any type of authorization from you for the following uses and disclosures:
A. Uses and Disclosures for Treatment, Payment and Health Care Operations
We may use and disclose PHI in order to treat you, obtain payment for services provided to you, and conduct our “health care operations” as detailed below:
- Treatment. We use and disclose your PHI to provide treatment and other services to you—for example, to diagnose and treat your injury or illness. In addition, 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. We may contact you after you leave WTH to inquire about your medical progress. We may also disclose PHI to other providers involved in your treatment.
- Payment. We may use and disclose your PHI to obtain payment for services that we provide to you–for example, disclosures to claim and obtain payment from your health insurer, HMO, or other company that arranges or pays the cost of some or all of your health care (“Your Payor”) to verify that Your Payor will pay for health care.
- Health Care Operations. We may use and disclose your PHI for our health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care that we deliver to you. For example, we may use PHI to evaluate the quality and competence of physicians, nurses, and other health care workers. In addition, WTH may ask that you fill out and return a patient satisfaction survey and may contact you to remind you to fill out the survey as well as ask your opinion on your stay at WTH.
We may also disclose PHI to your other health care providers when such PHI is required for them to treat you, receive payment for services they render to you, or conduct certain health care operations, such as quality assessment and improvement activities, reviewing the quality and competence of health care professionals, or for health care fraud and abuse detection, or compliance. In addition, we may share PHI with our business associates who perform treatment, payment, and healthcare operations services on our behalf.
We may send your PHI to one or more health information exchanges (HIE), secure electronic systems through which your health care providers participating in the HIE may view certain records of your care for purposes of treatment, payment, and health care operations. Please contact our Privacy Coordinator at 731-660-7720 if you would like to learn more about the HIE and/or your option to restrict sharing of your information through HIE.
We may further share PHI with those health care providers and their authorized representatives that are members of organized health care arrangements in which we participate. Purposes of data sharing include utilization review and quality assessment and improvement activities.
B. Use or Disclosure for Directory of Individuals
We may include your name, location in WTH facility, general health condition, and religious affiliation in a patient directory without obtaining Your Authorization unless you object to inclusion in the directory. Information in the directory may be disclosed to anyone who asks for you by name or members of the clergy provided, however, that religious affiliation will only be disclosed to members of the clergy.
C. Disclosure to Relatives, Close Friends and Other Caregivers
We may use or disclose your PHI to a family member, other relative, a close personal friend, or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if we (1) obtain your agreement; (2) provide you with the opportunity to object to the disclosure and you do not object; or (3) reasonably infer that you do not object to the disclosure.
If you are not present, or the opportunity to agree or object to a use or disclosure cannot be provided because of your incapacity or an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interest. If we disclose information to a family member, other relative, or a close personal friend, we would disclose only information that we believe is directly relevant to the person’s involvement with your health care or payment related to your health care. We may also disclose your PHI in order to notify (or assist in notifying) a family member, other relative, or close personal friend of your location, general condition, or death.
D. Public Health Activities
As required or authorized by law, we may disclose your PHI for the following public health activities: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to public health authorities or other government authorities authorized by law to receive such reports; (3) to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.
E. Victims of Abuse, Neglect or Domestic Violence
If we reasonably believe you are a victim of abuse, neglect, or domestic violence, we may disclose your PHI to a governmental authority, including a social service or protective services agency, authorized by law to receive reports of such abuse, neglect, or domestic violence.
F. Health Oversight Activities
We may disclose your PHI to a health oversight agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid.
G. Judicial and Administrative Proceedings
We may disclose your PHI in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
H. Law Enforcement Officials
We may disclose your PHI to the police or other law enforcement officials as required or permitted by law or in compliance with a court order, a grand jury, or administrative subpoena.
We may disclose your PHI to a coroner, medical examiner, or funeral director as authorized by law.
J. Organ and Tissue Procurement
To the extent required by law, we may disclose your PHI to organizations that facilitate organ, eye, or tissue procurement, banking, or transplantation.
We may use or disclose your PHI 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 PHI, and under other circumstances in accordance with regulations governing medical research. While most clinical research studies require specific patient consent, there are some instances when a retrospective record review with no patient contact may be conducted by such researchers. For example, the research project may involve comparing the health and recovery of certain patients with the same medical condition who received one medication to those who received another medication.
L. Health or Safety
We may use or disclose your PHI to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety.
M. Specialized Government Functions
We may use and disclose your PHI to units of the government with special functions, such as the U.S. military or the U.S. Department of State, under certain circumstances.
N. Workers’ Compensation
We may disclose your PHI as authorized by and to the extent necessary to comply with Tennessee law relating to workers’ compensation or other similar programs.
O. As Required by Law
We may use and disclose your PHI when required to do so by any other law not already referred to in the preceding categories.
IV. Uses and Disclosures Requiring Your Written Authorization
A. Use or Disclosure with Your Authorization
For any purpose other than the ones described above in Section III, we only may use or disclose your PHI when you grant us Your Authorization. For instance, you will need to execute an authorization form before we can send your PHI to your life insurance company. We will never sell PHI without Your Authorization.
We must also obtain your written authorization (“Your Marketing Authorization”) prior to using your PHI to send you any marketing materials. (We can, however, provide you with marketing materials in a face-to-face encounter without obtaining Your Marketing Authorization. We are also permitted to give you a promotional gift of nominal value, if we so choose, without obtaining Your Marketing Authorization.) In addition, we may tell you about products or services relating to your treatment, case management or care coordination, or alternative treatments, therapies, providers, or care settings without Your Marketing Authorization.
C. Uses and Disclosures of Your Highly Confidential Information
In addition, federal and state law requires special privacy protections for certain highly confidential information about you (“Highly Confidential Information”), including information about your PHI that: (1) is maintained in psychotherapy notes; (2) is about mental health and developmental disabilities services; (3) is about alcohol and drug abuse prevention, treatment, and referral; (4) is about HIV/AIDS testing, diagnosis, or treatment; (5) is about communicable disease(s); or (6) is about genetic testing. In order for us to disclose your Highly Confidential Information for a purpose other than those permitted by law, we must obtain Your Authorization.
V. Your Rights Regarding Your Protected Health Information
A. For Further Information; Complaints
If you want further information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we made about access to your PHI, you may contact our Compliance Office. You may also file written complaints with the Director, Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Compliance Office will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with us or the Director.
B. Right to Request Additional Restrictions
You may request restrictions on our use and disclosure of your PHI (1) for treatment, payment, and health care operations, (2) to individuals (such as a family member, other relative, close personal friend, or any other person identified by you) involved with your care or with payment related to your care, or (3) to notify or assist in the notification of such individuals regarding your location and general condition. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction unless you are restricting disclosure of PHI to a health plan and have paid out-of-pocket in full for the services. If you want to request additional restrictions, please obtain a request form from appropriate registration or admission personnel and submit the completed form to the Compliance Office.
C. Right to Receive Confidential Communications
You may request, and we will accommodate, any reasonable written request for you to receive your PHI by alternative means of communication or at alternative locations. For instance, we will send correspondence to an alternative mailing address.
D. Right to Opt Out of Fundraising Contacts
You may opt-out of any fundraising contacts at any time.
E. Right to Revoke Your Authorization
You may revoke Your Authorization or Your Marketing Authorization, except to the extent we have already taken action based on the original authorization, by delivering a written revocation statement to the Compliance Office identified below.
F. Right to Inspect and Copy Your Health Information
You may request access to your medical record file and billing records maintained by us in order to inspect and request copies of the records. Under limited circumstances, we may deny your access to a portion of your records. If you want access to your records, please obtain a record request form from the appropriate medical records personnel and submit the completed form to the Medical Records/Health Information Management Department. Reasonable and cost-based copying fees will be imposed according to department policies and fee schedules.
G. Right to Amend Your Records
You have the right to request that we amend Protected Health Information maintained in your medical record file or billing records. If you want to amend your records, please obtain an amendment request form from appropriate medical records personnel and submit the completed form to the Medical Records/Health Information Management Department. We will comply with your request unless we believe that the existing information that would be amended is accurate and complete or other special circumstances apply.
H. Right to Receive An Accounting of Disclosures
Upon request, you may get an accounting of certain disclosures of your PHI made by us during any period of time prior to the date of your request provided the period does not exceed six years and does not apply to disclosures that occurred prior to April 14, 2003. The first accounting in any 12-month period is free. For each additional request by an individual in any 12-month period, WTH may charge a reasonable, cost-based fee, including reasonable retrieval and report preparation costs, as well as any mailing costs.
I. Right to Be Notified of Breach
You have the right to be notified after a breach of unsecured PHI.
J. Right to Receive Paper Copy of this Notice
Upon request, you may get a paper copy of this Notice, even if you have agreed to receive such notice electronically.
VI. Effective Date and Duration of This Notice
A. Effective Date.
This Notice is effective on April 14, 2003.
B. Right to Change Terms of this Notice.
We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all Protected Health Information that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new notice in waiting areas around West Tennessee Healthcare and on our Internet site at www.wth.org. You also may obtain any new notice by contacting the Compliance Office.
VII. Compliance Office
You may contact the Privacy Coordinator at:
West Tennessee Healthcare
620 Skyline Drive
Jackson, Tennessee 38301
Telephone Number: (877) 746-3676 or (731) 541-8486
West Tennessee Healthcare (WTH.org) is committed to protecting your online privacy. We feel it is important for you to understand how we handle the information we receive from you through the internet.
We collect certain information for all visitors who visit wth.org. This information includes the domain name from which you access the WTH website, the IP address of your computer; the date and time you access our site, and the Internet address of the web site from which you linked to our site. We collect IP address information so that we can properly administer our system and gather aggregate information about how our site is being used, including the pages visitors are viewing.
We also use Google Analytics Demographics and Interest Reporting. This is information provided by Google that allows us to see the age and interests of visitors to our site. This information cannot be used to identify an individual visitor and is only used to provide insight into the demographic groups that visit wth.org for advertising purposes. The information provided by Google will not be shared with third parties. If you would like to opt out of this reporting, you may do so by following the directions at this link.
Contact forms submitted via wth.org are secured using 256-bit SSL encryption and submitted information is stored securely on our servers. Inquiries submitted via WTH.org contact forms are stored so that we may respond or retrieve the request later. We do not obtain any personally identifiable information unless you choose to provide such information to us.
While visiting sites within the WTH.net and WTH.org domains, you may occasionally encounter a page that uses “cookies.” A cookie is a small data file that a website transfers to your computer’s hard disk allowing our server to recall specific information about your session while you are connected. Cookies that come from our WTH.org are not designed to collect personal information about you, but only about your browser session.
Health Tools Information
You may need to provide personal information in order to use some of the health tools on our site. This information may include your answers to questions about your health status. All data that you enter is protected with industry standard encryption (SSL).
Newsletters and Related Services
WTH.org provides you with the opportunity to receive communications from us or third parties. You can sign up for a free e-mail newsletter, and you can unsubscribe from this newsletter at any time.
We may provide third parties with aggregate statistics about our visitors, traffic patterns and related site information. These data reflect site-usage patterns gathered during visits to our Web site each month, but they do not contain behavioral or identifying information about any individual member unless that member has given us permission to share that information.
If you have a complaint or problem, or if you believe your privacy rights have been violated, you may e-mail us by clicking the “Contact us” link at the bottom of any page. Our Customer Service department will forward your complaint to the appropriate department for response or resolution. If you don’t receive adequate resolution of an online privacy-related problem, you may write to West Tennessee Healthcare’s Privacy Coordinator at 620 Skyline Drive, Jackson, Tennessee 38301 or call the Compliance Hotline at 877-746-3676.
NONDISCRIMINATION NOTICE STATEMENT
West Tennessee Healthcare (WTH) does not exclude, deny benefits to, or otherwise discriminate against any person on the grounds of race, color, national origin, age, religion, disability, Limited English Proficiency or sex, including discrimination based on gender identity, sexual orientation, sex stereotyping or pregnancy in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by WTH directly or through a contractor or any other entity with which WTH arranges to carry out its programs and activities.
For further information about this policy, contact Amy Garner (731) 541-9914.