Notice of Privacy Policy

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Words and Terms to Know

Business Associate

People or companies who do work for BryanLGH Medical Center, but who are not members of our workforce.

Disclose

Sharing, transferring or giving access to people outside of our workforce and to other organizations.

Notice

Information made available to increase awareness of practices and policies (see below).

Provider

People and organizations that provide health care, such as doctors, ambulance companies and hospitals.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

Each time you receive care at BryanLGH Medical Center, a record is made of your visit. Your medical record may include your symptoms, what was found during the exam, test results, diagnoses, treatment given and a plan for future care or treatment. Your billing record may include facts about your bill and insurance. Together, this is called your health information.

Who Will Follow This Notice

BryanLGH Medical Center

This Notice describes the privacy practices of BryanLGH Medical Center (the “Medical Center”) and all of its programs and departments.

Medical Staff

This Notice also serves as the Joint Notice of Privacy Practices of the Medical Center and eligible members of its medical staff who participate with the Medical Center in an organized healthcare arrangement. Under this arrangement, the Medical Center and these medical staff members agree to follow the information practices described in this Notice when using or disclosing Medical Center records and information related to Medical Center visits. Under the arrangement, the Medical Center and these participating medical staff members will:

• Use and distribute this Notice as their Joint Notice of Privacy Practices.
• Obtain a single signed acknowledgment of receipt.
• Follow the information practices described in this Notice when using or disclosing Medical Center records and information.
• Share health information from inpatient and outpatient Medical Center visits among participants so that they can help the Medical Center with its healthcare operations.

The organized healthcare arrangement does not cover the information practices or health information of medical staff members in their private offices or at other practice locations.

Your Health Information Rights

Request for Voluntary Restrictions

You have the right to request a restriction on how we use and disclose your health information for treatment, payment, healthcare operations or to certain family members or friends identified by you, who are involved in your care or payment for your care. We are not required to agree to your request and will notify you if we are unable to agree.

Access to Health information

You may request to inspect and receive a copy of your health information. If you request copies, we may charge you a copying fee plus postage. If we agree to prepare a summary of your health information, we will charge a fee to prepare the summary.

Amendment

You may request that we amend or correct health information that we keep in your records. We are not required to make all requested amendments, but will give each request careful consideration. If we deny your request, we will provide you with a written explanation of the reasons and your rights.

Accounting

You have a right to receive an accounting of disclosures of your health information made by us or our business associates. The first accounting in any 12-month period is free; however, you may be charged a fee for each subsequent accounting you request within the same 12-month period.

Confidential Communications

You may request that we communicate with you about your health information in a certain way or at a certain location. We will accommodate your request if it is reasonable and specifies the alternate means or location.

Copy of this Notice

You have the right to receive a written copy of this Notice upon request.

How to Exercise These Rights

All requests to exercise these rights must be in writing. We will follow written procedures to handle requests and notify you of our actions and your rights. You may receive request forms or exercise your rights by contacting the Release of Information Manager in the Health Information Management Department at (402) 481-8223.

Our Responsibilities

BryanLGH is required by law to:

• Protect the privacy of your health information.
• Provide you with a current copy of the Notice of Privacy Practices.
• Do what we say we will do in our current Notice.
• Display the most current copy of the Notice on the BryanLGH Medical Center Web site (www.bryanlgh.org) and at service delivery sites.

We will use and disclose your health information only with your permission, except as described in this Notice or as required by State or federal law. We have the right to change this Notice and apply the changes to the health information we already have about you and any we receive in the future.

Uses and Disclosures without Your Permission

The following are the types of uses and disclosures we may make of your health information without your permission. Where State law restricts one of these uses or disclosures, we will follow State law. These are general descriptions only and do not cover every example of use and disclosure within a category.

1. We will use and disclose your health information for treatment purposes. For example:
   
   • We will use and disclose health information about you with nurses, physicians and technicians who are involved in your care at the Medical Center.
   • We will disclose your health information to your physician and other physicians, providers and healthcare facilities for their use in treating you in the future.
2. We will use and disclose your health information for payment purposes. For example:
   
   • We will use your health information to prepare your bill, and we will send health information to your insurance company with your bill.
   • We may disclose health information about you to other qualified parties for their payment purposes. For example, if you are brought in by ambulance, we may disclose your health information to the ambulance provider for its billing purposes.
3. We will use and disclose your health information for healthcare operations. For example:
   
   • We will disclose your health information to members of our medical staff and outside consultants so that they can help us assess our quality of care.
   • In some cases, we will furnish your health information to other qualified parties for their healthcare operations. The ambulance company, for example, may want information on your condition to help them know whether they have done an effective job of stabilizing your emergency condition.
4. We will allow our business associates to use or disclose your health information. For example:
   
   • We may send your health information to a billing service so that they can help us bill for services. We require our business associates to protect your health information.
5. Hospital Patient Directory. We will include your name, location in the facility, general condition and religious affiliation in a patient directory. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name. We will not include your information in the patient directory if you object or if State or federal law prohibits us.
   
6. Family and Friends. We may disclose your location or general condition to a family member or your personal representative. If any of these individuals or others you identify as being involved in your care, we may also disclose such information as is directly relevant to their involvement. We will only release this information if you agree, are given the opportunity to object and do not, or if in our professional judgment, it would be in your best interest to allow the person to receive the information or act on your behalf. For example, we may allow a family member to pick up your prescriptions, medical supplies or X-rays. We may also disclose your information to an entity assisting in disaster relief efforts so that your family or individual responsible for your care may be notified of your location and condition.
7. Required by Law. We will use and disclose your information as required by federal, State or local law.
   
8. Public Health Activities. We may disclose health information about you for public health activities.
   These activities may include disclosures:
   
   • To a public health authority authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury or disability.
   • To appropriate authorities authorized to receive reports of child abuse and neglect.
     
   • To FDA-regulated entities for purposes of monitoring or reporting the quality, safety or effectiveness of FDA-regulated products.
   • To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
9. Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure.
   
10. Judicial and Administrative Proceedings. We may disclose your health information for judicial or administrative proceedings as required or permitted by law or in response to a valid subpoena, court order or other binding authority.
11. Law Enforcement. We may release certain health information if asked to do so by a law enforcement official as required by law such as:
    
    • As required by law, including reporting wounds and physical injuries.
      
    • In response to a court order, subpoena, warrant, summons or similar process.
      
    • 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.
    • Under certain circumstances, we may use or disclose your health information to avert a serious threat to health and safety.
12. Deceased Individuals. We may release health information to a coroner, medical examiner or funeral director as necessary for them to carry out their duties.
    
13. Organ, Eye or Tissue Donation. We may release health information to organ, eye or tissue procurement, transplantation or banking organizations or entities as necessary to facilitate organ, eye or tissue donation and transplantation.
    
14. Research. Under certain circumstances, we may use or disclose your health information for research, subject to certain safeguards. For example, we may disclose information to researchers when a special committee who has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research. We may disclose health information about you to people preparing to conduct a research project, but the information will stay on site.
15. Specialized Government Functions. We may use and disclose your health information for national security and intelligence activities authorized by law. If you are a military member, we may disclose to military authorities under certain circumstances. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose to the correctional institution, its agents or the law enforcement official your health information necessary for your health and the health and safety of other individuals.
    
16. Workers’ Compensation. We may release health information about you as authorized by law for workers’ compensation or similar programs that provide benefits for work-related injuries or illness.
17. Incidental Uses and Disclosures. There are certain incidental uses or disclosures of your information that occur while we are providing service to you or conducting our business. For example, after surgery the nurse or doctor may need to use your name to identify family members that may be waiting for you in a waiting area. Other individuals waiting in the same area may hear your name called. We will make reasonable efforts to limit these incidental uses and disclosures.
    
18. Appointment Reminders. We may contact you as a reminder that you have an appointment for treatment or medical services.
19. Treatment Alternatives. We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.
20. Fundraising. We may contact you as part of a fundraising effort. We may also disclose certain elements of your health information, such as your name, address, phone number and dates you received treatment or services, to a business associate or a foundation related to the Medical Center so that they may contact you to raise money for the Medical Center.
21. Other Uses and Disclosures. Other uses and disclosures of your health information not covered above will be made only with your written authorization. If you authorize us to use and disclose your information, you may revoke that authorization at any time. Such revocation will not affect any action we have taken in reliance on your authorization.
    

Complaints and Questions

Complaints or questions about your privacy rights must be made in writing to the Information Security Officer at BryanLGH Medical Center, 1600 S. 48th Street, Lincoln, NE 68506. If you have questions about this process, call (402) 481-8224.

If you believe your privacy rights have been violated, you have the right to file a complaint in writing with the Secretary of Health and Human Services. Nothing will be held against you for filing a complaint.

Reference: Title 45 of the Code of Federal Regulations, Section 164.520

Effective Date: 4/13/2003
Version: #1

DOCS/534665.2