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MMC Health Systems, Inc. (MMCHS) includes
Meadville Medical Center, Mind-Body Wellness
Center, Community Health Services, Visiting
Nurse Association of Crawford County,
Hospice of Crawford County and affiliated
physician offices. These facilities operate
as a single affiliated covered entity
pursuant to 45 C.F.R. §164.504(d), and in
that capacity shall comply with the rules
governing the use and disclosure of
individually identifiable health information
set forth in the HIPAA Privacy Regulations.
This notice describes how health information
about you may be used and disclosed and how
you may obtain access to your health
information. Please review it carefully.
- This notice applies to all policies
concerning any health information generated
by MMCHS, whether medical, billing, or any
other identifying information. It does not
apply to policies governing your care in
your physician's office or in the office of
any other healthcare provider.
- MMCHS is required or permitted to
use/disclose your health information without
your consent or right to object for purposes
relating to treatment and healthcare
operations. Example: MMCHS may disclose your
health information to another doctor or
facility for the purpose of a consult or
additional treatment.
- MMCHS is permitted to use/disclose your
health information for the purpose of
securing payment for the healthcare services
provided you. Example: MMCHS may inform your
health insurance company of health
information such as diagnosis and treatment
to process your claim for payment.
- MMCHS may use/disclose your health
information for the purpose of our day- to-
day operations and functions. Examples:
Provide information for audits, quality
improvement, legal requirements or
investigations, public health purposes;
disclose information about victims of abuse,
neglect or domestic violence; assist
coroners, medical examiners, or funeral
directors with their official duties;
provide information for organ donation;
worker's compensation as permitted by law,
approved research projects that protect
patient's privacy; or if there is a serious
threat to health or safety.
- Meadville Medical Center maintains
directories of patients’ names and locations
within the facility. We may disclose this
information to any person who asks for you
by name except as restricted by state and
federal regulations.
- Relatives or close personal friends
involved in the provision of, or payment for
your care, may obtain health information
that is directly related to that person’s
involvement in your care. MMCHS may also use
and disclose your health information (of
your location, general condition or death)
for the purpose of locating and notifying
relatives, close personal friends, or other
organizations at the time of a disaster.
- HIV-related information, records of
mental health treatment, substance abuse
records, and reportable communicable disease
information will be used and disclosed only
as allowed by federal and/or state law.
- MMCHS, the independent contractor members
of its Medical Staff (including your
physician), and other healthcare providers
affiliated with MMCHS have agreed, as
permitted by law, to share your health
information among themselves for purposes of
treatment, payment or healthcare operations.
This enables us to better address your
healthcare needs.
Except as described previously, disclosures
of your health information will be made only
with your written authorization.
You may revoke your authorization at any
time, in writing.
Your
Rights
- You have the right to request
restrictions on the use/disclosure of your
health information for treatment, payment or
healthcare operations purposes or
notification. MMCHS is not required to agree
to your request. MMCHS will attempt to abide
by that restriction unless the information
is needed to provide emergency treatment.
- You have the right to opt-out of being
included in MMCHS’s patient directory or
from having your health information
disclosed to a family member, friend, or
another family member involved in your care.
A copy of the opt-out disclosure form is
attached.
- You have the right to request the receipt
of confidential communications about your
own health information by alternative means
or at alternative locations. To request
alternative communications, you must submit
a written request to the involved department
manager or designee, or affiliate office
manager.
- You have the right to inspect and copy
any health information about you other than
psychotherapy notes, substance abuse notes,
or information compiled in anticipation of
or for use in civil, criminal, or
administrative proceedings. To arrange for
access to your records or to receive a copy
of your records, you must sign a medical
record release form in the Medical Records
Department of the hospital or the
appropriate affiliate organization. If you
request copies, you will be charged our
regular fee for copying and mailing the
requested information. Access may be denied
if you are an inmate at a correctional
institution; if you are a participant of an
ongoing research program; or if access may
cause harm to you or any other person. If
access is denied, you have the right to have
the decision reviewed by a healthcare
professional who did not participate in the
original decision. If access is denied, the
reasons will be provided to you in writing.
- You may request that your health
information be amended. Your request may be
denied if the information in question was
not created by us, is not part of our
records, is not the type of information
available to you for copying (psychotherapy
notes), or if the information is accurate
and complete. If your request is denied, you
may submit a written record stating that you
disagree with the denial, which will be kept
on file and distributed with all future
disclosures of the information to which it
relates. A written request to amend health
information must be submitted to the manager
of the appropriate medical records
department.
- You have the right to an accounting of
any disclosures of your health information
made during the six-year period preceding
the date of your request. Exceptions:
disclosures for the purpose of carrying out
treatment, payment, or healthcare
operations; disclosures to you, disclosures
of information maintained in our patient
directory, to persons involved in your care,
or for the purpose of notifying your family
or friends about your whereabouts; national
security or intelligence purposes; to
correctional institutions or law enforcement
officials who had you in custody at the time
of disclosure; those that occurred prior to
April 14, 2003; disclosures authorized by
you, part of a limited data set, incidental
to another permissible use or disclosure,
disclosures to a health oversight agency or
law enforcement official if the agency asks
MMCHS not to account to you for such
disclosure and for the limited time covered
by that request. The accounting will include
the date, name or entity of person receiving
information, that person's address (if
known), a brief description of the
information disclosed and the purpose of the
disclosure. To request an accounting of
disclosures, submit a written request to the
manager of the hospital or affiliate Medical
Records Department.
- You have the right to have a paper copy
of this notice. You may obtain the most
current copy of this Notice by calling Guest
Services at 814-333-5580, on MMCHS website
at www.mmchs.org, or by requesting one at
the Registration Office, or at any affiliate
site.
Duties of
MMCHS
- MMCHS is required by law to maintain the
privacy of your health information and to
provide to you this notice of our legal
duties and privacy practices, and will
attempt to obtain a signature that states
you received this policy.
- MMCHS is required to abide by the terms
of this notice. We reserve the right to
change this notice and to make these changes
applicable to all health information that we
maintain. Any changes to this notice will be
posted on our website, at our affiliate
facilities and will be available upon
request.
Questions
or Complaints
If you have any questions or believe your
privacy rights have been violated, any
complaints should be addressed to the Guest
Services Department at 814-333-5580. If not
resolved to your satisfaction, complaints
may be made to the Secretary of the federal
Department of Health and Human Services,
Civil Rights Division at 1-866-627-7748.
rev. 6/03
Being a good patient does not mean being a
silent one. If you have questions, problems,
suggestions, or unmet needs, please let us
know immediately. If you would like further
explanation of the Patient's Rights and
Responsibilities as they affect you, please
call the Patient Representative at
814-333-5580.
See also
Patient Rights and Responsibilities.
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