Effective Date 01/01/2009 | Revised 2013, Revised 04/2021
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Understanding Your Health Information
Each Time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information is often referred to as your health or medical record.
Our hospital and clinics are required to follow specific rules on maintaining the privacy of your protected health information. This Notice describes your rights to access and control your protected health information. It also describes how we follow applicable rules and use and disclose your protected health information to provide your treatment, obtain payment for services you receive, manage our health care operations and for other purposes that are permitted or required by law.
We are required by law to:
- Make sure that health information that identifies you is kept private;
- Give you this notice of our legal duties and privacy practices with respect to health information about you;
- Notify you following a breach of your protected health information that was unsecured; and
- Follow the terms of the notice that are currently in effect.
Uses and Disclosures of Protected Health Information
The following categories describe examples of ways that we may use and disclose health information. For more inclusive description see 45 C.F.R. Part 164.
Health Information Organization (HIO)
We may disclose health information about you to a health information organization (HIO). HIO facilitate the exchange of electronic protected information or the purpose of treatment, payment and healthcare operations purposed between and among several health care providers, such as hospital, doctors, pharmacies, etc.
We may use health information about you to provide you with medical treatment or services. We may disclose health information about you to physicians, nurses, technicians, medical students or other health care personnel who are involved in your care at the hospital. We may use or disclose your protected information, as necessary, to contact you to remind you of your appointment. We may also provide your physician or subsequent healthcare provider with copies of hospital reports that should assist in your treatment. We may contact you by phone or other means to provide results from exams or tests and to provide information that describes or recommends treatment alternatives regarding your care. We may also contact you to provide information about health related benefits and services offered by our hospital and hospital clinics.
We may use and disclose health information about you so that payment for treatment and services you receive may be collected from you or a third party.
We may use and disclose health information in order to support the business activities of the hospital. These activities may include quality assessment to assess the care and outcomes in your case. We may combine the health information we have with health information from other hospitals to compare how we are doing and see where we can make improvements.
Health Oversight Activities
We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include accreditations, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.
We may use or disclose limited information in the hospital directory. You will be given an opportunity in advance to agree or object. The information used is limited to name, location in the hospital, and religious affiliation. Directory information may be disclosed to members of the clergy.
Notification/Communication with Family
We may release information to a family member, personal representative, or another person who is involved in your medical care or payment related to your care unless you object in whole or in part.
There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology, certain laboratory tests and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them. To protect your health information, we require the business associate to appropriately safeguard your information.
As required by law, we may disclose your health information to public health or legal authorities with preventing or controlling disease, injury, or disability. We report information about births, deaths and various diseases to government officials in charge of collecting that information. We provide coroners, medical examiners and funeral directors necessary information relating to deaths.
Federal, State, or Local Law
We will disclose health information when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect or domestic violence or when ordered in a judicial or administrative hearing.
Organ and Tissue Donation
Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
We may disclose your health information in order to conduct medical research after protocols have been established to ensure the privacy of your health information.
Should you be an inmate of a correctional institution, we may disclose to the institution health information necessary for your health and the health and safety of other individuals.
We may disclose health information for law enforcement purposes as required by law or response to a valid subpoena
We may disclose health information for workers’ compensation or similar programs.
We may contact you to raise funds for a particular hospital service or project. You have the right to opt out of receiving such communications.
OTHER USES OF HEALTH INFORMATION
We must have a written authorization for most uses and disclosures of psychotherapy notes, for marketing purposes, and for the sale of protected health information. If you give us permission to use or disclose health information, you may revoke that permission, in writing, at any time.
YOUR HEALTH INFORMATION RIGHTS
Right to Copy of this Notice
You have the right to receive, and we are required to provide you with, a copy of the Notice of Privacy Practices. We are required to follow the terms of the Notice. We reserve the right to change the terms of our Notice, at any time. If needed, new versions of the Notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with a revised Notice of Privacy Practices if you call our office and request that a revised copy be sent to you in the mail or ask for one at the time of your next appointment. You may agree to receive an electronic copy of this Notice, but if even if you do so, you still have a right to receive a paper copy as well.
Right to Access
Your have the right to inspect and receive a copy of your health information. You have the right to request a copy of your health information in written or electronic format. You may request that your protected health information be transmitted directly to another person designated by you. This request must be in writing, signed by you, and clearly identify the designated person, and where to send the copy of the protected health information.
There may be a fee for the costs of copying, mailing or other supplies associated with your request.
We reserve the right to deny you access to all or part of you health information. For example, psychotherapy notes, information compiled in reasonable anticipation of civil, criminal, or administrative action or proceeding.
Right to Amend
If you feel that your health information is incorrect or incomplete, you may ask for an amendment of that information. To request an amendment, you must submit your request in writing and include reasons that support your requested amendment.
Right to an Accounting of Disclosures
You have the right to request an Account of Disclosures. This is a list of disclosures we made of your health information to external organizations that is not included in this notice or part of treatment, payment and healthcare operations. We will provide your requested accounting within 60 days after receipt of the request or notify you in writing if we are unable to meet that deadline. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003.
Right to Request Restrictions
You have the right to request a restriction or limitation on the health information we use or disclose for treatment, payment, or healthcare operations. You also have the right to request a limit on health information we disclose about you to someone who is involved in your care or the payment for care. We are not required to agree to your request. However, if you request that we restrict the disclosure of your health information to your health plan for the purpose of carrying out payment or health care operations (and not otherwise required by law) and you pay out of pocket for your service in full at the time of service, we agree not to disclose your information to your health plan for that date of service.
To request restrictions, you must make your request in writing to the Health Information Department. In your request you must tell us (1)what 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.
Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We accommodate all requests for such confidential communication to the best of our abilities.
QUESTIONS OR COMPLAINTS
If you have questions regarding this Notice, you may contact the Privacy Officer at (601) 847-7121 or the Compliance Officer at (601) 847-7155 or by mail at the address below.
If you believe that your privacy has been violated or you have a complaint, you may file a complaint with the hospital or with the Secretary of the Department of Health and Human Services. To file a complaint with Simpson General Hospital, submit your complaint in writing to the address below. There will be no retaliation for filing a complaint.
Simpson General Hospital
1842 Simpson Hwy 149
Mendenhall, MS 39114
1842 Simpson Highway 149
Mendenhall, MS 39114
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