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Riverside General Hospital and The Medical Staff of Riverside General Hospital Notice of Privacy Practice This notice describes how information about you may be used and disclosed and how you can get access to this information. This Notice of Privacy Practices identifies the general ways your protected health information can be used or disclosed. Protected health information is the individual identifiable personal health information found in the medical billing records. This information is created or received by a health care provider, insurance company, or employer, and relates to your past, present or future physical or mental health conditions. This information can be transmitted or maintained in any form by Riverside General Hospital. This notice describes your legal rights regarding your health information. It also inform you or the legal duties and privacy practices of Riverside General Hospital and its Medical Staff members with respect to health information created for services generated at Riverside General Hospital. If you receive services by privacy polices or notices, and there will be different contact information. Riverside General Hospital and its Medical Staff members are independently responsible for complying with this Notice. While we may share protected health information each with other to carry out treatment, payment, or health care operations, the Medical Staff members treat patients at Riverside General Hospital but are not employees of the Riverside General Hospital, and we are not responsible for each other's actions and do not have equal control over the other's business. For the purpose of this Notice, the terms "Riverside" "we" and "our" refer to both Riverside General Hospital and its Medical Staff members only with respect to health information generated or maintained at Riverside General Hospital. OUR LEGAL DUTIES We are required, by law, to keep your identifiable health information private, provide you with Notice of our legal notices and privacy practices with respect to your health information; and follow the terms of the Notice as long as it is in effect. If we revise the Notice, we will follow the terms of the revised Notice, as long as it in effort. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFOMATION The following information describes how we are permitted, or required by law, to use and disclose your health information. Not every use or disclosure in a category will be listed. Treatment We may use or disclose your medical information to a physician or other health care provider care and treatment to you. For example, a physician treating you a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Different departments at Riverside General Hospital may share information about you in order to coordinate the different services you receive, such as lab works, X-rays and prescriptions. We also may disclose medical information about you to those who may be involved in your medical care outside Riverside, such as physicians and others who provide you with follow-up and medical equipment or product supplies. We may contract you to provide appointment reminder and to provide you with information about health-related benefits and service at Riverside General Hospital, or treatment alternative that may be of interest to you. Payment We may use or disclose your medical information to obtain payment for services we provide to you. We may disclose your medical information to another health care provider or entity. For example, Riverside may need to provide your health plan with information about services you received so your health plan will pay Riverside General Hospital or reimburse you. Riverside General Hospital will tell your plan health plan about a treatment you are going to receive to obtain the health plan's prior approval for this treatment or to determine whether your plan will cover the treatment. Health Care Operations We may use or disclose health information about you for the health care operations of Riverside General Hospital. Health care operations include: quality and service improvement; health care delivery review; staff performance evaluation; competence or qualification review of health care professionals; education and training of physicians and other health care providers; and business planning and development, business management and general administrative activities. Authorization for Other Disclosures We will not use or disclose your health information, except as described in this document, unless you authorize us, in writing to do so. You can revoke an authorization at any time, in writing. If your revoke an authorization, we will no longer use or disclose your health information for the purpose covered by the authorization. However, we are unable to take back any uses or disclosures already made by your authorization. Hospital Directory Unless you instruct otherwise, we may disclose your name, general condition, and location in the hospital to your friends, family, and others who ask for you by name. Upon requires, we will provide your name, location in the hospital, and religious affiliations to our Chaplin member of your faith or tradition Family and Friends We may use or disclose information to notify or assist in notifying a family member, personal representative or other person responsible for your care, of your location and general condition.. We also will disclose health information is relevant to that person's involvement with your care or payment for your care. You can prohibit disclosure of this information. Fundraising We may use health information about you to contact you in effort to raise money for our organization and its operations. We may disclose this information to the Riverside General Hospital Foundation to assist us in our fundraising activities. Only contact information such as your name, address and telephone number, and the dates our received treatment or services Riverside General Hospital will be released. Public Health and Safety We may use or disclose health information, as authorized or required by local, state, or federal law, for the following purposes deemed to be in the public interest or benefit. • To report certain diseases and wounds, births and deaths, and suspected cases of abuse, neglect or domestic violence. • To help identify, locate or report criminal suspects, crime victims, suspicious deaths, or criminal conduct on Riverside General Hospital premises; • To respond to a court order, subpoena, or other judicial process; • To assist federal disaster relief efforts. • To enable product recalls, repairs or replacements; • To respond to an audit inspection, or investigation by a health-related government agency; • To assist in federal intelligence, counterintelligence, and national security issues. • To facilitate organ and tissue donations; • TO assist corners, medical examiners, and funeral directors; • To respond to a request from your military command authority(if you are a member or veteran of the armed forces) • To provide information to a workers' compensation program. Business Association There are some services provided at Riverside General Hospital through contracts with business associates. When these services are contracted, we will disclose your health information to the business associate so they can perform the job we have requested them to do. However, we require the business associate to protect your information. Special Privacy Protections for Alcohol and Drug Abuse Information Alcohol and drug abuse information has special privacy protections. We will not disclose information identifying an individual as being a patient or provide any medical information relating to the patient's substance abuse treatment unless the patient consents in writing; a court order requires disclosure of the information; medical personnel need the information to meet medical emergency; qualified personnel use the information for the purpose of completing their job, management audits, financial audits or program evaluation; or it is necessary to report a crime or a threat to commit a crime, or to report abuse or neglect as required by law. Your Health Information Rights Your medical record is the property of Riverside General Hospital (the health care practitioner or facility that compiled it). You have the following rights, with certain exceptions, regarding the health information that is created about you at Riverside. Confidential Communication You have the right to request that we communicate health information to you by an alternate means or location other than your home address and telephone number. Your request must be made in writing to Riverside General Hospital and must specify how or where you wish to be contacted. We will try to accommodate your request for alternate communications. If your request an alternate means of communication, that request also should be communicated by you to all of your physicians, including your private physician. Restrictions You have the right to request that we restrict the use of disclosure of your health information for treatment, payment, or health care operations. While we are not required to agree to your request, if we do agree, your request will be complied with , unless the information is needed to provide emergency treatment to you. Your request must be made in writing in our listed contract person. Access You have the right to review and obtain a copy of your health information, with certain exceptions. Usually, this includes medical and billing records, but does not include psychotherapy notes. Your request to review or obtain a copy of your health information must be in writing to our listed contact person. You will be charged a fees for processing, copying and postage as authorized by Texas State law. Amendment If you feel that the health information we have about you is incorrect or incomplete, you have the right to ask for amendment of that information. You have the right to request an amendment for as long as the information is kept by or for us. Your request for an amendment must be made in writing to Riverside General Hospital, and include a reason that supports your request. Accounting and Disclosures You have the right to request a list of disclosures that we have made of your health information, except for the disclosures made for treatment, payment or healthcare operations those authorized by you and certain other disclosures. Your request must be in writing to our listed contact person, and must state a time period for which you want an accounting. The time period you may not be longer than six years, and may not include dates before April 14, 2003. The first accounting you request within a twelve-month period will be free. A fee will be charged for additional lists within this same time period. Revisions of this Notice We reserve the right to change this Notice, and the right to make the new provisions effective for all health information we currently maintain, as well as any information we receive in the future. If we make a major change of this Notice, the revised Notice will be posted at Riverside General Hospital and on our web site. In addition, a paper copy of the revised Notice will be available upon request. To Report A Compliant If you believe your health information privacy rights have been violated, you can file a compliant with us or with the Secretary of the United States Department of Health and Human Services. There will not be any penalty or retaliation against your for making a compliant to us or to Department of Health and Human Services. Contact Information If you have questions or need information regarding our legal duties and privacy practices, or how to exercise any of the health information rights listed in this Notice, please contact. Compliance Officer Riverside General Hospital 3204 Ennis Houston, Texas 77004 713.526.2441 ext. 206 Effective Date: 03/01/2010 |
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| 3204 Ennis Street, Houston, Texas, 77004, (713) 526-2441 | |||||||||