Center Care Health Benefit Programs
NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
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
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, a plan for
future care or treatment, and billing-related information. This notice
applies to all of the records of your care as requested in order to comply
with your health plan benefits. Your personal doctor and hospital may have
different policies or notices regarding their use and disclosure of your
medical information created in the doctor’s office, clinic or hospital.
This notice will tell you about the ways in which we may use and disclose
medical information about you. We also describe your rights and certain
obligations we have regarding the use and disclosure of medical
We are required by law to maintain the privacy of your health
information and provide you a description of our privacy practices. We will
abide by the terms of this notice.
How We May Use and Disclose Medical Information About
The following categories describe examples of the way we use and
disclose medical information:
- We may use medical information about you to provide you treatment or
services. We may disclose medical information about you to doctors,
nurses, technicians, medical students, or other hospital personnel who
are involved in taking care of you. For example: a doctor treating you
for a broken leg may need to know if you have diabetes because diabetes
may slow the healing process. We also may disclose information about you
to people outside the hospital, such as family members, and other
providers of care.
We may also provide your physician or a
subsequent healthcare provider with copies of various reports that should
assist him or her in treating you throughout the continuum of care.
- We may use and disclose medical information about your treatment and
services to process your medical claim. For example, we may need to give
your third party administrator, medical and disease management company
and reinsurance carriers information about your surgery so they will
reimburse for the treatment.
For Health Care Operations
- Members of the quality improvement team may use information in your
health record to assess the care and outcomes in your case and others
like it. The results will then be used to continually improve the quality
of care for all patients we serve. For example, we may combine medical
information about many patients to evaluate the need for new services. We
may disclose information to doctors, nurses, and other students for
educational purposes. And we may combine medical statistics we have with
that of other health care entities in order to make improvements. We may
remove information that identifies you from this set of medical
information to protect your privacy.
How We Will Contact You
Unless you tell us otherwise in writing, we may contact you by either
telephone or by mail at either your home or your workplace. At either
location, we may leave discreet messages for you on the answering machine
or voice mail. If you want to request that we communicate to you in a
certain way or at a certain location, please inform the Registration staff
during the registration process or contact the Director of Member Services.
Your request must state how or where you can be contacted. We will
accommodate your request. However, we may, when appropriate, require
information from you concerning how payment will be handled. We also may
require an alternate address or other method to contact you.
We may also use and disclose your medical information in accordance with
federal and state laws for the following purposes.
- Treatment Alternatives
We may contact you with information about treatment alternatives or
other health-related benefits and services that may be of interest to you.
- Individuals Involved in Your Care or Payment for Your Care
We may release medical information about you to a friend or family
member who is involved in your medical care. We may also give information
to someone who helps pay for your care. In addition, we may disclose
medical information about you to an entity assisting in a disaster relief
effort so that your family can be notified about your condition, status and
location. If there is a family member, other relative or friend that you do
not want us to disclose medical information about you to, please request
the Opt-out Form from the Director of Member Services.
- As Required By Law
We will disclose medical information about you when required to do so by
federal, state or local law.
- To Avert a Serious Threat to Health or Safety
We may use and disclose medical information about you when necessary to
prevent a serious threat to your health and safety or the health and safety
of the public or another person. Any disclosure, however, would only be to
someone able to help prevent the threat.
- Organ and Tissue Donation
If you are an organ donor, we may release medical information to
organizations that handle organ procurement or organ, eye or tissue
transplantation or to an organ donation bank, as necessary to facilitate
organ or tissue donation and transplantation.
- Military and Veterans
If you are a member of the armed forces, we may release medical
information about you as required by military command authorities.
- Workers’ Compensation
We may disclose medical information about you to the extent necessary to
comply with workers’ compensation and similar laws that provide benefits
for work-related injuries or illness without regard to fault.
- Public Health Activities
We may disclose medical information about you for public health
activities and purposes. This includes reporting medical information to a
public health authority that is authorized by law to collect or receive the
information for purposes of preventing or controlling disease. Or, one that
is authorized to receive reports of child abuse and neglect. It also
includes reporting for purposes of activities related to the quality,
safety or effectiveness of United States Food and Drug Administration
regulated product or activity.
- Victims of Abuse, Neglect or Domestic Violence
We may disclose your medical information when it concerns abuse, neglect
or violence to you in accordance with federal and state law.
- Health Oversight Activities
We may disclose medical information about you to a health oversight
agency for activities authorized by law, including audits, investigation,
inspections, licensure or disciplinary actions. These and similar types of
activities are necessary for appropriate oversight of the health care
system, government benefit programs, and entities subject to various
- Lawsuits and Disputes
If you are involved in a lawsuit or dispute, we may disclose medical
information about you in response to a court or administrative order. We
may also disclose medical information about you in response to a subpoena,
discovery request, or other lawful process by someone else involved in the
dispute, but only if efforts have been made to tell you about the request
or to obtain an order protecting the information requested.
- Disclosures for Law Enforcement Purposes
We may disclose medical information about you to law enforcement
officials for law enforcement purposes.
- We may also use and disclose health information for the following:
- National Security and Intelligence Activities
- Protective Services for the President
- Security Clearance
- Inmates: Persons in Custody
If you are an inmate of a correctional institution or under the custody
of a law enforcement official, we may release medical information about you
to the correctional institution or law enforcement official. This release
would be necessary (1) for the institution to provide you with health care;
(2) to protect your health and safety or the health and safety of others;
or (3) for the safety and security of the correctional institution.
- Business Associates
There are some services provided in our organization through contracts
with business associates. Examples include medical and disease management
companies, payers, insurance and financial service providers such as
workers compensation insurers, automobile liability insurers, pharmacy
benefit managers, insurance agents and brokers, subrogation companies and
reinsurance companies. . 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 do and bill you or your third-party
payer for services rendered. To protect your health information, however,
we require the business associate to appropriately safeguard your
- Affiliated Covered Entity
Protected health information will be made available to health care
providers as necessary to carry out treatment, payment and health care
operations. Health care providers may have access to protected health
information at their locations to assist in reviewing past treatment
information as it may affect treatment at this time.
Your Health Information Rights
Although your health record is the physical property of the healthcare
practitioner or facility that compiled it, you have the following rights.
- Right to Inspect and Copy
You have the right to inspect and copy medical information that may be
used to make decisions about your care. Usually, this includes medical and
billing records, but does not include psychotherapy notes. We may deny your
request to inspect and copy in certain very limited circumstances. If you
are denied access to medical information, you may request that the denial
be reviewed. Another health care professional chosen by Center Care will review your request and the denial. The person
conducting the review will not be the person who denied your request. We
will comply with the outcome of the review. You must submit your request in
writing to the HIPAA Compliance Coordinator. If you request a copy of the
information, we may charge a fee for the cost of copying, mailing or others
supplies associated with your request.
- Right to Amend
If you feel that medical information we have about you is incorrect or
incomplete, you may ask us to amend the information. You have the right to
request an amendment for as long as the information is kept by us. We may
deny your request for an amendment and, if this occurs, you will be
notified of the reason for the denial. To request an amendment, your
request must be made in writing to the Director of Member Services.
- Right to an Accounting of Disclosures
You have the right to request an accounting of disclosures. This is a
list of certain disclosures we make of your medical information for
purposes other than treatment, payment or health care operations. To
request this list or accounting of disclosures, you must submit your
request in writing to the Director of Member Services. . Your request must
state a time period that 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 medical
information we use or disclose about you for treatment, payment or health
care operations. You also have the right to request a limit on the medical
information we disclose about you to someone who is involved in your care
or the payment for your care, like a family member or friend. For example,
you could ask that we not use or disclose information about a surgery you
had. To request restrictions, your request must be made to the Registration
staff or send your request in writing to the Director of Member Services.
We are not required to agree to your request. If we do agree, we will
comply with your request unless the information is needed to provide you
- 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. For example, you may ask
that we contact you at work or by U.S. Mail. The facility will grant
requests for confidential communications at alternative locations and/or
via alternative means only if the request is submitted in writing and the
written request includes a mailing address where the individual will
receive bills for services rendered by the facility and related
correspondence regarding payment for services. Please realize, we reserve
the right to contact you by other means and at other locations if you fail
to respond to any communication from us that requires a response. We will
notify you in accordance with your original request prior to attempting to
contact you by other means or at another location. To request confidential
communications, your request must be made to the Director of Member
- A Paper Copy of This Notice
You have the right to a paper copy of this notice. You may ask us to
give you a copy of this notice at any time. Even if you have agreed to
receive this notice electronically, you are still entitled to a paper copy
of this notice.
You may obtain a copy of this notice at our website, which is
- CHANGES TO THIS NOTICE
We reserve the right to change this notice and the revised or changed
notice will be effective for information we already have about you as well
as any information we receive in the future. The current notice will be
posted in the Center Care office and include the
effective date. In addition, we will offer you a copy of the current notice
in effect with your summary plan description, through distribution by your
employer, or via the Center Care directory.
If you believe your privacy rights have been violated, you may file a
complaint with the Commonwealth Health Corporation / Medical Center HIPAA
Compliance Coordinator at the below address or with the Secretary of the
Department of Health and Human Services, Washington, D.C. All complaints
should be submitted in writing.
- To file a complaint with us, contact:
Vice President of Corporate Compliance and
HIPAA Privacy Officer
Commonwealth Health Corporation d.b.a. Center Care
800 Park Street
Bowling Green, KY 42102
- To file a complaint with the United States Secretary of Health and
Human Services, send your complaint in care of:
Director, Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C. 20201
You will not be penalized in any way for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
- Other uses and disclosures of medical information not covered by this
notice or the laws that apply to us will be made only with your written
permission. If you provide us permission to use or disclose medical
information about you, you may revoke that permission, in writing, at any
time. If you revoke your permission, we will no longer use or disclose
medical information about you for the reasons covered by your written
authorization. You understand that we are unable to take back any
disclosures we have already made with your permission, and that we are
required to retain our records of the care that we provided to you.
- If you have any additional questions or comments about this Notice of
Privacy Practices, please contact Neil Shields, HIPAA Privacy Officer at (270) 745-1851.