Doctors Hospital at Renaissance
Notice of Privacy Practices
Effective Date: 4/14/2003
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.
Doctors Hospital at Renaissance (“DHR”) recognizes that health information about you is personal, and we are committed to protecting the privacy of your information. As a patient at DHR, the care and treatment that you receive is recorded in a medical record. So that we can meet your medical needs, we must share your health information with the health care providers involved in your care. We share your information only to the extent necessary to collect payment for the services we provide you, to conduct our business operations, and to comply with the laws that govern the health care industry. We will not use or disclose your information for any other purpose without your permission. We have a responsibility to safeguard the privacy and integrity of our patient records. This Notice explains the Privacy Practices at DHR and our patients’ rights regarding their health information.
This Privacy Notice is being provided to you as a requirement of federal law, the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). This Notice describes how we, at DHR, may use and disclose your protected health information (“PHI”) to carry out treatment, payment or other health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI in some cases. Your PHI, as defined by HIPAA, means your personal health information which is found in your medical and billing records and which relates to your past, present, or future physical or mental health conditions or the provision of payment for services related to those health conditions. During the course of the treatment, payment and health care operations activities, this may include information created or received by health care providers, insurance companies and/or your employer.
The following parties share DHR’s commitment to protect your privacy and will comply with this Notice:
Any health care professional authorized to enter information into your medical record
All department and units of DHR, including our outpatient departments/clinics
All employees, volunteers, trainees, students, contractors and medical staff members of DHR
Your Health Information Rights
Although your health record is the physical property of DHR, the information belongs to you. You have the right to:
A copy of this Notice. You have the right to a copy of this Notice. You may obtain a paper copy of this Notice at any time, even if you have been provided with an electronic copy. You do not have to submit a written request to obtain the Notice. Paper copies of this Notice may be obtained from any DHR registration or admissions desk. You may also obtain an electronic copy of this Notice here (**Link to Privacy Practices**).
Inspect and Copy your Medical Records. You have the right to inspect and obtain a copy of your medical records maintained by DHR, subject to certain limited exceptions. This information includes your medical and billing records. DHR may charge you a reasonable fee for copying/providing your records to you. To inspect or obtain a copy of your medical records, you may contact our Medical Records Department at (956) 362-7750 and you can access our Release of Information Forms here (**Link to Authorization for Release of Information**).
Request Confidential Communications. You have the right to request that DHR communicate with you about medical matters in a certain way or at a certain location. For example, you may prefer to receive mail regarding your health information at an address other than your usual mailing address. You must specify how and where you wish to be contacted and we will accommodate reasonable requests.
Request Restriction. You have the right to request limitations on how DHR uses and/or discloses your health information. However, DHR is not required by law to agree to a requested restriction. If DHR agrees to your request, DHR will comply with your request unless the use or disclosure is necessary in order to provide you with emergency treatment or otherwise is required by law.
Request Amendment to your Medical Records. If you believe your health information maintained by DHR is incorrect or incomplete, you may request an amendment to your information. DHR can only correct information that we have created or that was created on our behalf. DHR is not required to agree with your request. If your health information is accurate and complete, or if the information was not created by DHR, we may deny your request; however, if we deny any part of the request, we will provide a written explanation of our reasons for doing so.
Accounting of Hospital Disclosures of your Health Information. You have the right to request an accounting of certain disclosures of your health information as provided by law, which a list is describing how we have shared your health information with outside parties.
: To obtain information about how to request a copy of your medical records, receive an accounting of disclosures of, or request an amendment to your health information, please contact our Medical Records Department at (956)-362-7750 or (fax) 956-362-7795.
In addition to the responsibilities set forth above, DHR is also required to:
Use and Disclosure of your Protected Health Information
Maintain the privacy of your health information
Provide you with a notice as to our legal duties and privacy practices with respect to information we maintain about you
Abide by the terms of this Notice
Notify you if we are unable to agree to a requested restriction on certain uses and disclosures
We reserve the right to change our practices and to make the new provisions effective for all PHI we maintain, including information created or received before the change. Should our information practices change, we are not required to notify you, but we will have the revised notice available for you to request at
any DHR site and on this Website.
The following categories describe different ways that we use and disclose health information. For each category of uses or disclosures we will explain what we mean and try to give some examples. To respect your privacy, we will try to limit the amount of information that we use or disclose to that which is “minimum necessary” to accomplish the purpose of the use or disclosure. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information should fall within one of the categories:
: DHR may disclose health information about you to doctors, nurses, technicians, medical students or other personnel who are involved in taking care of you within DHR. We may share health information about you in order to coordinate different treatments, such as prescriptions, lab work and X-rays. We may also provide your physician or a subsequent healthcare provider with copies of various reports to assist in treating you once you are discharged from care at DHR.
: DHR may use or disclose your health information to obtain payment from your insurance company or a third party. For example, DHR may need to provide your health plan with information about treatment you received so that your health plan will pay us or reimburse you for the treatment. Or DHR may need to provide your health plan with information regarding a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used.
FOR HEALTHCARE OPERATIONS
: DHR may use or disclose your health information for routine health care operations that are necessary to run the Hospital and assure that all of our patients receive quality care. Health care operations at DHR include, but are not limited to, training and education programs, reviewing the quality of care provided by health care professionals, obtaining health insurance, conducting legal services and auditing services, conducting business planning and development activities, conducting risk management activities and investigations, and managing the business and general administrative activities of DHR.
APPOINTMENTS and ALTERNATIVES:
DHR may use or disclose your health information to contact you as a reminder that you have an appointment for treatment or medical care at DHR. Also, we may use or disclose health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. Further, we may use and disclose health information to tell you about health-related benefits or services that may be of interest to you.
DHR contracts with outside companies that perform business services for us, such as billing companies, management consultant, quality assurance reviewers, accountants or attorneys. In certain circumstances, we may need to share your medical information with a business associate so it can perform a service on our behalf. DHR will limit the disclosure of your information to a business associate to the amount of information that is “minimum necessary” for the company to perform such services for DHR. In addition, we will have a written contract in place with the business associate requiring him/her to protect the privacy of your health information.
DHR may include your name, location in the facility and general condition (but not specific health information about you) in hospital’s patient directory while you are receiving care as an inpatient. We make this information available so that individuals can contact you or visit you in the hospital. Unless you specifically request that your information be excluded from the patient directory, DHR may release this directory information to people who ask for you by name. This does not apply to patients who are receiving treatment for certain conditions, such as mental health problems. Further, DHR may disclose our name and location in the hospital to you clergy even if you are not asked for by name. In the event that you do not wish your information to be included in the directory and be available, you may notify DHR at the time of your admission.
NOTIFICATION TO INDIVIDUALS INVOLVED IN YOUR CARE
: DHR may use or disclose information to a family member, other relative, or close personal friend who is involved in your medical care or to someone who helps pay for your care if the information disclosed is directly relevant to such person’s involvement with your care, unless you tell us otherwise.
DHR may use or disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
DHR may disclose health information to funeral directors consistent with applicable law to carry out their duties.
ORGAN PROCUREMENT ORGANIZATIONS:
Consistent with applicable law, DHR may disclose your 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 contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits, goods and services provided by University Health System that may be of interest to you.
DHR may use certain portions of your health information, including your name, address, phone number and the dates you received treatment or services at DHR (no medical information is provided) to contact you regarding efforts to raise funds to support hospital programs and operations. If you do not want DHR to contact you about a contribution or fundraising program, please contact DHR’s Privacy Officer at (956) 362-7750.
LAWSUITS and DISPUTES.
DHR may disclose your health information in response to a court or administrative order. In addition, DHR may disclose your health information in response to a valid subpoena, discovery request, or other lawful process provided that efforts have been made to tell you about the request or to obtain an order protecting the information requested, as required by law.
HEALTH OVERSIGHT ACTIVITIES:
DHR may disclose your health information to a health oversight agency for activities authorized by law. These oversight activities might include audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the healthcare system, government benefit programs and compliance with civil rights laws.
DHR may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
As required by law, DHR may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.
ABUSE, NEGLECT OR DOMESTIC VIOLENCE:
As required by law, DHR may disclose health information to a governmental authority authorized by law to receive reports of abuse, neglect or domestic violence.
JUDICIAL, ADMINISTRATIVE AND LAW ENFORCEMENT PURPOSES:
Consistent with applicable law, DHR may disclose health information about you for judicial, administrative and law enforcement purposes. This may include disclosures to avert a serious threat to your or a third party's health or safety as well as victims of crime or criminal conduct at DHR.
TO AVERT A SERIOUS THREAT TO HEALTH OR SAFETY:
DHR may use and disclose your health information when we believe it is 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 or lessen the threat or to law enforcement authorities in particular circumstances.
NATIONAL SECURITY AND INTELLIGENCE ACTIVITIES:
DHR may release your health information to authorized federal officials for lawful intelligence, counterintelligence and other national security activities authorized by law.
Military and Veterans
: If you are a member of the armed forced, DHR may release health information about you as required by military authorities. DHR may also share information about foreign military personnel to the appropriate foreign military authority.
If you are an inmate in a correctional institution and if the correctional institution or law enforcement authority makes certain representations to DHR, DHR may disclose your health information to a correctional institution or law enforcement official.
REQUIRED OR ALLOWED BY LAW:
DHR will disclose health information about you when required or allowed to do so by federal, state or local law.
OTHER USES OF YOUR HEALTH INFORMATION:
Other uses and disclosures of health information not covered by this Notice or the laws that apply to DHR will be made only with your written permission. If you give DHR permission to use or disclose your health information, you may cancel that permission, in writing, at any time. If you cancel your permission, DHR will no longer use or disclose health information about you for the reasons covered by your written authorization. DHR is unable to take back any disclosures we have already made with your permission.
Changes to this Notice
DHR reserves the right to change this Notice and to make the revised Notice effective for PHI DHR already has about you as well as any information DHR receives in the future. A copy of the current Notice or a summary of the current Notice will be posted at various locations at DHR and on our Website. In addition, each time you register at or are admitted at any DHR facility for treatment or health care services as an inpatient or outpatient, DHR will have available for you, at your request, a copy of the current Notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with the DHR Privacy Officer at (956) 362-7750, or with the Secretary of the United States Department of Health and Human Services. You will not be penalized or retaliated against in any way for making a complaint.
If you have any questions about this Notice or your privacy rights, or wish to obtain a form to exercise your rights as described above, you may contact the DHR Privacy Officer at 956-362-7750.
Notice to Patient Destruction of Medical Records
In accordance with Texas Health and Safety Code, Section 241.103, this notice is given to you regarding the destruction of medical records.
It is the policy of Doctors Hospital at Renaissance (“DHR”) to authorize the disposal of any medical records on or after the tenth (10th) anniversary of the date on which you, the patient, were last treated at this facility.
If you, the patient, are younger than 18 years of age when you were last treated, DHR may authorize the disposal of medical records relating to you, the patient, on or after your twentieth (20th) birthday, or after the tenth (10th) anniversary of the date on which you were last treated, whichever date is later.
DHR will not destroy medical records that relate to any matter that is involved in litigation if the hospital knows the litigation has not been fully resolved.