EAST OHIO

• Effective Date: 05/01/04

• Revision 9/1/2014

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

If you have any questions about this notice, please contact: Compliance & Privacy Officer at 304-234-1690

How do we use or share your health information? We use or share your health information in the following ways.

We can use your health information and share it with other professionals who are treating you.

Examples: A doctor treating you for an injury may ask another doctor about your overall health condition. Different departments of the hospital may share medical information about you in order to coordinate the different things you need such as prescriptions, lab tests, and x-rays.

We can use and share your health information to run our organization, improve your care, and contact you when necessary.

Examples: We use health information about you to manage your treatment and services.

We may disclose information to physicians, nurses, technicians, medical students, and other personnel at the hospital for review and learning purposes.

We may use your health information to remind you about appointments or to tell you about possible treatment alternatives.

We can use and share your health information to bill and get payment from your health insurance or other entities.

Examples: We give information about you to your health insurance plan so it will pay for your services.

We may tell your health plan about a treatment planned for you to obtain prior approval or to determine whether your plan will cover the treatment.

How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

We can share health information about you for certain situations such as:

• Preventing disease violence Preventing or reducing a serious threat to anyone’s health or safety

• Helping with product recalls

• Reporting adverse reactions to medications

• Reporting suspected abuse, neglect, or domestic

We can use or share your information for health research.

We will share information about you if state or federal law requires it, including the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

We can share health information about you with organ procurement organizations.

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

• We can use or share health information about you:

• For workers’ compensation claims

• For law enforcement purposes or with a law enforcement official

• With health oversight agencies for activities authorized by law

• For special government functions such as military, national security, and presidential protective services

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

• In these cases we never share your information unless you give us written permission:

• Marketing purposes

• Sale of your information

• Most sharing of psychotherapy notes

We may contact you for fundraising efforts, but you can tell us not to contact you again.

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Contact the Medical Records Department at EORH (740-633-4202) or (304-234-8864) to ask us how.

We will provide a copy or a summary of your health information, usually within 30 days of your written request. We may charge you a reasonable cost-based fee.

We may deny your request in certain circumstances but you may ask that the denial be reviewed.

You may also access certain parts of your medical record on our Patient Portal. Ask us how.

You can ask us to correct health information about you that you think is incorrect or incomplete. We have a form to help you do this. Contact the Medical Records Department at EORH (740-633-4202) or (304-234-8864) to ask us how.

We may say “no” to your request, but we’ll tell you why in writing within 60 days.

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

You can ask for a list (accounting) of the disclosures we have made of your health information. You must submit this request in writing to the Medical Records Manager at the hospital address. Your request must include the time period for the accounting which may not be longer than 6 years.

We will include all the disclosures in the accounting except for those about treatment, payment, and our operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge you a reasonable, cost-based fee if you ask for another one within 12 months.

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. You may also access the privacy notice on our website at http://www.eohospital.com/.

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information with your health insurer. We will ask you to complete a form at the time of your request and we will say “yes” unless a law requires us to share that information.

You can complain if you feel we have violated your rights by contacting the Privacy Officer at 304-234-1690.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or by visiting www.hhs.gov/hipaa/filing-a-complaint/what-to-expect/index.html.

We will not retaliate against you for filing a complaint.

To the extent state law provides greater protection in connection with the privacy of your health information, we will follow the state law as it applies.

We are required by law to maintain the privacy and security of your protected health information.

We will let you know if a breach occurs which may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html.

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our organization, and on our web site.

Organized Health Care Arrangement

East Ohio Regional Hospital, 90 North Fourth Street, Martins Ferry, Ohio 43935 and its off-site locations; and all physicians with medical staff privileges at the hospitals who have agreed to be bound by the terms of this notice for the purposes of their treatment of patients at the hospitals.