Student Health Center: Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
1. Our Organization-This notice describes the privacy practices of the University of Utah Student Health Center, its providers, employees, students, trainees, and volunteers. Affiliated providers are not employed by SHC, but are either authorized to provide services to you or have a contractual relationship with SHC. They should provide you with a notice describing their privacy practices when you receive services from them
2. Our Privacy Responsibilities- SHC is required by law to maintain the privacy of your health information; provide this notice that describes the ways we may use and share your health information; and follow the terms of the notice currently in effect.
3. Privacy Promise-SHC understands that your health information is personal and protecting your health information is important. We follow strict federal and state laws that require us to maintain the confidentiality of your health information.
4. Uses and Disclosures of Health Information Permitted by Law-The following categories describe the ways that SHC may use and disclose your health information. Some health records, including confidential communications with a mental health professional, some substance abuse treatment records, some genetic test results, and some health information of minors, may have additional restrictions for use and disclosure under state and federal laws. Your health information will be used or disclosed only for the following purposes:
When you receive care from SHC, we may use your health information for treating you, billing for services, and conducting our normal business known as health care operations. Examples of how we use your information include:
Treatment: We keep records of the care and services provided to you. Health care providers use these records to deliver quality care to meet your needs. For example, your provider may share your health information with a specialist who will assist in your treatment. SHC may use your health information to contact you to reschedule your appointment with SHC. If you do not wish to be contacted for this purpose, notify the scheduler.
Payment: We keep billing records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment from you, your insurance company, or another third party. We may also contact your insurance company to verify coverage for your care or to notify them of upcoming services that may need prior notice or approval. For example, we may disclose health information about the services provided to you to claim and obtain payment from your insurance company.
Health Care Operations: We use health information to improve the quality of care, train staff and students, provide customer service, manage costs, conduct required business duties, and make plans to better serve our students. For example, we may use your health information to evaluate the quality of treatment and services provided by our providers, nurse support and other health care workers.
Individuals Involved in Your Care of Payment for Your Care: We may disclose your health information to a spouse, family members, close personal friend, or any individual identified by you if we obtain your agreement. You will have the opportunity to identify this person or to object to our disclosing information to them. No health information will be disclosed unless you have authorized us to release this information.
Outside Contractors: To people who contract with us to provide goods and services used in your treatment at SHC. Examples include interpreters or consultants. These contractors are required by SHC to protect the confidentiality of your health information as we do.
Research: Under certain limited circumstances, SHC may use or disclose health information about you for research after the University's Institutional Review Board (IRB) has approved the research proposal. The IRB is a committee that reviews all research at the University involving patients to protect patients and their privacy.
Public Health Activities: To public health authorities in charge of preventing or controlling disease, injury, or disability. For example, SHC is required to report infectious diseases to the Utah Department of Health; billing practices may be audited by the Utah State Auditor; records are subject to review by the Secretary of Health and Human Services' and the Federal Food and Drug Administration (FDA) to ensure product safety.
Workers Compensation: For workers' compensation or similar programs that provide benefits for work-related injuries or illnesses. U of U employees should go to an OccMed for care.
Health Oversight Activities: To a health oversight agency that oversees the health care system and ensure compliance with the rules of government health programs.
Judicial and Administrative Proceedings: In the course of a judicial or administrative proceedings in reponse to a legal order or other lawful purpose.
Threat to Health and Safety: To reduce or prevent a serious threat to public health and safety.
Law Enforcement Officials; Specialized Government Functions: SHC may disclose information to the police or other law enforcement officials as required by law or in compliance with a court order; to military or veterans' authorities about Armed Forces personnel, under certain circumstances; to authorized federal officials for purposes of lawful intelligence, counterintelligence and other national security activities.
Decedents: To a coroner, medical examiner or funeral director as authorized by law.
ALL OTHER USES AND DISCLOSURES, NOT DESCRIBED IN THIS NOTICE, REQUIRE YOUR SIGNED AUTHORIZATION. YOU MAY REVOKE YOUR AUTHORIZATION AT ANY TIME WITH A WRITTEN STATEMENT TO THE SHC HIPPA COMPLIANCE OFFICER.
6. Your Individual Rights: You have the following rights concerning your health information. A request to exercise any of these rights must be made in writing.
-Right to Alternative Communications: You have the right to request SHC communicate with you in a certain manner. For example, you may ask that SHC contact you only at work or at a different address than your home address. You may request this during registration.
-Right to Inspect of Receive Copy: You have the right to inspect or receive a copy of your health information. Contact SHC at 801-581-6431 to find out how to do this.
-Right to Amend: You have the right to request an amendment to your health information. Contact SHC at 801-581-6431 to find out how to do this.
-Right to an Accounting: You have the right to request an accounting of certain disclosures of your health information made by SHC. The list does not include disclosures made for treatment, payment, and health care operations and some disclosures required by law. Your request must state the period of time requested for the accounting. An accounting goes back only six years and does not cover disclosures made prior to April 14, 2003. The first accounting is free but a fee will apply if more than one request is made in a 12-month period. Call SHC at 801-581-6431 to find out how to do this.
-Right to Revoke Authorization: You have the right to revoke your authorization to disclose your health information, except to the extent that action has already been taken in reliance on your authorization. Call SHC at 801-581-6431 to find out how to do this.
-Request a paper copy of this notice even if you agree to receive it electronically.
7. Changes to This Notice: SHC will follow the terms of the notice currently in effect. SHC reserves the right to change this notice and to make the new notice effective for all health information that it maintains. An updated version of this notice may be obtained at the Student Health Center during regular business hours.
THIS NOTICE IS EFFECTIVE: April 14, 2003
8. Contact us: If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision that we made about access to your health information:
Contact the Student Health Center
555 Foothill Blvd., Level 1
Salt Lake City, UT 84112
All complaints will be investigated and you will not be retaliated against for filing a complaint. You may also file a written complaint with the Office of Civil Rights of the U.S. Department of Health and Human Service. There will be no retaliation for filing a complaint.
Adapted for Use by Permission