This notice describes how health information about you may be used and disclosed and how you can get access to this information according to the Health Insurance Portability and Accountability Act, also known as HIPAA.
Please review it carefully.
Portage Health keeps records of the care and services you receive at its facilities we need these records to provide you with quality care and comply with certain legal requirements. We recognize that your health information is personal. We are committed to protecting the confidentiality of your health information. We are required by law to maintain the privacy of your health information, provide you our Joint Notice of Privacy Practices (“Notice”) and follow the terms of the Notice that is currently in effect.
If you have any questions about this notice, please contact our Privacy Officer/Risk Manager at (906) 483-1000 or (800) 573-5001 (toll free).
This notice describes Portage Health’s practices and that of:
We understand that health information about you and your health is personal. We are committed to protecting health information about you. We create a record of the care and services you receive at Portage Health. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Portage Health, whether made by Portage Health personnel, your personal doctor or other practitioners involved in your care.
This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of health information.
We are required by law to: make sure that health information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to health information about you; and follow the terms of the notice that is currently in effect.
We will comply with all applicable state and federal laws. For example, under State law there are more limits on the disclosure of HIV and AIDS information, and we will comply with these more stringent laws.
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 examples. Not every use or disclosure in a category will be listed. However, all of the ways we use and disclose information will fall within one of the categories.
For Treatment. We may use health information about you to provide you with health treatment or services. We may disclose health information about you to doctors, nurses admissions/billing office, technicians, healthcare students, clergy or others who are involved in your care. 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. In addition, the doctor may need to tell the dietician if you have diabetes so that we can arrange for appropriate meals. Different departments of Portage Health also may share information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose health information about you to people outside Portage Health who may be involved in your healthcare such as family members or friends involved in your care, or your other healthcare providers.
For Payment. We may use and disclose health information about you so that the treatment and services you receive at Portage Health may be billed to and payment may be collected from you, an insurance company or third party. For example, we may need to give your health plan information about treatment you received so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the treatment.
For Healthcare Operations. We may use and disclose heath information about you for Portage Health operations. These uses and disclosures are necessary to run the Portage Health and make sure that all of our patients receive quality care. For example, we may use information in your health record to assess the care and outcomes in our care and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and services we provide. We may send you a patient-satisfaction survey. We may remove information that identifies you from this set of healthcare information so others may use it to study healthcare and healthcare delivery without learning who the specific patients are.
We may record and transmit health information, including medicine and prescription information, electronically. Health information may be shared electronically through local, state and national health information networks. Portage Health may participate in one or more of these networks or health information exchanges (“HIEs”). There are rules regarding how that health information can be accessed and there are limits on the uses and disclosures of that information. For more information through HIE’s and other interconnected health information exchanges, please contact our Privacy Officer/Risk Manger at (906) 483-1000 or (800) 573-5001 (toll free).
Facility Directory/Clergy. Unless you notify us that you object, we will use your name, location in the facility and religious affiliations for directory purposes. This is so your family, friends, and clergy can visit you in the facility and generally know how you are doing. Only clergy members are given religious affiliation. In addition, we may disclose health 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.
Appointment Reminders. We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or healthcare at Portage Health or the doctor’s office.
Treatment Alternatives. We may use and disclose health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use and disclose health information to tell you about health-related benefits, services or health education classes that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care. Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you verbally authorize, health information relevant to that person’s involvement in your care or payment related to your care.
Research. Under certain circumstances, we may use and disclose minimally necessary health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another for the same condition. All research projects, however, are subject to a special approval process. Before we use or disclose health information for research, if required, we will ask you for specific permission if the researcher will have access to information that reveals who you are.
Fundraising Activities. We may use information about you to contact you in an effort to raise money for Portage Health and its operations. We may disclose information to a foundation related to Portage Health so that the foundation may contact you in raising money for Portage Health. We will only release contact information, such as your name, address, and phone numbers, and the dates you received treatment or services at Portage Health. If you do not want Portage Health to contact you for fundraising efforts we will include in any fundraising materials we send you a description of how you may opt-out, additionally you may opt-out at any time by notifying our Privacy Officer/Risk Manger in writing or by calling (906) 483-1000 or (800) 573-5001 (toll free).
As Required By Law. We will disclose protected health information about you when required to do so by federal, state or local law.
Organ and Tissue Donation. If you are an organ donor or recipient, we may disclose health 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. If you are a member of the armed forces, we may disclose health information about you as required by military command authorities. We may also disclose health information about foreign military personnel to the appropriate foreign military authority.
Workers’ Compensation. We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law. These programs provide benefits for work-related injuries or illness.
Public Health Risks (Health and safety to you and/or others). As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability. We may use and disclose health information about you to agencies when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. These activities generally include the following: to prevent or control disease, injury or disability; to report births and deaths; to report child abuse or neglect; to report reactions to medications or problems with products; to notify people of recalls of products they may be using; to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; to notify the appropriate government authority if we believe a patient has been a victim of abuse, neglect or domestic violence. We will only make this disclosure when required or authorized by law.
Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the healthcare system, government programs and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health 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, obtain an order protecting the information requested or an authorization signed by yourself.
Law Enforcement. We may disclose health information for law enforcement purposes or required by law or in response to a court order, subpoena, warrant, summons or similar process; to identify or locate a suspect, fugitive, material witness or missing person; about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at Portage Health; and in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Coroners, Health Examiners and Funeral Directors. We may release health information to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients of Portage Health to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law. We may disclose health information about you to authorized federal officials for special investigations.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you 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.
Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care. Usually, this includes health and billing records, but does not include psychotherapy notes.
If we maintain health information about you in electronic format, you also have the right to obtain a copy of such information in an electronic format that is readily producible, or in format agreed to by you and Portage Health. You also have the right to have us transmit such electronic information directly to an entity or person that you specifically designate.
To inspect and copy health information that may be used to make decisions about you, contact the Medical Records Department at (906) 483-1000. If you request a copy of the information, we may charge a fee for the costs of retrieving and any copying, mailing or other supplies associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by Portage Health 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.
Right to Amend. If you feel that health 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, or for, Portage Health. To request an amendment, your request must be made in writing and submitted to the Medical Records Department. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of health information about you to others. Disclosures for treatment, payment and operations are not included at this time.
To request this list of accounting of disclosures, you must submit your request in writing to the Medical Records Department. Your request must state a time period which may not be longer than six (6) years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or healthcare operations.
We are not required to agree with your request, except for services for which you paid out-of-pocket in full and that you request not be disclosed to your health plan. In all other circumstances, we are not required to agree with your request.
If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment, or the disclosure is otherwise required by law.
To request restrictions, you must make your request in writing to the Privacy Officer/Risk Manager. In your request, you must tell us: (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; (3) to whom you want the limits to apply, for example, disclosure for quality improvement.
Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to the Privacy Officer/Risk Manager. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this privacy notice. You may ask us to give you a copy of this privacy notice at any time by requesting a copy from a member of Portage Health personnel. You may obtain a copy of this notice at our website, www.portagehealth.org/HIPAA.
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the Registration and Waiting Areas of all Portage Health entities. The notice will contain the current effective date.
Complaints. If you believe your privacy rights have been violated, please contact or submit your complaint in writing to the Privacy Officer/Risk Manager at Portage Health. You also have the right to file a written complaint with the Secretary of the Department of Health and Human Services. The quality of your care will not be jeopardized nor will you be penalized for filing a complaint.
Other uses and disclosures of health 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 health 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 health 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.
Privacy Officer/Risk Manager by phone at (906) 483-1000 or (800) 573-5001 (toll free) or in writing at: Portage Health 500 Campus Drive Hancock, MI 49930
Revised: September 7, 2012
500 Campus DriveHancock, MI 49930(906) 483-1000
921 W. Sharon AvenueHoughton, MI 49931(906) 483-1777
945 Ninth StreetLake Linden, MI 49945(906) 483-1030
751 S. Seventh StreetOntonagon, MI 49953(906) 884-4120
600 MacInnes DriveHoughton, MI 49931(906) 483-1860