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Notice of Privacy Practices

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.

EFFECTIVE DATE: April 14, 2003.

WHO WILL FOLLOW THIS NOTICE:

This notice describes our institution’s practices and that of:

  • Any health care professional authorized to enter information into your Medical/Dental record.
  • All departments and units of the Health Center.
  • Any member of a volunteer group we allow to help you while you are a patient at the Health Center.
  • All employees, staff, affiliated/contract staff, students and other Health Center personnel.
  • All these entities noted below are considered “The Health Center” and follow the terms of this notice. In addition, these entities may share medical, dental and billing information with each other for treatment, payment or health care operations purposes described in this notice.
    • University of Connecticut Health Center Main Campus (Includes the John Dempsey Hospital)
    • University of Connecticut School of Medicine
    • All University of Connecticut Medical Group practice sites, both on and off campus
    • School of Dental Medicine Clinics and University Dentists, Burgdorf Dental Clinic, and Connecticut Children’s Medical Center Pediatric Dental Clinic.

OUR PLEDGE REGARDING MEDICAL/DENTAL INFORMATION:

We understand that medical/dental/billing information about you and your health is personal and confidential. We are committed to protecting this information about you. We create a record of the care and services you receive at the Health Center. 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 the Health Center, and any records contained within your medical/dental/billing record here. Non Health Center providers may have different policies or notices regarding their use and disclosure of this information created in their office or clinic.

This notice will tell you about the ways in which we may use and disclose medical/dental/billing information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of this information.

We are required by law to:

  • Make sure that medical/dental/billing information that identifies you is kept private;
  • Notify you of our legal duties and privacy practices with respect to medical/dental/billing information about you; and
  • Follow the terms of the notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE YOUR MEDICAL/DENTAL/BILLING INFORMATION

The following categories describe different ways that we use and disclose medical/dental/billing information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

  • For Treatment. We may use medical/dental/billing information about you to provide you with treatment or services. We may disclose this information about you to doctors, dentists, nurses, technicians, students, or other Health Center 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. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. Different departments or sites of the Health Center also may share medical/dental/billing information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose medical/dental information about you to people outside the Health Center who may be involved in your continued care, such as family members, nursing service providers or others we use to provide services that are part of your care.
  • For Payment. We may use and disclose medical/dental information about you so that the treatment and services you receive at the Health Center may be billed to and payment may be collected from you, an insurance company, a third party or a State or Federal Program. For example, we may need to give your health plan information about surgery you received at the hospital so your health plan will pay us or reimburse you for the surgery. 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 Health Care Operations. We may use and disclose medical/dental/billing information about you for health care operations at the Health Center. These uses and disclosures are necessary to run UConn Health Center and make sure that all of our patients receive quality care. For example, we may use medical/dental/billing information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical/dental/billing information about many Health Center patients to decide what additional services the Health Center should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, dentists, nurses, technicians, students, and other Health Center personnel for review and learning purposes. We may also combine the information we have with information from other providers of care to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical/dental/
    billing information so others may use it to study health care and health care delivery without learning who the specific patients are.
  • Appointment Reminders. We may use and disclose medical/dental information to contact you as a reminder that you have an appointment for treatment or care at the Health Center.
  • Treatment Alternatives. We may use and disclose medical/dental/billing 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 medical/dental information to tell you about health-related benefits or services that may be of interest to you.
  • Fundraising Activities. We may contact you in an effort to raise money for the Health Center and its operations. We may disclose information about you to The University of Connecticut Foundation, Inc., so that they may contact you to raise money for the Health Center. The Foundation has been designated with the primary responsibility for all fundraising for the benefit of the University. The information released would only include your name, address, telephone number, gender, insurance status and dates of service at the Health Center. If you do not want the Health Center to release this information about you for fundraising efforts, you must notify the University of Connecticut Foundation, Inc. at 1-800-269-9965 or www.foundation.uconn.edu.
  • Hospital Directory. We may include certain limited information about you in the John Dempsey Hospital patient Directory while you are a patient at the hospital. This information may include your name, location in the hospital and your religious affiliation. Patients on the Psychiatric units are not included in the hospital's Directory. The information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name. This is so your family, friends and clergy can visit you in the hospital. If you don’t wish to be included on our patient list, please notify the unit manager or designee.
  • Individuals Involved in Your Care or Payment for Your Care. We may release medical/dental/billing information about you to a friend or family member that you indicate is involved in your care or the payment for your care unless you object in whole or in part. Information is not released routinely about patients on the Psychiatric Units. In addition, we may disclose this 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.
  • Research. Under certain circumstances, we may use and disclose medical/dental 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. This process evaluates a proposed research project and its use of your information, trying to balance the research needs with patients' need for privacy of their medical/dental information. Before we use or disclose information for research, the project will have been approved through this research approval process. We may, however, disclose medical/dental information about you to people preparing to conduct a research project. For example, this information may help researchers look for patients with specific medical needs. This information will remain within the institution. We will ask for your specific permission to give a researcher your name, address or other information that reveals who you are. In rare cases, your permission may be waived as directed by federal, state, and local law.
  • As Required by Law. We will disclose medical/dental/billing 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/dental 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 help prevent the threat.

SPECIAL SITUATIONS:

  • Organ and Tissue Donation: If you are an organ donor, we may release medical information to organizations that handle organ, eye or tissue procurement/transplantation.
  • Military and Veterans: If you are a member of the armed forces, we may release medical/dental/billing information about you as required by military command authorities. We may also release information about foreign military personnel to the appropriate foreign military authority.
  • Workers' Compensation: We may release medical/dental/billing information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
  • Public Health Risks: We may disclose medical/dental information about you for public health activities. These activities generally include the following:
    • To prevent or control disease, injury or disability;
    • To report births and deaths;
    • To report child or elder abuse;
    • 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.
  • Health Oversight Activities: We may disclose medical/dental/billing 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 health care 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 medical/dental/billing information about you in response to a court or administrative order, or to comply with a subpoena, court order, or other lawful process by someone else involved in the dispute, provided that the request meets all of the legal requirements and is valid.
  • Law Enforcement: We may release medical/dental/billing information:
    • 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 a victim or the suspected victim of a crime.
    • About a death we believe may be the result of criminal conduct;
    • About criminal conduct at the hospital; and
    • In certain 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;
    • To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence.
  • Coroners, Medical Examiners and Funeral Directors: We may release medical/dental information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the hospital to funeral directors as necessary to carry out their duties.
  • National Security and Intelligence Activities: We may release medical/dental/billing information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
  • Protective Services for the President and Others: We may disclose medical/dental/billing information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
  • Patients Under Custody of Law Enforcement: If you are under the custody of a law enforcement official we may release medical/dental information about you to the law enforcement official. This release would be necessary for the institution to provide you with health care and/or to protect your health and safety or the health and safety of others.

YOUR RIGHTS REGARDING MEDICAL/DENTAL/BILLING INFORMATION ABOUT YOU.

  • Right to Inspect and Copy. You have the right to inspect and have copied information that is considered part of your medical/dental/billing records that may be used to make decisions about your care. To inspect and have copied medical/dental/billing information about you, you must submit your request in writing to the Director of the Medical Records Department. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We will respond within 30 days of receiving your written request. We may deny your request to inspect and copy in certain very limited circumstances and we will provide you the reason for the denial. In certain circumstances, if you are denied access to your information, you may request that the denial be reviewed. Another licensed health care professional chosen by the Health Center 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 Correct or Update. If you feel that medical/dental/billing information we have about you is incorrect or incomplete, you may ask us to correct or update the information, however, we cannot delete information from your record. You have the right to request this for as long as the information is kept by or for the Health Center. To request a correction or update, your request must be made in writing with a reason to support the request and submitted to the Director of the Medical Records Department. We will respond within 60 days of receiving your written request. We may deny your request 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:
    • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
    • Is not part of the information kept by or for the Health Center;
    • Is not part of the information which you would be permitted to inspect and have copied or;
    • Is accurate and complete.
  • Right to a List of Disclosures We Have Made About You. You have the right to request a list of the disclosures we made of your medical/dental/billing information except for disclosures made for treatment, payment and health care operations. We are not obligated to list all disclosures made about you. To request this list of disclosures, you must submit your request in writing to The Director of the Medical Records Department. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). 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 costs involved and you may alter your request before any costs are incurred.
  • Right to Request Restrictions. You have the right to request a restriction or limitation on the medical/dental/billing 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/dental/billing 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. We are not required to agree to your request. However, if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions regarding payment, you must make your restriction request known at the time of your registration to the doctor's office or by calling the Registration Department. Any restrictions on release of information must be in writing to the Director of Medical Records. 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; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
  • Right to 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 can ask that we only contact you at work or by mail. To request confidential communications, you must make your request at the time of registration at the doctor's office or by calling the Registration Department. 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 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, www.uchc.edu. You may obtain a paper copy of this notice at the Office of Patient Relations or at any location where you receive care. We will ask that you acknowledge receipt of this notice in writing.

CHANGES TO THIS NOTICE. We reserve the right to change this notice and to make the revised or changed notice effective for medical/dental/billing information we already have about you as well as any such information we receive in the future. We post copies of the current notice in all Health Center locations where you may receive care. The effective date of the notice is contained on the first page. In addition, each time you register at or are admitted to the hospital for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.

QUESTIONS ABOUT THIS NOTICE. You may refer questions about this notice to your health care provider. Remaining questions may be referred to the Health Center's Privacy Officer.

COMPLAINTS. You will not be penalized for filing a complaint. If you believe your privacy rights have been violated, you may file a complaint with the Health Center or with the Secretary of the Federal Department of Health and Human Services (DHHS).

  • To file a complaint with the Health Center, contact the Director of Patient Relations at 860-679-3176. All complaints must be submitted in writing.
  • To file a complaint with the DHHS, you must file in writing (electronic or paper), within 180 days of when you knew, or should have known of the problem. Send your complaint to:

    DHHS Regional Manager, Office for Civil Rights
    U.S. Department of Health and Human Services Government Center
    J.F. Kennedy Federal Building - Room 1875
    Boston, Massachusetts 02203
    Voice phone: 617-565-1340
    FAX: 617-565-3809
    TDD: 617-565-1343

OTHER USES OF MEDICAL INFORMATION. Other uses and disclosures of medical/dental/billing information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose medical/dental/billing information about you, you may revoke it, in writing, at any time. If you revoke it, we will no longer use or disclose medical/dental/billing information about you for the reasons covered by your written authorization, unless required by law. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you.