COLLEGE OF ST BENEDICT
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
The College of St. Benedict and the CSB Health Center value the privacy of its patients and the confidentiality of the personal and health information entrusted to us. In order to protect your personal health information, we have policies and procedures regarding disclosing your Personal Health Information (PHI).
This organization is required by law to:
•· Maintain the privacy of your health information
•· Provide you with this Notice as to our legal duties and privacy practices with respect to your health information
•· Abide by the term of this Notice
•· Notify you if we are unable to agree to a requested restriction
•· Accommodate reasonable requests you may have to communicate health information by alternative means or at alternate locations
NOTICE OF CHANGE TO PRIVACY PRACTICES:
If we make a change in our privacy practices, we will change this notice and make the new notice available upon request. We will not use or disclose your health information without your authorization, except as described in this notice.
Examples of Disclosures for Treatment, Payment and Health Operations
Potential disclosures for an individual's information include:
•1. Medical treatment: Medical and personal information may need to be shared with health care providers such as medical practitioners, nurses, pharmacists, health educators, dietitians, medical records and clinic clerical personnel, and medical technologist (laboratory, radiology, and pharmacy) in order to provide effective and efficient care. Members of training groups may also have access to this information while in the facility, i.e. flu vaccine clinics.
•2. Information Technology Services has access to the electronic medical record system for the sole purpose of providing technology support.
•3. Payment: Unless they are paid for at the time the service is rendered, the CSB Health Services will send the charge(s) to the Business Office to be processed. The bill will show the following health information: name, student identification number, and date of service. No medical diagnoses, procedure or medications will be on this document. The bill will be documented as "Health Services Charge". You may choose to pay cash directly to Health Services at the time of service, if desired.
Itemized billing statements that include health information as set forth above as well as diagnoses, procedures, and/or medications will be released to the patient or the patient's designated representative only upon the request and with the written consent of the patient.
•4. Oversight activities: Oversight includes internal and external audits, chart reviews, investigations, licensures, and inspections required for compliance with government, college, and accreditation programs and laws as well as the Health Center's quality assurance/risk management programs. Only the minimal necessary information will be released. However, on occasion, these reviews will involve sighting of individual information by the auditor, accreditation examiners, etc. All individuals performing these reviews, audits, etc. will be required to agree with and sign the non-disclosure confidentiality standards of the Health Services before being allowed access.
•5. Public health and safety: Health information may be disclosed as required by law to the proper authorities to report deaths, certain infectious diseases, occupational injuries and diseases, child abuse/neglect, domestic violence, problems with medications and other products as required by law to prevent/control disease, injury or disability to the patient or to others.
•6. Legal requirements: Health information may be disclosed as required by court or administrative order, subpoena, discovery request, or other lawful process. It may also be disclosed when legally requested by national security, intelligence, and other federal officials.
•7. Contacts: CSB Health Services may be in contact with the patient to provide information of health-related services or benefits that may be of interest to the patients. Notices that do not disclose specific Protected Health Information may be provided to patients via voice mail and/or campus e-mail. Unless the patient withdraws consent in writing, protected Health Information will be made available to the patient via a secure Health Services student portal established for each student.
•8. Serious threat to health or safety: The CSB Health Services may use and disclose your individual health information when necessary to reduce or prevent a serious threat to your individual health or the public.
•9. Other uses: CSB Health Services may contact patients by phone, utilizing a cell phone number if you provide us with that number and authorize the contact. Health Services may also contact patients via campus e-mail to confirm scheduling, but not provide information concerning your care or any other private health information. When cell phone contact is unavailable, this email system will only be used to notify the patient to call CSB Health Services.
YOUR INDIVIDUAL RIGHTS
You have a Right to:
•1. Look at or obtain copies of your health information. You must make your request in writing. You may request access by sending a letter to the CSB Health Services. A cost based fee may be charged for copying medical records.
•2. Request additional restrictions are placed on our use of disclosure of your medical information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in the case of an emergency).
•3. Request we communicate with you about your health information by different means or to different locations. Your request that we communicate your health information to you by different means or to different locations must be made in writing to the CSB Health Services.
•4. Request that we change your medical information. We may deny your request if we did not create the information you want changed or for certain other reasons. If we deny your request, we will provide you a written explanation. You may respond with a statement of disagreement that will be added to the information you wanted changed. If we accept your request to change the information, we will make reasonable efforts to tell others, including people you name, of the change and to include the changes in any future disclosing of that information.
OUR DUTIES ARE TO:
Maintain the privacy of your health information.
•1. Provide you with notice as to your legal duties and privacy practices with respect to information we collect about you through this Notice.
•2. Abide by the terms of this Notice.
•3. Notify you if we are unable to agree to a requested restriction.
•4. Accommodate reasonable requests you have to communicate health information by alternative means or at alternative locations.
Changes to This Notice:
•· The CSB Health Services reserves the right to change its privacy practices.
•· If the Notice changes, you will be advised of the changes.
The patient Notice of Privacy Practice will be available in the CSB Health Center lobby, on the CSB Health Services public web site at www.csbsju.edu/csbhealthcenter. Copies of the Notice may be obtained by requesting them at reception desk.
Information and complaints: Patients may file complaints regarding the security and/or privacy of their personal health information with:
Michael Ewing, PhD Mary Geller
Director of CSB Health Center Vice President, Student Development
College of St. Benedict College of St. Benedict
37 South College Ave. 37 South College Ave.
St. Joseph, MN 56374 St. Joseph, MN. 56374
320-363- 5605 320-363-5601
If you believe your privacy rights have been violated, you can file a complaint with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
Effective Date: August 3, 2009 A 1.1
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