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OUR PLEDGE REGARDING YOUR HEALTH
INFORMATION
East Jefferson General Hospital is dedicated to protecting
your personal health information. We take those precautions
reasonably necessary to ensure your health information is
held in confidence and only used by and disclosed to those
who have a justifiable need to know. When you receive care
at East Jefferson General Hospital we create a record set
necessary for:
- your care and treatment
- our actions related
to receiving payment for your treatment
- management of our hospital
operations related to your treatment.
REQUIRED BY LAW
This notice applies to how we may use and disclose your
health information in connection with receiving care at
EJGH. It also describes your rights with respect to your
personal health information. We are required by law to:
- make sure that medical
information that identifies you is treated confidentially
- give you this Notice
of our legal duties and privacy practices with respect
to your medical information
- follow the terms of
the Notice currently in effect.
WHO WILL FOLLOW THIS NOTICE
- All East Jefferson
General Hospital (EJGH) employees and volunteers including
employees of the East Jefferson Physicians Network which
is wholly owned by EJGH
- Physicians with privileges
at EJGH including contract physicians and other health
care professional contract services including but not
limited to emergency medicine, pathology, anesthesiology,
radiation oncology, radiology, pulmonology and cardiology
services.
- Health care professionals
and others who are not employees of EJGH but who are authorized
to enter information into the EJGH records system or authorized
to use your health information already contained in the
EJGH records system for treatment, payment or operations
including Business Associates of EJGH.
Health records may be created, used and disclosed by your
personal doctor and other health care professionals who
treat you at EJGH but who are not EJGH employees. These
direct care providers have agreed to follow EJGH's privacy
practices while you are a patient at the hospital. However
they may have different policies regarding use and disclosure
of your health information created, used or stored in
their personal offices or clinics.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION
ABOUT YOU
The following categories describe different ways we use
and disclose medical information. For each category of uses
or disclosures we explain what we mean and give some examples.
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 medical
treatment or services. We may disclose medical information
about you to doctors, nurses, technicians, medical students,
or other EJGH personnel who are involved in taking care
of you. For example, a doctor treating you for flu may
need to know if you have other health conditions that
need to be considered in your treatment. Also, different
departments of EJGH may share your health information
in order to coordinate the different things you need,
such as prescriptions and lab work. With your authorization,
we also may disclose your health information to new providers
outside EJGH who may be involved in your health care after
you leave the hospital, such as home care service or others
you chose to provide services.
We may also provide your physician or a subsequent healthcare
provider with copies of various reports to assist in treating
you once you have been discharged from this hospital.
- For Payment We
may use and disclose health information about you so that
the treatment and services you receive at EJGH may be
billed and payment collected from you, an insurance company
or a third party. For example, we may need to give your
health insurance plan information about treatment you
received at EJGH so your health insurance plan will pay
us for the treatment. We also may 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 proposed treatment.
- For Health Care Operations
We may use and disclose your health information for EJGH
operations. These uses and disclosures are necessary to
run EJGH and to make sure all of our patients receive
quality care. This may include an assessment of your satisfaction
with our services. For example, we may use medical information
to evaluate the performance of our staff in caring for
you. We may also combine health information about many
EJGH patients to decide what additional services we should
offer, what services are not needed, and whether certain
new treatments are effective. We also may disclose information
to doctors, nurses, technicians, medical students, and
other EJGH personnel for review and learning purposes.
We may remove the information that personally identifies
you from this set of health information so others may
use it to study health care and health care delivery without
knowing anything about you.
- Appointment Reminders
We may use and disclose health information to contact
you as a reminder that you have an appointment for treatment
at EJGH.
- 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 or services
that may be of interest to you.
- Future Communications
We may communicate with you via newsletters, mail or other
means regarding treatment options, health related information,
disease-management programs, wellness programs or other
community based initiatives or activities our facility
is participating in.
- Fundraising Activities
We may disclose contact information to the East Jefferson
General Hospital Foundation so that the foundation may
contact you in its money raising efforts for the hospital.
Contact information consists of your name, address and
phone number and the dates you received treatment or services
at EJGH. If you do not want the East Jefferson General
Hospital Foundation to contact you for fundraising, you
must notify the EJGH Privacy Office, 4200 Houma Boulevard,
Metairie, LA, 70006 in writing of your preference.
- Hospital Directory
While you are a patient, we may include certain limited
information about you in a Hospital Directory. This information
may include your name and information related to visiting
you and may be released to people who ask for you by name.
Your religious affiliation may also be released to members
of the clergy, such as a priest, minister or rabbi, who
share your religious affiliation. If you do not want the
hospital to include your information in the Directory
you must advise the Registration personnel of your preference.
- Individuals Involved
in Your Care or Payment for Your Care We may release
health information about you to a family member or friend
who is involved in your care. We also may tell your family
or friends that you are in the hospital and your medical
condition. We also may give information to someone who
helps pay for your care. You have the right to object
to such disclosures. If you are incapacitated, we will
exercise professional judgment and act in your best interest
in making disclosure of your health information to family
members or friends involved in your care.
- Business Associates
There are some services provided in our organization through
contracts with business associates. Some examples of these
include physician services for certain laboratory tests,
a billing service for our owned physician practices, and
a copy service we use when making copies of your health
record. These business associates may have access to your
health information so that they can perform the job we've
asked them to do on our behalf. To protect your health
information, however, we require them to agree to safeguard
your information in their possession.
- Disaster Relief
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.
- Research Under
certain circumstances, we may use and disclose health
information about you for research purposes. For example,
a research project may involve comparing the health and
recovery of all patients with the same medical condition
who received one medication to those who received another
medication. All research projects are subject to a special
approval process. This process evaluates a proposed research
project and its use of health information to ensure patient
health information is only used and disclosed as necessary
for the research project. Normally we use or disclose
health information for research only after the project
has been approved through the research approval process.
However, we may disclose health information about you
to researchers to help them identify patients with specific
medical needs. In these pre-research actions, we will
not allow researchers to copy or otherwise transmit your
identifiable health information outside EJGH.
- As Required By Law.
We will disclose medical 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 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 someone authorized to receive
it.
SPECIAL SITUATIONS FOR RELEASE OF
HEALTH INFORMATION
- Military and Veterans.
If you are a member of the armed forces, we may release
health information about you as required by military command
authorities. We may also release health information about
foreign military personnel to the appropriate foreign
military authority. If you are a member of the Armed Forces,
we may disclose health information about you to the Department
of Veterans Affairs upon your separation or discharge
from military services. This disclosure is necessary for
the Department of Veterans Affairs to determine if you
are eligible for certain benefits.
- Workers' Compensation
and Disability Insurance. We may release medical information
about you for workers' compensation, disability insurance
or similar programs. These programs provide benefits for
work-related injuries or illness.
- Public Health Risks.
We may disclose medical 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
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
the victim of abuse, neglect or domestic violence.
We will only make this disclosure if you agree or
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 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 health information about you in response to a
court or administrative order. We may also disclose health
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 or your representative to afford you the opportunity
to obtain an order protecting the information requested.
- Law Enforcement.
We may release health information if asked to do so by
a law enforcement official:
- 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 or affecting EJGH;
- 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, Medical
Examiners and Funeral Directors. We may release health
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 health
information about a deceased person to funeral directors
as necessary to carry out their duties.
- Organ and Tissue
Donation. If you are a possible organ or tissue donor,
we may release medical 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.
- 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.
- Protective Services
for the President and Others. We may disclose medical
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.
- 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
for the following:
- for the institution
to provide you with health care;
- to protect your
health and safety or the health and safety of others;
or
- for the safety and
security of the correctional institution.
YOUR RIGHTS REGARDING MEDICAL INFORMATION
ABOUT YOU
You have the following rights regarding medical information
we maintain about you:
- Right to Inspect
and Copy. You have the right to inspect and copy medical
information that may be used to make decisions about your
care. Usually, this includes medical and billing records.
To inspect and copy medical information that may be used
to make decisions about you, you must submit your request
in writing to the EJGH Health Information Management Department,
4200 Houma Boulevard, Metairie, LA, 70006 or East Jefferson
Physician Network, 4200 Houma Boulevard, Metairie, LA,
70006. You do not have to provide any justification to
exercise this right. If you request a copy of your health
information, EJGH may charge a fee for the costs of copying,
mailing or other expenses associated with your request.
We may deny your request to inspect and copy in certain
very limited circumstances. If you are denied access to
your health information you may appeal the denial. Your
appeal will be considered by a licensed health care professional
chosen by EJGH and not previously involved in the denial
of your original request for inspection and copy. EJGH
will abide by the decision of the appeal reviewer.
- 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 EJGH.
To request an amendment, your request must be made in
writing and submitted to the EJGH Health Information Management
Department or for records maintained by the EJPN physicians,
sent requests to East Jefferson Physician Network, 4200
Houma Boulevard, Metairie, LA, 70006. You must provide
justification and documentation that supports your amendment
request. We may deny your request for an amendment if
it is not in writing or does not include sufficient justification
and documentation to support the request. In addition,
we may deny your request if you ask us to amend information
that:
- Was not created
by us or the person or entity that created the information
is no longer available to make the amendment;
- Is not part of the
medical information kept by or for EJGH;
- Is not part of the
information which you would be permitted to inspect
and copy; or
- Is accurate and complete.
If your request to amend is denied, your written statement
of disagreement and your original request for amendment,
denial, and any rebuttal will be filed in the designated
record.
- Right to an Accounting
of Health Information Disclosures. We maintain a record
of disclosures of your health information that are made
outside the purposes of treatment, payment and operations
or without your authorization. We generally classify these
type disclosures as "non-routine" and we control
and track such disclosures. To request an accounting of
these "non-routine" disclosures, you must submit
your request in writing to EJGH Health Information Management
Department, 4200 Houma Boulevard, Metairie, LA, 70006.
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 prefer the accounting (paper, electronic or other
form). The first accounting you request within a twelve
(12) month period will be provided free of charge. For
additional accountings within a twelve (12) month period,
we may charge you for the costs of providing the accounting.
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 operations. You also
have the right to request a limit on the health 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 disclose
information to them about your treatment at EJGH. To request
restrictions, you must make your request in writing to
EJGH Privacy Office, 4200 Houma Boulevard, Metairie, LA,
70006 or East Jefferson Physician Network, 4200 Houma
Boulevard, Metairie, LA, 70006. In your request, you must
tell us:
- what information
you want to limit;
- whether you want
to limit our use, disclosure or both; and
- to whom you want
the limits to apply, for example, disclosures to your
spouse.
We are not required to agree to your request. If we
do agree, we will comply with your request but only
to the extent that we have not already acted or unless
the information is needed to provide you emergency treatment.
- 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 EJGH Privacy
Office, 4200 Houma Boulevard, Metairie, LA, 70006 or East
Jefferson Physician Network, 4200 Houma Boulevard, Metairie,
LA, 70006. Your request must specify how or where you
wish to be contacted. You do not have to provide the reason
for your request. East Jefferson General Hospital will
honor all reasonable requests. Your request will not be
accepted however if it unreasonably interferes with our
efforts to collect for services already rendered.
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Right to a Paper Copy of This Notice. You have
the right to a paper copy of this notice. You may ask
for a copy of this notice at any time. To obtain a paper
copy of this notice, contact the EJGH Privacy Office,
4200 Houma Boulevard, Metairie, LA 70006. You may obtain
an electronic copy of this notice at our website, www.eastjeffhospital.com
Even if you have an electronic version of the Notice,
you are still entitled to a paper copy.
CHANGES TO THIS NOTICE
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 health information we create in the future. We will
post a copy of the current notice at appropriate patient
access points in our treatment facilities. The notice will
contain its effective date on all pages. In addition, each
time you register at or are admitted to East Jefferson General
Hospital for treatment as an inpatient or outpatient, you
will have an opportunity to receive a copy of the current
notice.
COMPLAINTS
If you believe your privacy rights have been violated,
you may file a complaint with the East Jefferson General
Hospital Privacy Officer or with the U.S. Secretary of the
Department of Health and Human Services. Complaints submitted
to the EJGH Privacy Officer must be in writing and may be
mailed or hand delivered to EJGH Privacy Officer, 4200 Houma
Boulevard, Metairie, LA, 70006. You must include your contact
information in your request. The Privacy Officer will contact
you about the complaint promptly after it is received. Your
complaint actions will be held in the strictest confidence.
Additionally, East Jefferson General Hospital will not take
any actions to discourage you from filing a complaint nor
will we act against you in any way if you file a complaint.
AUTHORIZATION FOR OTHER USES OF YOUR MEDICAL
INFORMATION
Other uses and disclosures of medical information, not
covered by this notice or otherwise required by law will
be made only with your written authorization.
- EJGH has a specific
authorization form that identifies all of the required
information necessary for a valid authorization to release
your health information that requires your signature or
the signature of your legally authorized personal representative.
- We caution you about
authorizing release of your health information. You should
always make sure you fully understand the purposes for
the authorization and how your health information will
be protected by the organization or individual you authorize
to receive your health information. When EJGH acts on
your authorization for use and disclosure of your health
information, we are not responsible for how that information
may be used by others after it is disclosed.
- EJGH will require detailed
justification for any authorization that requests the
disclosure of your complete medical record. We are required
to do this by law.
If you provide us authorization to use or disclose your
medical information you may revoke the authorization at
any time. You may revoke your authorization by writing
to the EJGH Health Information Management Department,
4200 Houma Boulevard, Metairie, LA, 70006 or if this relates
to an authorization given to a physician in EJPN, by writing
to East Jefferson Physician Network, 4200 Houma Boulevard,
Metairie, LA, 70006. If you revoke your authorization,
we will no longer use or disclose medical information
about you for the reasons covered by your original written
authorization except to the extent we have already acted.
We will be unable to take back any disclosures already
made based on your original authorization.
Questions about this notice should
be directed to the East Jefferson General Hospital Privacy
Officer who can be reached by calling 504-454-4000.
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