Privacy Notice Highlights

This notice highlights how we may use and disclose health information we have about you and how you can get that information. Accompanying this short notice is our complete privacy notice containing details about our current privacy practices. Please refer to that notice for additional information.

SCOPE

This notice applies to Moses Cone Health System, including all of its facilities and services, and to those who provide care through Moses Cone Health System.

USES AND DISCLOSURES

As explained in our complete privacy notice, some of the ways we may use and share health information about you are:

For treatment, payment, business and administrative activities.

To inform you about our health-related benefits and services.

To recommend other treatments and health-care providers.

For public health activities.

For other proposed uses and disclosures, except as required or permitted by law, we will explain the use or disclosure and ask your permission as necessary.

YOUR CHOICES

For other proposed uses and disclosures, except as required or permitted by law, we will explain the use or disclosure and ask your permission as necessary. Unless you tell us otherwise, we may include your name, location, general condition and religious affiliation in our patient directory. This information may be released to people who ask for you by name.

Unless you object, we may disclose medical information about you to a friend or family member who is involved in your medical care.

Unless you object, we may use our professional judgment to disclose necessary information to an agency assisting in disaster relief.

You have a 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, or at a mailing address other than your home address.

Unless you object, we may disclose medical information to contact you as a reminder that you have an appointment for medical care.

If you want to place restrictions on ANY information, you must request a restriction form from the individual who handled your registration.

YOUR RIGHTS

You may:

Review, copy and ask us to amend certain health information we have about you.

Ask us to deliver health information to an alternative address.

Ask us not to share your information with certain family members or friends.

Ask us for certain disclosures we have made of that information.

HOW TO REACH US

For general information, please call (336) 832-7000 If you have questions or concerns about your privacy or care, call our Privacy Officer at (336) 832-7075 or the Service Excellence Department at (336) 832-7090. The Privacy Officer may also be reached by e-mail at privacy.officer@mosescone.com or write to:
Privacy Officer, Audit and Compliance Services
Moses Cone Health System
1200 N Elm St, Greensboro, NC 27401 78497 (4/06)

MOSES CONE HEALTH SYSTEM
JOINT NOTICE OF PRIVACY PRACTICES

EFFECTIVE DATE: April 17, 2006 (Third Edition)

THIS JOINT NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND SHARED AND HOW YOU CAN GET THIS INFORMATION. PLEASE READ IT CAREFULLY. If you have any questions about this notice, please contact the Moses Cone Health System Privacy Officer at (336) 8327075.

THE PURPOSE OF THIS NOTICE

We are committed to protecting medical information about you. We are required by law to make sure that medical information that identifies you is kept private, give you this notice of our legal duties and privacy practices at Moses Cone Health System (hereafter referred to as the “health system”) with respect to medical information about you, and follow the terms of the notice that is currently in effect.

WHO WILL FOLLOW THIS NOTICE This notice describes how the health system practices at all its locations and that of:

Any independent health-care professional who is on the Medical Staff and allowed to enter information into your medical record.

All departments and units of the health system.

Any member of a volunteer group we allow to help you while you are in the health system.

All employees, staff and other people.

All students, trainees or volunteers at the health system.

All these people, entities, sites and locations follow the terms of this notice. Also, these people, entities, sites and locations may share medical information with each other for your treatment or the health system operations purposes and the purposes described in this notice. The independent health-care professionals who give care at the health system and who have agreed to follow the terms of this Notice may not be employees or agents of the health system, and the health system is not responsible for how they treat the patients.

This notice applies to all of the records of your care and billing for care that is given at the health system, whether this care is given by the health system personnel or your independent personal doctor or other independent health-care personnel, who are responsible for their own actions. Your personal doctor or other independent health-care personnel treating you may have different policies or notices regarding confidentiality and sharing of your medical information that they use in their office or other location outside the health system.

HOW WE MAY USE AND SHARE MEDICAL INFORMATION ABOUT YOU

For Treatment. The following categories describe different ways that we use and share medical information. For each category of uses or sharing we will explain what we mean and try to give some examples, but not every use or disclosure is listed. We may use medical information about you among the persons in the health system involved in your care to provide you with needed medical treatment, items or services, such as prescriptions, lab work and surgery. We may use and share medical information to tell you about different ways to treat you, or health-related benefits or services that may be of interest to you. We also may need to share medical information about you to people outside the health system who may be involved in your medical care before or after you leave the health system, such as family members, other health care facilities, labs, home health agencies or medical equipment companies. We will only share, with your permission, medical information about you with people outside the health system who are not currently involved in your care at the health system, or if sharing is required or allowed by law. We may also use and share medical information to tell you about or recommend different ways to treat you.

For Payment. We may need to use and share medical information about you so that the treatment and services you get at the health system or as given by other providers may be billed by the health system or other independent providers and payment may be collected from you, an insurance company or health plan, or a third party. For example, we may need to give your insurance company or health plan information about surgery you received at the health system so your insurance company or health plan will pay us or pay you back for the surgery. We also may tell your insurance company or health plan about a treatment that requires prior approval or to see if your insurance company or health plan will cover the treatment. To obtain payment, we will only share, with your permission, medical information about you that identifies you to people outside the health system who are not currently involved in your care at the health system, or if sharing is required or permitted by law.

For Health-Care Operations. Our staff and business associates may use and share medical information about you for health system operations. These uses and sharing of information are needed to run the health system and make sure that all of our patients get good care. For example, we may use medical information to review our treatment and services and to evaluate the qualifications and performance of our staff and medical staff in caring for you. We also may combine medical information about many health system patients to decide what other services the health system should offer, what services are not needed and whether certain new treatments work. We also may share information with health system personnel, doctors and students for teaching purposes. We also may combine the medical information we have about you and other patients with medical information from other health systems to compare how we are doing and learn how we can make our care and services better. We will remove information that identifies you from this set of medical information so others may use it to study health care and health-care delivery without learning who you are. We will only share, with your permission, medical information about you that identifies you to people outside the health system who are not involved in operations of the health system or if sharing is required or permitted by law.

Appointment Reminders. We may use and share medical information to contact you as a reminder that you have an appointment for treatment or medical care at the health system. We will leave a message for you at any telephone number or email address you give us stating the time of the appointment and the name of the person with whom you have the appointment unless we have agreed in writing to your written request to handle appointment reminders differently.

Health-Related Benefits and Services. We may use and share medical information to tell you about health-related benefits or services that may be of interest to you.

Fund-raising Activities. We may share information about you with people or organizations that are involved in fund-raising activities by or for the benefit of the health system. We may share medical information with a business partner or a foundation related to the health system so that the business partner or the foundation may contact you in raising money for the health system. We only would release contact information, such as your name, address and phone number and the dates you received treatment or services at the health system. If you do not want the health system to contact you for fund-raising efforts, you must notify the health system’s Privacy Officer in writing or indicate your choice on the health system restriction form or fundraising mailing.

The Directory. Unless you object, we may include certain limited information about you in the health system directory while you are a patient at the health system. This information may include your name, location in the health system, your general condition (e.g., good, fair, serious, critical, etc.) and your religion. The directory information, except for your religion, may also be given to people who ask for you by name. Your religion 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 call or visit you in the health system and find out how you are doing. If you do not want to be in the directory or do not want anyone to know your condition or your religion, you must notify the health system’s Privacy Officer in writing or indicate your choice on the health system’s Standard Restrictions Form.

Individuals Involved in Your Care. Except as explained above concerning information given in connection with the health system Directory, unless you object, we may share medical information about you with a friend or family member who is involved in your medical care. Also, we may share medical information about you with a business assisting in a disaster-relief effort so that your family can be told about your condition, status and location. You can object to the sharing of this information by telling us that you do not wish any or all people involved in your care to get this information. If you are not there or cannot agree or object, we will decide whether it is in your best interest to share needed information with someone who is involved in your care or with a person or business assisting in a disaster-relief effort.

Individuals Involved in the Payment for your Care (spouse or other responsible party). If you have agreed to our sharing of medical information for the purpose of getting payment for the care provided to you, this sharing also may mean giving information to other family members who are also insured on your insurance policy or to someone who helps pay for your care, and your agreeing to this allows us to share information with these people.

Research. Sometimes, we may use and share medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who got one medication to those who got another for the same problem. All research projects will require you to agree to it in writing if the researchers will know who you are.

As Required By Law. We will share medical information about you when we have to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use and share medical information about you when we have to in order to prevent a serious threat to your health and safety or the health and safety of the public or another person. The information shared, however, would only be to someone able to help prevent the threat.

SPECIAL SITUATIONS

Organ and Tissue Donation. We are required by law to give out medical information concerning deceased patients to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, so that they can determine organ or tissue donation potential. If you are an organ or tissue donor, by law, we also have to provide medical information about you after your death to the person or organization that gets the organ or tissue donation.

Workers’ Compensation. We may give out, without having you agree, medical information about you for workers’ compensation or similar programs under certain circumstances. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may share medical information about you for public health activities, without your permission. These activities generally include the prevention or control of disease, injury, or disability, to report births and deaths, to report suspected abuse or neglect as required by law, to report reactions to medications or problems with products, to notify people of recalls of products they may be using and to notify a person who may have been exposed to a disease or may be at risk for getting or spreading a disease or condition.

Health Oversight Activities. We may share, without your permission, medical information to a health oversight agency for activities prescribed by law. These activities include audits, investigations, inspections, and licensure. They are necessary for the government to check on 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 share medical information about you because of a court or administrative order. We also may share medical information about you because of a subpoena or other lawful process by someone else involved in the dispute by giving your medical records or information under seal to the court. The parties to the case or their attorneys may only open the copies of your medical record under seal, unless a judge orders otherwise.

Law Enforcement. We may give out your medical information without your permission if asked to do so by a law enforcement official in response to a court order, grand jury demand or search warrant, about a death or injury we believe may be the result of a crime or about suspected criminal conduct at the health system.

Coroners, Medical Examiners and Funeral Directors. We may give out your medical information to a coroner or medical examiner without your permission. This may be necessary, for example, to identify a deceased person or to figure out the cause of death. We also may give out medical information about patients of the health system to funeral directors as needed to carry out their duties.

Security, Intelligence Activities and Protective Services. We may give out your medical information without your permission to authorized federal or state officials for intelligence, counterintelligence and other governmental activities prescribed by law to protect our national security.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we are required to give out medical information without your permission to the correctional institution or law enforcement official who has custody of you if necessary for the health system to provide you with health care, to protect your health and safety, to obtain payment or for operations of the health system.

Behavioral Health Care. Regardless of the other parts of this Notice, any information relating to alcohol and drug treatment or other behavioral health care treatment, including psychotherapy notes, will not be disclosed outside the health system except with your written permission, because of a court order, or as required by law. Private notes that the licensed mental health professional has decided to make about a session with you, keep in his or her personal files, and label as psychotherapy notes will not be shared to people working within the health system, other than to the person who wrote the notes, except for training reasons or to defend a legal action brought against the health system, unless you have given permission in writing.

Minors. A parent, guardian, or other person with authority to act in loco parentis has authority to have and decide how to use the protected health information concerning a minor patient, except:
(1) In circumstances when the law provides otherwise, such as suspected abuse or neglect of a minor.
(2) The minor has the right to get health care and protected health information on his or her own behalf when seeking outpatient treatment for the outpatient diagnosis or treatment of emotional illness, the diagnosis or treatment of pregnancy (not abortion), and the diagnosis or treatment of sexually transmitted diseases. In these circumstances, however, the health system may choose to share such information with the parent or guardian if the parent or guardian contacts the health system and wants such information.

OTHER USES OF MEDICAL INFORMATION

All other information that is shared that is not addressed in this notice will be made only after you give your written permission or as required by law. You may change your mind and take back your permission in writing at any time. We will stop sharing this information the day that this request is received in writing by our Privacy Officer.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU

You have the following rights regarding medical information we keep about you:

Right to Look At and Copy. You have the right to look at and get a copy of medical information that may be used to make decisions about your care, unless your treating physician decides that giving you such information would be harmful to your well-being. When we do not allow you to look at and get a copy of your medical information, you may ask that the denial be reviewed. Another licensed health-care professional chosen by the health system will review your request and the denial. The person looking at the review will not be the person who denied your request. We will do what this reviewer decides. To look at and get a copy of medical information that may be used to make decisions about you, you may ask for the copy in writing from the health system’s Privacy Officer. If you ask for a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies needed for your request and may get the fee before giving the copy to you. If you agree, we may give you a summary of the information instead of giving you access to it, or provide an explanation of the information instead of a copy. Before giving you such a summary or explanation, we first will get your agreement to pay the fees, if any, for preparing the summary or explanation.

Right to Amend. If you feel that medical information we have about you is not right, you may ask us to change the information for as long as the information is kept by the health system. We may charge and collect a fee before we give you a copy. You must ask for this in writing and send it to the health system’s Privacy Officer. You must also give us your reasons for asking for the change.

We may decide to not make changes if you ask us to change information that is not in writing, does not include a reason why you are asking for the change, was made by another provider (inpatient or outpatient care center or a doctor, nurse or pharmacist who is not an employee of the health system). If a doctor, nurse or pharmacist is no longer available to ask for changes, then we can review your request with this in mind. We may also deny changes to information that is not part of the medical information kept by the health system, is not part of the information which you would be allowed to see and copy or has been found to be accurate and complete.

Right to know what has been shared. You have the right to ask for a list of what medical information has been shared about you. This does not include information for treatment, payment, health care operations or information that you gave your consent to share. You must ask for it in writing to the health system’s Privacy Officer. You must state a time period that may not be longer than six years and may not include dates before April 14, 2003. You should include in your request, the form in which you want the list (on paper or electronically). The first list you get within a 12-month period will be free. For additional lists, we may charge and collect a fee.

Right to Request Restrictions. If we do agree, we will act on your request unless the information is needed to give you emergency treatment or to share information as required by law. You must make your request in writing and send to our Privacy Officer. In your request, you must tell us what information you want to limit, whether you want to limit information shared inside the health system, outside the health system, or both, and who do you want the limits to apply to. For example, do you want to limit sharing information with your spouse?

Right to Ask for a Different Type of Communication. You have the right to ask that we tell you about medical matters in a certain way or at a certain place. For example, you can ask that we only contact you at work or by mail, or at a mailing address other than your home address. To request certain types of communications, you must make your request in writing to our Privacy Officer and specify how or where you wish to be contacted. We will not ask you the reason for your request. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice or any new notice. You may ask us to give you a copy of this notice at any time or you may get a copy of this notice at our Web site, www.mosescone.com. To obtain a paper copy of this notice, contact the Privacy Officer at (336) 832-7073.

CHANGES TO THIS NOTICE

We can change this notice and make the changed notice effective for medical 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 at the health system.

COMPLAINTS

If you have a complaint about your privacy rights, contact our Privacy Officer at (336) 832-7075. You may also send a written complaint to the Secretary of the United States Department of Health and Human Services. Complainants will not be penalized.