Huntsman Cancer Hospital (HCH) and University of Utah Health Sciences Center
NOTICE OF PRIVACY PRACTICES
Effective: April 14, 2003

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.

Privacy Promise

HCH understands that your medical and health information is personal. Protecting your health information is important. We follow strict federal and state laws that require us to maintain the confidentiality of your health information.

How We Use Your Health Information

When you receive care from HCH, we may use your health information for treating you, billing for services, and conducting our normal business known as health care operations. Examples of how we use your information include the following:

Treatment - We keep records of the care and services provided to you. Health care providers use these records to deliver quality care to meet your needs. For example, your doctor may share your health information with a specialist who will assist in your treatment. Some health records, including confidential communications with a mental- health professional and substance abuse records, may have additional restrictions for use and disclosure under state and federal law.

Payment – We keep billing records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment from you, your insurance company, or another third party. We may also contact your insurance company to verify coverage for your care or to notify them of upcoming services that may need prior notice or approval. For example, we may disclose health information about the services provided to you to claim and obtain payment from your insurance company or Medicare.

Health care operations – We use health information to improve the quality of care, train staff and students, provide customer service, manage costs, conduct required business duties, and make plans to better serve our communities. For example, we may use your health information to evaluate the quality of treatment and services provided by our physicians, nurses, and other health care workers.

Sharing Your Health Information

In certain limited situations, we are permitted or required to disclose health information without your signed authorization (permission):

• for public health purposes such as reporting communicable diseases, work-related illnesses, or other diseases and injuries permitted by law; reporting births and deaths, and reporting reactions to drugs and problems with medical devices
• for protection of abuse, neglect, or domestic violence victims
• for health oversight activities such as investigations, audits, and inspections
• for lawsuits and similar proceedings
• when required by law
• when requested by law enforcement as required by law or court order
• for coroners, medical examiners, and funeral directors
• for organ and tissue donation
• for research approved by our review process under strict federal guidelines
• for reduction or prevention of serious threats to public health and safety
• for workers’ compensation or other similar programs if you are injured at work
• for specialized government functions, such as intelligence and national security

All other uses and disclosures not described in this notice require your signed authorization. You may revoke your authorization at any time with a written statement submitted to the Health Information department.

Our Privacy Responsibilities

HCH accepts these responsibilities:

• maintaining the privacy of your health information
• providing this notice that describes the ways we may use and share your health information
• following the terms of the notice currently in effect

We reserve the right to make changes to this notice at any time and apply the new privacy practices to all information we maintain. Current notices will be posted in HCH and UUHSC facilities and on our website, http://uuhsc.utah.edu/privacy/. You may also request a copy of this notice, or a more detailed notice, from Customer Service or registration.

Your Individual Rights

You have specific rights concerning your health information. You may:

• request special restrictions on how we use and share your health information. We will consider all requests for special restrictions carefully but are not required to agree to any restriction.*
• request that we use a specific telephone number or address to communicate with you. You may request this during registration.*
• inspect and receive a copy of your health information, including medical and billing records. Fees may apply. Under limited circumstances, we may deny you access to a portion of your health information and you may request a review of the denial.*
• request an amendment to your health information.*
• request an accounting of certain disclosures we make of your health information, not including disclosures for treatment, payment, and health care operations and some disclosures required by law. Your request must state the period of time requested for the accounting. An accounting goes back only six years and does not cover disclosures made prior to April 14, 2003. The first accounting is free, but a fee will apply if more than one request is made in a 12-month period.*
• request a paper copy of this notice even if you agree to receive it electronically.

Requests marked with a star (*) must be made in writing. Contact the Health Information Department at (801) 587-3887 or visit our web site at http://uuhsc.utah.edu/privacy/ for the appropriate form for your request.

Other Services We Provide

We may also use your health information to:

• recommend treatment alternatives
• tell you about health services and products that may benefit you
• share information with family or friends directly involved in your care or in paying for your care
• share information with third parties who assist us with treatment, payment, and health care operations. Our business associates must follow our privacy practices.
• remind you of an appointment. You may notify the scheduler if you do not wish to be reminded.
• include you in our patient directory for callers, visitors, and the clergy, if you are admitted to one of our inpatient facilities You may notify the admitting clerk if you do not wish to participate in the directory or have clergy visit you. If you opt out of the directory, UUHSC will be unable to provide information to your family, friends, or others who ask for you by name. Note that information about patients receiving psychiatry or substance abuse treatment will not be included.

The UUHSC is a charitable institution with a threefold mission of patient care, research, and teaching. To further this mission, we may wish to contact you occasionally for fundraising purposes. If you do not wish to be contacted for this purpose, please notify the UUHSC Development office in writing at 50 North Medical Drive, Salt Lake City, UT 84132.

Our Organization

This notice describes the privacy practices of the University of Utah Health Sciences Center (UUHSC). UUHSC includes University Hospital, Huntsman Cancer Hospital (HCH), University Neuropsychiatric Institute (UNI), clinics, doctor’s offices, and other health care facilities owned by the University of Utah, as well as the UUHSC providers, employees, students, trainees, and volunteers at those facilities. This notice also describes the privacy practices of affiliated providers while they are performing services in a UUHSC facility, unless they provide you with a notice of their specific privacy practices. Affiliated providers are not employed by UUHSC but are either authorized to provide services to patients in a UUHSC facility or have a contractual relationship with University of Utah Employee Health Plan and Healthy “U” insurance.

The UUHSC participates in an organized health care arrangement with other providers. For a complete list, contact the UUHSC privacy office or visit their web page at http://uuhsc.utah.edu/privacy/. University of Utah Employee Health Plan, Healthy “U” insurance, and affiliated providers may have different privacy practices from those described in this notice. For more information about the privacy practices of our health plans and affiliated providers, please contact them directly.

Contact Us

If you are concerned that your privacy rights may have been violated, or disagree with a decision that we made about access to your health information, contact us. We will investigate all complaints and will not retaliate against you for filing a complaint. You may also file a written complaint with the Office of Civil Rights of the U.S. Department of Health and Human Services.:

UUHSC Customer Service Office

50 North Medical Drive
Salt Lake City, UT 84132
(801) 581-2668
E-mail: Customer.Service@hsc.utah.edu

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