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.
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OUR COMMITMENT
Our principal goal at Aurora Health Care, Inc. is to keep you healthy and to
offer services that will meet your needs. In order to perform these services, we
collect, create, use, and disclose information about you. We are dedicated to
keeping your health information private, in accordance with federal and state
law. As required by the federal Health Insurance Portability and Accountability
Act of 1996 ("HIPAA"), we provide you with this notice of our legal duties with
respect to health information. We are required to follow the terms of this
notice or any revision to it that is in effect. We reserve the right to make
changes to this notice as allowed by law. Changes to our privacy practices will
apply to all health information we maintain. If we change this notice, you can
access the revised notice using one of these options:
At any of the registration areas of our hospitals and clinics;
From home health, hospice, nursing home, retail pharmacy, or optical staff;
or
From this web site (www.AuroraHealthCare.org).
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use your health information and disclose it to appropriate persons,
authorities and agencies, as allowed by federal and state law. We may do this
without your written permission for the following purposes:
Treatment. As we treat you, we may need to use and disclose your
health information to other health care providers within or outside of Aurora
Health Care, Inc. For example, a doctor may use the information in your medical
record to find the best treatment option for you or a pharmacist may call your
doctor to ask questions about a prescription. In some cases, our staff may use
or disclose your health information to help your doctor and our health care team
manage your disease.
Payment. We may use your health information and disclose it to
insurance companies or employer health plans, and to others in order to receive
payment for your bill. For example, we must submit a bill to your insurance
company that states your name, what is wrong with you, how we are treating you,
and other information in order for us to receive payment. In certain situations,
we may disclose your health information to a collection agency if a bill is not
paid.
Health Care Operations. We may use the information in your medical
record to help us improve the quality or cost of the care we give or to respond
to appropriate questions about the care provided. For example, we may study how
doctors and nurses manage patient treatment after surgery, to learn the best way
to help patients recover. We may use your health information to look at the care
you received from doctors, nurses, pharmacists, or other health care
professionals. We may disclose your health information to another health care
professional that you have seen so they may improve their quality or cost.
Reminders and Information Sharing. We may use your health information
to remind you of an appointment or to tell you about treatment options or health
products and services that may be of interest to you. For example, we may send
you a letter telling you about a new health care facility that is opening in
your area.
Fundraising. In support of our charitable mission, we may use your
health information (for example, your name, address, phone number and treatment
dates) to contact you about supporting our fundraising efforts. Through
philanthropy, we seek to advance our patient care programs and services. For
example, we use charitable gifts to fund heart and cancer research and needed
charity care.
OTHER WAYS WE MAY DISCLOSE YOUR HEALTH INFORMATION
We may also use and disclose your health information without your written
permission for the following purposes:
Hospital and Nursing Home Patient Directory. If you are hospitalized or a
resident in a nursing home, we may keep brief information about you in our
directory. Unless you tell us otherwise, we may disclose where you are in our
facility (for example, your room or phone number) and your general health
condition (for example "stable" or "good") to anyone who asks for you by name.
We will also disclose your religious affiliation to clergy, even if they do not
ask for you by name.
Family and Friends for Care and Payment. Unless you request otherwise and in
emergency situations, we may disclose information to your family members,
relatives, close friends, or others who are helping care for you or helping you
pay your medical bills. For example, we may tell these persons where you are and
how you are doing.
Disaster Relief Efforts. We may disclose your health information to
organizations for the purpose of disaster relief efforts.
Required by Law. We may disclose your health information when required by law
to do so.
Public Health. We may disclose your health information with authorities to
help prevent or control disease, injury, or disability. For example, we are
required to report certain diseases (for example, cancer), injuries, birth or
death information, and information of concern to the Food and Drug
Administration (FDA) and the State of Wisconsin. We may also report work-related
illnesses and injuries to your employer for workplace safety purposes.
Reporting Victims of Abuse or Neglect. We may disclose your health
information, if we believe you have been a victim of abuse or neglect, to a
government authority if required or allowed by law, or if you agree to the
disclosure.
Health Care Oversight. We may disclose your health information to authorities
and agencies for oversight activities allowed by law, including audits,
investigations, inspections, licensing, disciplinary actions, or legal
proceedings. These activities are necessary for oversight of the health care
system, government programs and civil rights laws.
Legal Proceedings. We may disclose your health information in the course of
certain legal proceedings. For example, we may disclose your information in
response to a court order.
Law Enforcement. We may disclose your health information to law enforcement
officials for specific purposes. For example, we may disclose your health
information when required by law to report certain injuries.
Death. We may disclose your health information to coroners, medical examiners
(for example, to find out the cause of death) and funeral directors so they can
carry out their duties.
Organ, Eye, or Tissue Donation. We may disclose information to people
involved in obtaining, storing or transplanting donated organs, eyes or tissue.
Research. We may disclose your health information to researchers who have
received approval from the Aurora Health Care, Inc. Institutional Review Board
to conduct a specific research project. These researchers agree not to disclose
information that would allow you to be identified, except as allowed by law. For
example, a research study may measure the success of a treatment or medication
in treating or curing a targeted illness or condition.
Serious Threats to Health or Safety. We may disclose your health information
to the proper authorities if we believe in good faith that this will help
prevent or lessen a serious threat to your or the public's health or safety. We
do so as allowed by law and standards of ethical conduct.
Military, National Security, Law Enforcement Custody. We may disclose your
health information with the proper authorities so they may carry out their
duties under the law. This applies if you are or were involved with the
military, national security or intelligence activities. It also applies if you
are in the custody of law enforcement officials or an inmate in a correctional
institution.
Workers' compensation. We may disclose your information in order to comply
with the laws related to workers' compensation or similar programs. These
programs may provide benefits for work-related injuries or illness.
We may use or disclose your information only with your written permission,
except as described in the previous sections. If you give us your permission,
you may withdraw such permission at any time by notifying us in writing, except
if we have already taken action based upon your permission.
A NOTE ON OTHER RESTRICTIONS
Please be aware that state and federal law may have more requirements than
HIPAA on how we use and disclose your health information. If there are specific
more restrictive requirements, even for some of the purposes listed above, we
may not disclose your health information without your written permission as
required by such laws. For example, we will not disclose your HIV test results
without obtaining your written permission, except as permitted by state law. We
may also be required by law to obtain your written permission to use and
disclose your information related to treatment for a mental illness,
developmental disability, or alcohol or drug abuse. There may be other
restrictions on how we use and disclose your health information than those
listed above. We believe state and federal laws discussing such restrictions are
Wisconsin Statutes Sections 146.82, 51.30, 252.15, 895.50 and 905.04; Wisconsin
Administrative Code HFS 92 and 124.14; and 42 C.F.R. Part 2 and 45 C.F.R. Parts
160 and 164. If you would like a copy of these laws, please contact our Chief
Privacy Officer at 414-647-6404.
YOUR HEALTH INFORMATION RIGHTS
As a patient or customer who receives health care services from Aurora Health
Care, Inc., you have the right to:
Read and copy your health information. With a few exceptions, you have the
right to read and obtain a copy of your health information. We may charge you a
reasonable fee if you want a copy of your health information. If we deny your
request to review or obtain a copy, you may submit a written request for a
review of that decision.
To obtain your health information, contact the Health Information/Medical
Record Department of the facility where you were treated.
To obtain your billing information, contact the Central Business Office.
To request information from a retail pharmacy or optical shop, inquire at the
counter.
Request to correct your health information. If you believe there is an error
in your health information or something has been left out, you may ask us to
correct the information. You must make the request in writing and give the
reason why your health information should be changed. If we did not create the
information you believe is incorrect, or if we disagree with you and believe
your health information is correct, we will deny your request. You may appeal to
us in writing if we deny your request.
To request a correction to your health information, contact the Health
Information/Medical Record Department of the facility where you were treated.
To request a correction from a retail pharmacy or optical shop, inquire at
the counter.
Request to restrict certain uses and disclosures of your information. You
have the right to ask that we restrict how your health information is used or
disclosed. Under the law, we are not required to agree to your request. In some
cases, we may not be able to agree to your request because we do not have a way
to tell everyone who would need to know about the restriction. There are other
instances in which we are not required to agree with your request. We will
inform you when we cannot find a way to carry out your request. You may request
a restriction in these ways:
Ask during the registration or sign-in process; o Ask the person giving you
care (e.g., physician, nurse, pharmacist)
Contact the Health Information/Medical Record Department
Contact the business office for billing-related requests
Receive information at a different place or by different means. You have the
right to ask that we send information to you in different ways or at different
places. For example, you may wish to receive a test result at an address other
than your home address. We will grant reasonable requests.
Receive a record of how we disclosed your health information. You have the
right to ask us in writing for a list of places or persons with whom your health
information was disclosed during the past six years. The list will contain the
date your health information was disclosed to others, who received the
information, a brief description of what was disclosed and why. However, the
list will not include disclosures for the following purposes: treatment,
payment, health care operations, hospital/nursing home patient directories,
family and friends for care and payment, national security or intelligence, and
law enforcement/corrections. In addition, the list will not include information
that was disclosed to you and to others with your permission, incidental
disclosures and disclosures of limited or de-identified health information. We
must provide you the list within 60 days of your request, unless you agree to a
30-day extension. You will not be charged for this list, unless you request more
than one list per year.
The request must be for health information disclosed on or after April 14,
2003
To request this list, contact the Health Information/Medical Record
Department at the facility where you were treated
If you wish to request a list from a pharmacy or optical store, inquire at
the counter
Obtain a paper copy of this notice. Upon your request, you may at any time
receive a paper copy of this notice. This notice is available at the
registration desks and customer service counters of all our facilities.
File a complaint. You have the right to file a complaint with us if you
believe your privacy rights have been violated. To file a complaint, call the
Chief Privacy Officer at 414-647-6404. You also have the right to complain to
the United States Secretary of the Department of Health and Human Services. We
will not take any action against you for filing a complaint.
CONTACT FOR INFORMATION, QUESTIONS, OR CONCERNS
If you have questions or concerns about your privacy rights, Aurora Health
Care, Inc.'s privacy-related policies or the information contained in this
notice, please contact our Chief Privacy Officer at 414-647-6404.
WHO WILL USE THIS NOTICE TO MEET FEDERAL LAW NOTICE REQUIREMENTS
Aurora Health Care, Inc., through owned and controlled corporate and limited
liability affiliates and employees of such entities, provides health care to
patients, residents and clients jointly with health care providers and other
organizations. The following persons and entities, who have agreed to be bound
by this notice, will jointly use this notice for convenience to meet federal law
requirements; provided that, each person and entity is solely and separately
responsible and liable for complying with this notice and applicable law (and
Aurora Health Care, Inc. and its affiliates are only liable for their own
violations):
All employed staff or volunteers of Aurora Health Care, Inc., including staff
of other affiliated entities
Any health care professional who agrees to be bound by this notice and who
treats you at any of our facilities with respect to your information stored at
the facility. Please be aware that many health care professionals are
independent contractors, which means they are not employed or controlled by
Aurora Health Care, Inc. Such independent health care professionals may have
different policies or notices regarding the use or disclosure of your health
information stored at their office and that each person or entity is
independently responsible for their own compliance with this notice and federal
and state law. You should determine if your health care professional is employed
or controlled by Aurora Health Care, Inc. or one of its controlled entities
Any of our business partners or associates with whom we share health
information and who agree to be bound by this notice.
This notice is effective on and after April 14, 2003, unless and until it is
revised by Aurora Health Care, Inc.
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