VIRGINIA TECH
SCHIFFERT HEALTH CENTER
NOTICE OF PRIVACY PRACTICE
This notice describes how medical information about the Health Center’s patients may be used and disclosed and how patients can obtain access to their information. Please review it carefully.
The Schiffert Health Center values the privacy of its patients and the confidentiality of the personal and health information entrusted to us. In order to protect this privacy we have policies and procedures to limit disclosures of personal information to those minimally necessary for the medical care of the patient, those for which the patient has given permission, and/or those required by law or public safety.
A. Potential disclosures of an individual's information include:
1. Medical treatment. Medical and personal information may need to be shared with medical practitioners, nurses, pharmacists, health educators, dietitians, medical records and clinic clerical personnel, and medical technologists (laboratory, radiology, and pharmacy) employed by the Schiffert Health Center in order to provide effective and efficient care.
2. Billing. Billing information which contains personal information to include name, student-identification number, date of service, and charge is sent to the University's Accounts Receivable Office for billing. The bill appears as "Medical Clinic Charge" or "Pharmacy Charge" without the medical diagnoses or procedures or the medication disclosed. Bills are mailed by the Accounts Receivable Office to the address provided by the student.
3. Third party payment. Itemized billing statements that include the information given in (2) above AND diagnoses, procedures, or medications will be released to the patient or his/her designated representative only upon the specific 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, university, 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 and it will usually be of a general/composite nature. However, on occasion, these reviews will involve sighting of individual information by the auditor, accreditation examiner, etc. All individuals performing these reviews, audits, etc. will be required to agree with and sign the non-disclosure confidentiality standards of the Health Center before being allowed access.
5. Public health and safety. Personal and health information may be disclosed 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. Personal and medical 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. The patient may be contacted by SHC to provide appointment reminders or other information of health-related benefits or services that may be of interest to the patient.
8. Other uses. Uses and disclosures of health and personal information other than described above will be made only with the patient's (your) written authorization. Such authorization when given may be revoked in writing by the patient (you) at any time.
B. The patient also has certain rights. These include:
1. The right to inspect and obtain copies of personal medical information. Any such requests must be made in writing by the patient to give SHC permission to release the information. A cost-based fee may be charged for copying medical records. SHC may deny, in writing, the release or viewing of personal medical information if the SHC Administration determines that the release of the information may be harmful to the patient or another person. When such a request is denied the patient may request a review of the denial by a designated SHC and/or University reviewing official who did not participate in the decision to deny. Such requests must be made in writing to the SHC privacy official(s) designated in paragraph E. below.
2. The right to request amendments of medical information. Such requests must be made in writing to the Medical Records Department. Such requests will be reviewed by SHC and may be denied. If denied a written denial and its reasons will be provided to the patient and he/she has to the right to submit a rebuttal and request for review of such denial. Such requests are to be made in writing to the SHC designated privacy official(s) designated in paragraph E. below.
3. The right to receive an accounting of any disclosures of protected information made after April 14, 2003.
4. The right to request limits on the amount or types of medical information released. Such requests must be made in writing to the Medical Records Department. SHC may not agree with this request when it is felt to be in the patient’s best interest to release the information and/or when such a release is mandated by the uses outlined in paragraph A. above.
5. The right to request that communications between the patient and SHC be kept confidential.
C. Duties of Schiffert Health Center.
1. Maintaining privacy. Schiffert Health Center is required by law to maintain the privacy of protected health information and to provide and abide by this notice of its legal duties and privacy practices.
D. Effective date and changes. This notice is effective from April 14, 2003 and is posted in prominent locations throughout the Health Center. It is also posted on the SHC public web site at www.healthcenter.vt.edu. Copies of the notice may be obtained by requesting them at Medical Records or any of the clinic reception desks. Additionally, patients/clients may request to see the written Schiffert Health Center procedure on patient privacy. SHC reserves the right to make changes to this notice and/or its procedures without notification other than posting or making available copies of revised notices in locations as above. Such changes, if and when made, will become effective for all of the health information that SHC maintains.
E. Information and complaints. Patients/clients may file complaints regarding the security and/or privacy of their personal health information with the Vice President for Student Affairs, Zenobia L. Hikes, PhD. or the Director of Schiffert Health Center, Kanitta Charoensiri, DO.
Zenobia L. Hikes, PhD Kanitta Charoensiri, DO
Vice President for Student Affairs Director, Schiffert Health Center
Room 112, Burruss Hall 213, McComas Hall
Virginia Tech Virginia Tech
Blacksburg, VA 24061-0250 Blacksburg, VA 24061-0140
540-231-6272 540-231-5313
zhukes@vt.edu charkx@vt.edu
Additionally, patients may file formal complaints about possible violations of the privacy rules with the United States Department of Health and Human Services at:
Office for Civil Rights
U. S. Department of Health and Human Services
200 Independence Avenue, S. W.
Room 509F, HHH Building
Washington, DC 20201
OR
OCR Hotlines-Voice: 1-800-368-1019