1200 Providence Road
Wayne, NE 68787
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.
You have the right to:
You have some choices in the way that we use and share information as we:
We may use and share your information as we:
This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
Ask us to correct your medical record
Request confidential communications
Ask us to limit what we use or share
Get a list of those with whom we’ve shared information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you feel your rights are violated
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
In the case of fundraising:
How do we typically use or share your health information? We typically use or share your health information in the following ways
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
Example: We use health information about you to manage your treatment and services. Bill for your services
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
Comply with the law
Respond to organ and tissue donation requests
Work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
Respond to lawsuits and legal actions
Health Information Exchanges. We participate in one or more electronic health information exchanges which permits us to electronically exchange medical information about you with other participating providers (for example, doctors and hospitals) and health plans and their business associates. For example, we may permit a health plan that insures you to electronically access our records about you to verify a claim for payment for services we provide to you. Or, we may permit a physician providing care to you to electronically access our records in order to have up to date information with which to treat you. Participation in a health information exchange also lets us electronically access medical information from other participating providers and health plans for our treatment, payment and health care operations. We may, in the future, allow other parties, for example, public health departments that participate in the health information exchange, to access your medical information electronically for their permitted purposes.
Incidental Uses and Disclosures. There are certain incidental uses or disclosures of your information that occur while we are providing service to you or conducting our business. For example, after surgery the nurse or doctor may need to use your name to identify family members that may be waiting for you in a waiting area. Other individuals waiting in the same area may hear your name called. We will make reasonable efforts to limit these incidental uses and disclosures.
Threats to Health or Safety. We may use or disclose your medical information to avert a serious threat to health and safety if we, in good faith, believe the use or disclosure is necessary to prevent or lessen the threat and is to a person reasonably able to prevent or lessen the threat (including the target) or is necessary for law enforcement authorities to identify or apprehend an individual involved in a crime.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
This notice is effective on May 10, 2018
This Notice of Privacy Practices applies to the following organizations.
Providence Medical Center – This Notice describes the privacy practices of Providence Medical Center (PMC) and all of its programs and departments, including its offsite therapy locations in Wakefield, NE and Laurel, NE.
Medical Staff – This Notice also describes the privacy practices of an “organized health care arrangement” or “OHCA” between PMC and eligible providers on its Medical Staff. Because PMC is a clinically-integrated care setting, our patients receive care from PMC staff and from independent practitioners on the Medical Staff. PMC and its Medical Staff must be able to share your medical information freely for treatment, payment and health care operations as described in this Notice. The OCHA does not cover the information practices of practitioners in their private offices or at other practice locations.
1200 Providence Road
Wayne, NE 68787
Providence Medical Center Statement of Nondiscrimination
Providence Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.