This notice describes your rights regarding your medical information and informs you of how medical information about you may be used. Please review it carefully.
This notice applies to Mercy Health and to the Mercy Health facilities and clinics listed below (together referred to as “Mercy”).
By law, Mercy must keep protected health information (“PHI”) private. PHI is any information, including verbal, electronic and on paper that is created or received by Mercy for purposes of providing health care to patients and for purposes of billing and payment for those services. PHI includes test results, notes written by doctors, nurses and other clinical staff, and general information such as your name, address and telephone number that is included in your health care records and your billing records.
Mercy is required by law to give you this notice and to follow the notice that is currently in effect.
This notice covers Mercy and Mercy co-workers, volunteers, students and trainees. The notice also covers other health care providers that come to Mercy’s facilities and clinics to care for patients (such as physicians, physician assistants, therapists and other health care providers not employed by Mercy), unless these other health care providers give you their own notice of privacy practices.
Below is a list of ways in which Mercy may use or share your PHI without your advance permission:
Mercy may also use or share PHI without your permission for the following purposes:
Mercy may use or share your PHI for any of the purposes described in this section unless you specifically request in writing that we do not. Your written request must be given to your care provider or to the Health Information Management Office listed below.
For any purpose other than the ones listed earlier in this notice, we may use or share your PHI only when you give us written permission.
Psychotherapy Notes. We must obtain your written permission for most uses and disclosures of psychotherapy notes.
If you give us written permission to use and share your PHI, you can take back your permission at any time, as long as you tell us in writing. If you take back your permission, we will stop using or sharing your information, but we will not be able to take back any information that we have already shared.
You have the following rights
We hope you will tell us if you have a concern so we can try to fix it, but you also have the right to file a complaint with the Office for Civil Rights (OCR). If you decide to report a complaint to Mercy or to the OCR this will not affect your ability to obtain care and treatment at Mercy.
We have the right to change this notice at any time. If we change this notice, we may make the new terms effective for all PHI that we maintain. Any changes that we make will comply with federal, state and other laws. The most recent copy of this notice will be on our website. You can also call or write the Director of Health Information Management listed above to obtain the most recent version of this notice.
If you have any questions about this Notice, or any concern about the privacy of your PHI, please contact the Privacy Officer for the Mercy provider where you obtained health care services listed below.
Last updated 10/31/2016