NOTICE OF PRIVACY PRACTICES
Effective Date: January 2007
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.
If you have any questions about this Notice,
please contact the Privacy Manager at 011 632
8190210
WHO
WILL FOLLOW THIS NOTICE
This Notice describes Beverly Hills Medical
Groups’ (BHMG or the “center”) privacy
practices and that of:
Any individuals authorized to enter information
into your center record.
All departments, units, and programs of the
center are included, except those listed on
Attachment A, as amended from time to time.
Any member of a volunteer group we allow to help
you while you are in the center.
All employees, staff and other center personnel,
including non-employees who have a
need to use your medical information to perform
their job, and including physicians and
allied health professionals while they are
caring for you in the center.
This Notice does not cover physician offices.
OUR PLEDGE REGARDING MEDICAL INFORMATION
We understand that medical information about you
and your health is personal. We are
committed to protecting medical information
about you. We create a record of the care and
services you receive at the center. We need this
record to provide you with quality care
and to comply with certain legal requirements.
This Notice applies to all of the records of
your care generated by the center, whether made
by center personnel or your personal doctor.
Your personal doctor may have different policies
or Notices regarding the doctor's use and
disclosure of your medical information created
in the doctor's office or clinic.
We are required by law to:
maintain the privacy of medical information that
identifies you (with certain exceptions);
give you this Notice of our legal duties and
privacy practices with respect to medical
information we collect and maintain about you;
and
follow the terms of this Notice that is
currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION
ABOUT YOU
The following categories describe different ways
that we may use and disclose medical
information. For each category we will explain
what we mean. Not every use or disclosure in
a category
will be listed. However, all of the ways we are
permitted to use and disclose information
will fall within one of the categories.
For treatment:
We may use medical information about you to
provide you with medical treatment or services.
We may disclose medical information about you to
doctors, nurses,
technicians, medical students, nursing and
allied health students, or other center
personnel
who are involved in taking care of you at the
center. For example, a doctor treating you for
a broken leg may need to know if you have
diabetes because diabetes may slow the healing
process. Additionally, the doctor may need to
tell the dietician if you have diabetes so we
can arrange for appropriate meals. Different
departments of the center also may share medical
information
about you in order to coordinate the different
things you need, such as medications, lab work
and x-rays. We also may disclose medical
information about you to individuals who may be
involved in your medical care during your
admission or after you leave the center,
such as family members, clergy, skilled nursing
facilities or home health
agency
staff.
For Payment:
We may use and disclose medical information
about you so that the treatment and services you
receive at the center may be billed to and
payment may be collected from
you, an
insurance company or a third party. For example,
we may need to give your health plan
information about surgery you received at the
center so your health plan will pay us or
reimburse you
for the surgery. We may also tell your health
plan about a treatment you are going to receive
to obtain prior approval or to determine whether
your health plan will cover
the
treatment.
For Health Care Operations:
We may use and disclose medical information
about you for our health care operations
activities. These uses and disclosures are
necessary to run the
center and make sure that all of our patients
receive quality care. For example, we may use
medical information to review our treatment and
services and to evaluate the performance of
our staff in
caring for you. We may also combine and analyze
medical information about many center
patients to decide what additional services the
center should offer, what
services are
not needed, and whether certain new treatments
are effective. We may also disclose
information to doctors, nurses, technicians,
medical students, nursing and allied health
students and other center personnel for review
and learning purposes. Additionally,
we may
combine the medical information we have with
medical information from other hospitals to
compare how we are doing and to see where we can
make improvements in the care and services we
offer. We may remove information that identifies
you from this set of medical information
so others may use it to study health care and
health care delivery without
learning who
the specific patients are.
Additional uses and disclosures of medical
information include:
Appointment Reminders:
We may use and disclose medical information to
contact you
as a reminder that you have an appointment for
treatment or medical care at the center.
As Required by Law:
We will disclose medical information about you
when required to
do so by federal, state or local law.
Business Associates:
Some of our functions are accomplished through
contracted
services provided by business associates.
Examples include the copy services we use when
making copies of your health record, auditors,
and organizations that accredit us. When these
services are contracted, we may disclose your
medical information to our
business
associates so that they can perform the job we
have asked them to do. To protect your
medical information, however, we require the
business associate to
appropriately safeguard your information.
Directory:
We may include certain limited information about
you in the center directory
while you are a patient at the center. This
information may include your name, location in
the center, general condition (e.g., fair,
stable, etc.), and religious affiliation. Unless
there is a specific written request from you to
the contrary, this directory information,
except for
your religious affiliation, may also be released
to people who ask for you by
name. Your religious affiliation may be given to a member of the clergy,
such as a priest
or rabbi,
even if they do not ask for you by name. This
information is released so your family, friends
and clergy can visit you in the center and
generally know how you are
doing.
Health-Related Products and Services:
We may use and disclose medical information to
tell you about our health-related products or
services that may be of interest to you.
Individuals Involved in your Care or Payment for
Your Care:
We may release medical information about you to
a friend or family member who is involved in
your medical care. We may also give information
to someone who helps arrange payment for your
care. Unless there is a specific written request
from you to the contrary, we may also tell your
family or friends your condition and that you
are in the center. In addition, we may disclose
medical information about you to an entity
assisting in a disaster relief effort so that
your family can be notified about your
condition, status and location.
Research:
Under certain circumstances, we may use and
disclose medical information
about you for research purposes. For example, a
research project may involve comparing
the health
and recovery of all patients who received one
medication to those who received another,
for the same condition. All research projects,
however, are subject to a special approval
process. This process evaluates a proposed
research project and its
use of
medical information, trying to balance the
research needs with patients' need for privacy
of their medical information. Before we use or
disclose medical information for
research, the project will have been approved
through this research approval process. However,
we may also disclose medical information about
you to people preparing to
conduct a
research project, for example, to help them look
for patients with specific medical needs,
so long as the medical information they review
does not leave the center. If you do not want to
participate in research efforts, you must notify
the Health Information Department-Release of
Information Section at 81 90210 and in writing
at 57 Paseo De Roxas, Makati City Philippines.
.
To Avert a Serious Threat to Health or Safety:
We may use and disclose medical
information about you when necessary to prevent
a serious threat to your health and
safety or the health and safety of the public or
another person. Any disclosure, however,
would only be to someone able to help prevent
the threat.
Treatment Alternatives:
We may use and disclose medical information to
tell you about or recommend possible treatment
options or alternatives that may be of interest
to you.
SPECIAL SITUATIONS
Funeral Directors, Coroners and Medical
Examiners:
We may disclose medical
information to funeral directors as necessary to
carry out their duties. We may also
disclose medical information to a coroner or
medical examiner. This may be necessary, for
example, to identify a deceased person or
determine the cause of death.
Health Oversight Activities:
We may disclose medical information to a health
oversight
agency for activities authorized by law. These
oversight activities include, for example,
audits, investigations, inspections, and
licensure. These activities are necessary for
the
government to monitor the health care system,
government programs, and compliance with
civil rights laws.
Law Enforcement:
We may release medical information if asked to
do so by a law
enforcement official:
•
In response to a court order, subpoena, warrant,
summons or similar process;
•
To identify or locate a suspect, fugitive,
material witness, or missing person;
•
About the victim of a crime if, under certain
limited circumstances, we are unable to
obtain the
person's agreement;
•
About a death we believe may be the result of
criminal conduct;
•
About criminal conduct at the center; and
•
In emergency situations to report a crime; the
location of the crime or victims; or the
identity, description or location of the person
who committed the crime.
Lawsuits and Disputes:
If you are involved in a lawsuit or a dispute,
we may disclose
medical information about you in response to a
court or administrative order. We may also
disclose medical information about you in
response to a subpoena, discovery
request, or other lawful process by someone else
involved in the dispute, but only if efforts
have been made to tell you about the request
(which may include written Notice to you) or to
obtain an order protecting the information
requested.
Military and Veterans:
If you are a member of the armed forces, we may
release medical information about you as
required by military command authorities. We may
also release medical information about foreign
military personnel to the appropriate foreign
military
authority.
National Security and Intelligence Activities:
We may release medical information
about you to authorized federal officials for
intelligence, counter-intelligence, and other
national security activities authorized by law.
Organ Procurement Organizations:
We may disclose medical information to
organizations that handle organ procurement or
organ, eye or tissue transplantation or to
an organ
donation bank, as necessary to facilitate organ
or tissue donation and
transplantation.
Protective Services for the President and
Others:
We may disclose medical
information about you to authorized federal
officials so they may provide protection to the
President,
other authorized persons, or foreign heads of
state or to conduct special
investigations.
Public Health l Reporting of Abuse:
We may disclose medical information about you
for
public health activities. These activities
generally include the following:
•
To prevent or control disease, injury or
disability;
•
To report births and deaths;
•
To report the abuse or neglect of children,
elders and dependent adults;
•
To report reactions to medications or problems
with products;
•
To notify people of recalls of products they may
be using;
•
To notify a person who may have been exposed to
a disease or may be at risk for contracting or
spreading a disease or condition; and
•
To notify the appropriate government authority
if we believe a patient has been the
victim of abuse, neglect, or domestic violence.
We will only make this disclosure if you agree
or when required or authorized by law.
Workers' Compensation:
We may disclose medical information about you
for workers'
compensation or similar programs. These programs
provide benefits for work-related
injuries or
illness.
Electronic Health Care Records
Currently, some or all of your medical
information may be stored in an electronic
format. When
permissible for valid purposes (e.g., providing treatment or billing for
services), your health care providers may access
your medical information from their offices or
other locations
outside of
the center. Additionally, BHMG may act as a
business associate (contractor)
for physicians or other health care providers
who would have the ability to access your
medical
information stored electronically in BHMG data
storage systems. All access to your medical
information will be permitted only in a manner
consistent with applicable law.
Your Medical Information Rights
You have the following rights regarding medical
information we maintain about you:
Right to inspect and copy.
You have the right to inspect and copy medical
information
that may be used to make decisions about your
care. Usually this includes medical and
billing records, but may not include some mental
health information.
To inspect and copy medical information that may
be used to make decisions about you,
you must submit your request in writing to the
Health Information Department at 57 Paseo De
Roxas
Boulevard, Makati City Philippines, 81-90210. If
you request a
copy of the information, we may charge a fee for the costs of copying,
mailing or other supplies associated with
your request.
We may deny your request to inspect and copy in
specific circumstances. If you are denied access
to medical information, you may request that the
denial be reviewed.
Another
licensed health care professional chosen by the
center will review your request and the
denial. The person conducting the review will
not be the person who denied your request. We
will comply with the outcome of the review.
Right to request restrictions.
You have the right to request a restriction or
limitation on
the medical information we use or disclose about
you for treatment, payment or health
care operations. You can also request a
restriction or limitation on the medical
information
we disclose about you to someone who is involved
in your care or the payment for your care, like
a family member or friend. For example, you
could ask that we not use or disclose
information about a surgery you had.
We reserve the right to accept or reject your
request.
If we do agree, we will
comply with your request unless the information
is needed to provide you emergency
treatment. We
will notify you if we do not agree to a
requested restriction.
To request restrictions, you must submit a
written request to the Health Information
Department at
the above address. In your request, you must
tell us (1) what information you want to
limit; (2) whether you want to limit our use,
disclosure or both; and (3) to whom you want the
limits to apply, for example, disclosures to
your spouse.
Right to amend.
If you feel that medical information we have
about you is incorrect or
incomplete, you may ask us to amend the
information. You have the right to request an
amendment to your medical information for as
long as the information is kept by or for the
center. You must make your request to amend your
medical information in writing and
submit it to
the Health Information Department at the above
address. You must include a reason that
supports your request. In addition, we may deny
your request if you ask us to
amend
information that:
•
Was not created by us, unless the person or
entity that created the information is no longer
available to make the amendment;
•
Is not part of the medical information kept by
or for the center;
•
Is not part or the information which you would
be permitted to inspect and copy; or
•
Is accurate and complete.
The law permits us to deny your request for an
amendment if it is not in writing or does not
include a reason to support the request.
Even if we deny your request for amendment, you
have the right to submit a written
addendum, not to exceed 250 words, with respect
to any item or statement in your record
you believe
is incomplete or incorrect. If you clearly
indicate in writing that you want the addendum
to be made part of your medical record we will
attach it to your records and include it
whenever we make a disclosure of the item or
statement you believe to be
incomplete
or incorrect.
Right to an accounting of disclosures.
You have the right to request an "accounting of
disclosures." Such an accounting is a list of
the disclosures we made of medical information
about you other than our own uses for treatment,
payment and health care
operations (as those functions are described
above) and with other expectations pursuant
to law.
To request this list or accounting of
disclosures, you must submit your request in
writing to the Health Information Department at
the above address. Your request must
state a time
period that may not be longer than six years and
may not include dates before April 14,
2003. Your request should indicate in what form
you want the list (for
example, on paper or electronically). The first list you request within a
12-month period will be free. For additional
lists, we may charge you for the costs of
providing the list. We will notify you of the
cost involved and you may choose to withdraw or
modify your request at that time before
any costs are incurred.
Right to request confidential communications.
You have the right to request that we
communicate with you about medical matters in a
certain way or at a certain location. For
example, you can ask that we only contact you at
work or by mail.
You must make your request for confidential
communications in writing to the Health
Information Department at the above address We
will not ask you the reason for your
request. We will accommodate all reasonable
requests. Your request must specify how
or where you wish to be contacted.
Right to obtain a paper copy of this Notice.
You have the right to a paper copy of this
Notice. You may ask us to give you a copy of
this Notice at any time. Even if you have agreed
to receive this Notice electronically, you are
still entitled to a paper copy of this
Notice.
You may obtain a copy of this Notice at our
website,www.beverlyhills.ph.
Changes to this Notice
We reserve the right to change this Notice. We
reserve the right to make the revised or changed
Notice effective for all medical information we
have about you as well as any
information we receive in the future. We will
post a copy of the current Notice in the center.
The Notice will contain on the first page, in
the top right-hand corner, the effective date.
If we amend
this Notice, we will offer you a copy of the
current Notice in effect.
For More Information or to Report a Problem
If you believe your privacy rights have been
violated, you may file a complaint with the
center and/or with the Secretary of the federal
Department of Health and Human Services.
All complaints must be submitted in writing. To
file a complaint with the center, send a
written complaint to: Privacy Manager,
Corporate Compliance Department, BHMG
Medical Center 57 Paseo De Roxas, Makati City
Philippines. If you would like to
discuss a
problem without submitting a formal complaint,
you may contact the Privacy Manager at81
90210.
You will not be penalized for filing a
complaint.
Other Uses of Medical Information
Other uses and disclosures of medical
information not covered by this Notice or the
laws that apply to us will be made only with your written permission. If you
provide us permission to use or disclose
medical information about you, you may revoke
that permission, in writing, at
any time. If you revoke your permission, we will stop the uses and
disclosures allowed by that permission, except
to the extent that we have already acted in
reliance on your permission. For example,
we are unable to take back any disclosures we
have already made
with your permission.
ATTACHMENT A
The following departments, units and programs of the
center are not bound by this Notice:
•
Voluntary Blood Donor Program
•
Research Institute (except Clinical Research Nurses
and Clinical Research Coordinators when performing
healthcare services or functions preparatory to
research, as well as staff members responsible for
Clinical Research Compliance
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