NOTICE OF PRIVACY PRACTICES


THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOUR CAN GET ACCESS TO THIS INFORMATON.


PLEASE REVIEW IT CAREFULLY.


Your Privacy Is Important To Us. We Want You To Understand:

Who will follow this Notice
How we may use and share your medical Information
Your rights concerning your medical information
How to file a complaint about your privacy

Who Will Follow This Notice:


The law requires us to maintain the privacy of your medical information and to tell you our duties and practices regarding your medical information. The law requires us to follow the terms of our current Notice. We reserve the right to make changes to this Notice, which may include new privacy changes, we will give you a copy of the new Notice the next time you visit us. The latest version of this Notice can always be found on your website at www.dwmcmillanhospital.org.

We May Use And Share Your Medical Information For:


Treatment purposes: We will share your information with those who are caring for you. For example, if you come in with a broken arm, we will give your x-rays to your doctor. If you need medication, the doctor may share your information with your pharmacist.

Payment Purposes: We may share your medical information with the person or company paying for your care. For example, if you come to us with a broken arm, we will tell your insurance company why you came in and what we did for you.

Health Care Operations: We may use your medical information to improve the way we provide care to you and others. For example, we may share your medical information to teach others.

Appointment Reminders: We may call or send a letter to remind you about your appointment. Please tell us if you do not want your information used in this way.

Sign-in Sheets: We may use sign-in sheets in our offices and call your name when the doctor is ready to see you.

Treatment Choices and Other Services: We may send you information about different ways to treat you and about other health benefits or services that you may want to know about.

Hospital Directory: We may use your information in our directory. Our directory has your name, religion, room number and how you are doing. If someone asks for you by name, we will tell them your room number and how you are doing. Please tell us if you do not want to be listed in your directory.

People Involved In Your Care: We may share your medical information with a family member or a friend who is involved in your care. We may also share your information with a person or company who is helping pay your bill. Please tell us if you do not want your information shared in this way.

Disaster Relief: If there is a disaster such as a hurricane, plane crash, or tornado, we may use your medical information to notify your family. We may also release information to an agency such as the Red Cross. Please tell us if you do not want your information shared in this way.

Satisfaction Surveys: We may use your information to conduct surveys (either by mail or phone). Your answers will help provide better care.

Special Programs: If you sign-up for one of our programs such as Senior Care, we may share your health information with our volunteers and others so they can check on you while you are in our care.

We May Share Your Medical Information Without Your Permission:


As Required By Law: An example is the mandatory reporting of positive cancer tests to State Agencies.

To Stop a Serious Threat to Someone's Health or Safety: We may share this information with someone who can stop the threat.

For Public Health: We may share your medical information with a public health agency such as the Center for Disease Control.

Law Enforcement: In some situations, we may share your medical information with law enforcement. If we believe you are a victim of abuse or some other crime, we may tell the police. We may also tell the police if you commit a crime at our facility.

State and Federal Review: We may share your medical information when we are being reviewed. For example, we may share your information with Medicare or Medicaid when they are reviewing the way we provide care.

Legal Proceedings: We may share your medical information when responding to proper requests in legal proceedings.

Children: In some cases, we may not share your child's medical information with you. For example, there are times when your child can seek care without your permission.

Organ Donation: If you are an organ donor, we may share your medical information when appropriate.

In Case of Death: We may share your medical information with a medical examiner or funeral director.

Military and Veterans: If you are in the military or a veteran, we may share your medical information when required by law.

National Security: We may share your medical information when required by law for national security purposes.

Protection of The President and Others: We may share your medical information when required by law for protective services of the President and other important leaders.

Department of State: We may share your medical information when required for security clearances and physicals of State Department personnel and their dependents.

Inmates: If you are a prisoner or in police custody, we may share your medical information when required by law.

Work Injuries: If you are receiving care because you were hurt at work we may share your medical information with your employer and others as required by Workers' Compensation laws.

Your Rights Concerning Your Medical Information:


Right To Request Restrictions:


You can ask us not to share your medical information for treatment, payment and health care operations. Usually, we will not agree to this request because it would make it difficult for us to care for you.

You can ask us not to share your medical information with family or friends who are involved in your care.

If you want to make any of these requests you must do so in writing. The law does not require to agree to your request.

If you need emergency treatment, we may share your medical information even if you have asked us not to.

Right To See And Get A Copy:


You have the right to see and get a copy of your medical information for as long as we have it.

We may charge you for giving a copy.

Sometimes the law does not allow us to let you see your medical information. If this happens, you can appeal our decision. Your appeal must be made in writing.

Right To Request Confidential Communications:


You can ask us to contact you in certain ways. For example, you can ask that we not send your bills or appointment reminders to your home address or call you at your work number.

This request must be made in writing and tell us how you would like to be contacted.

We will agree to reasonable requests.

Right to Amend:


You can ask us to change your medical information. For example, you can ask us to correct errors such as your date of birth.

Your requests must be made in writing.

The law does not require us to agree to your request.

If we deny your request to change your medical information, you can appeal our decision. Your appeal must be made in writing.

Right To An Accounting:


You can ask us to give you a list of people we have shared your medical information with.

This does not include information shared for treatment, payment and health care operations.

This also does not include information shared at your request.

This request must be made in writing.

We are required to keep track of who we have shared your information with for six years.

This right starts on April 14, 2003 and we will not have any information prior to that date.

If you request more than one accounting in a twelve-month period, we may charge you a fee.

Right To A Paper Copy Of This Notice: If asked, we will give you a paper copy of this Notice.


No Other Use Of Your Medical Information Without Your Authorization:

We will not share your medical information except in the ways indicated in the Notice unless you give us your written authorization to do so. You may revoke your authorization for other use of your medical information at any time.

We ask that you please give us the opportunity to resolve any issues you concerning your privacy. If you feel that we have violated your privacy, you may file a written complaint with D W McMillan Memorial Hospital Privacy Officer at the address below. If you prefer, we will be happy to assist you in completing a written complaint. There will be no retaliation against you for filing a complaint. For further information or assistance, you may contact us at:

Privacy Officer
D W McMillan Memorial Hospital
1301 Belleville Avenue
Brewton, AL 36426
251-809-8279

You also have the right to file a complaint with the Secretary of the U. S. Department of Health and Human Services but we ask that you first allow us the opportunity to correct any issues you may have concerning your privacy.


Revised: 10/05

Effective Date: 4/14/03