In-Network Insurance Companies
Harrisburg Medical Center NOTICE OF PRIVACY PRACTICES
This Notice Describes How Health Information About You May Be Used And Disclosed And How You Can Get Access To This Information. Please review it carefully. The privacy of your health information is important to us.
Harrisburg Medical Center is dedicated to protecting your medical information. We are required by law to maintain the privacy of protected health information and to provide you with this notice of our legal duties and privacy practices with respect to protected health information. Harrisburg Medical Center is required by law to abide by the terms of this notice, and we reserve the right to change the terms of this notice, making any revision applicable to all the protected health information we maintain. If Harrisburg Medical Center revises the terms of this notice, it will post a revised notice at the hospital, on our website, and will make paper copies of this Notice of Privacy Practices for Protected Health Information available upon request.
Uses And Disclosures Of Your Medical Information:
Except for the purposes described below, we will use and disclose health information only with your written permission. You may revoke such permission at any time by writing to our Privacy Officer.
Harrisburg Medical Center will use your medical information as part of rendering patient care. For example, your medical information may be used by the health care professionals treating you, by the Business Office to process your payment for the services rendered and by Administrative personnel reviewing the quality and appropriateness of the care you received.
Harrisburg Medical Center may also use and/or disclose your information in accordance with Federal and State laws for the following purposes:
- We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- We may disclose health information to a health oversight agency for activities authorized by law. These may include audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
- Unless you object, and with the exception of Behavioral Health Patients, we may include general information, including your name, location in the hospital, general health condition, and your religious affiliation in a patient directory. The directory information, except for your religious affiliation, will be released to people who ask for you by name. Your religious affiliation will only be disclosed to members of the clergy.
- Unless you object, and with the exception of Behavioral Health Patients, we may disclose, when appropriate, to family members, other relatives, a close friend or any other person you identify, the medical information directly relevant to such person’s involvement with your care. We may also use or disclose your medical information to notify a family member, a personal representative or another person responsible for your care, of your location, general condition or death.
- We may disclose your medical information to a public or private entity for the purpose of coordinating with that entity to assist in disaster relief efforts or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.
- We may disclose health information for public health activities. These generally include disclosures of disease, injury, disability, vital events, child abuse or neglect, a person who may have been exposed to a disease or at risk for contracting or spreading a disease, and notifying the appropriate government authority if we believe a patient has been the victim or abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
- We may disclose your medical information for law enforcement purposes or other specialized governmental functions when required to do so by international, federal, state or local law.
- We may disclose your medical information to a coroner, medical examiner or a funeral director.
- We may disclose your medical information to any research program in which you may have elected to participate.
- We may disclose your medical information due to specialized government functions related to: military and veteran’s activities, national security and intelligence activities, protective services for the President and others, medical suitability determinations, correctional institutions and other law enforcement custodial situations and covered entities that are government programs providing public benefits.
- If you are an organ donor, we may disclose your medical information to an organ donation or procurement organization.
- We may use or disclose your medical information to prevent or lessen a serious threat to your health and safety or the health and safety of another person or the public. Disclosures, however, will be made only to someone who may be able to help prevent the threat.
- We may disclose your medical information as authorized by laws relating to workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
- We may disclose health information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. All our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
Your Rights Regarding Your Medical Information:
You have the following rights with respect to your medical information:
- The right to request restrictions or limitations on certain uses and disclosures of your medical information. We are not required to agree to your requested restriction. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment. Your request for restriction must be in writing.
- The right to make out-of-pocket payments (you have requested that we not bill your health plan) in full for a specific item or service. You have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.
- The right to request that we communicate with you about medical matters in a certain way or at a certain location. Your request must be in writing. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
- The right to inspect and copy your medical information, other than psychotherapy notes. This right is subject to certain specific exceptions and you may be charged a reasonable fee for any copies of your records. Your request must be in writing and we have up to 30 days to make this information available to you. You have the right to request an electronic copy of your record be given to you or transmitted to another individual or entity. Every effort will be made to provide access to your Protected Health Information in the form or format you request.
- The right to request an amendment of your medical information. We may deny your request for specific reasons and, if denied, the hospital will provide you with a written explanation for the denial and information regarding further rights you would have at that point. You must make your request in writing.
- The right to receive an account of certain disclosures of your medical information we made in the six years prior to your request, except for disclosures for treatment, payment and healthcare operations or for which you provided written authorization. To request an account of disclosures, you must make your request in writing.
- The right to request a paper copy of this Notice of Privacy Practices. You may ask for a copy of this notice at any time.
- The right to be notified of a breach of any of your unsecured Protected Health Information. We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information.
- The right to opt out of fundraising communication from the hospital. Uses and disclosures of Protected Health Information for marketing purposes and disclosures that constitute a sale of your Protected Health Information will be made only with your written authorization. If you do give us authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer.
If you believe your privacy rights have been violated, you may file a complaint with Harrisburg Medical Center or with the Secretary of the Department of Health and Human Services. To file a complaint with the hospital, contact our Privacy Officer at 618-253-0360, or by writing to P.O. Box 428, 100 Dr. Warren Tuttle Drive, Harrisburg, IL 62946. You will not be penalized for filing a complaint. If you would like further information regarding your rights or regarding the uses and disclosure of your medical information, you may contact Harrisburg Medical Center’s Privacy Officer at 618-253-0360.
Complaints, Appeals and Grievances
Harrisburg Medical Center’s Complaint/Grievance Process
Phone Number 618-253-7671 Ext 10407
Mailing Address: 100 Dr. Warren Tuttle Drive
Harrisburg, Il 62946
It is the policy of Harrisburg Medical Center that all internal and external customer (patient, family, physician, staff, or visitor) complaints and problems will be addressed at the time of the occurrence in an effort to resolve the complaint or grievance and or review and improve the process.
- Patients have the right to complain without any fear of reprisal. Any patient or patient’s representative who expresses an issue or grievance is assured that these processes are welcome and not fear any retaliation for initiating this action.
- Any grievance involving situations or practices that place the patient in immediate danger are resolved in a timely manner.
- All patient and or family complaints received will be responded to promptly. All complaints or grievances will be documented on the hospital form designated for such.
- While you are a patient in the hospital if you have a concern or complaint, you, or your representative can speak with the Director of the area providing your service, or the nursing supervisor. Your concerns will be responded to and an effort made to resolve the issues immediately.
- If your concerns cannot be resolved, or you are not satisfied with the follow up, you may contact the Quality/Risk Management Department via telephone at 618-253-7671 extension 10407, or in writing. Your concerns will be acknowledged in writing within seven (7) days and a resolution response within thirty (30) days. Occasionally, complaint investigation may take longer than 30 days. In this event, you will be notified promptly.
- If in the event there is no satisfaction achieved through the Quality/Risk Management Department, the issue will be forwarded to the Grievance Committee of the hospital for their decision on the issue.
- All issues forwarded to the Grievance Committee will be acknowledged in writing within 7 days and a resolution response within 30 days.
- If you have concerns about the care provided to you during your stay in Harrisburg Medical Center or HMC Ambulatory Care, you may file a complaint with the Department of Public Health by writing to the following street address or e-mail, or by calling the hotline at 800-252-4343 during regular business hours. You may also wish to first discuss your concerns with the personnel available at the facility.
Address written complaints by mail to:
Illinois Department of Public Health
525 W. Jefferson St. Longterm Care CCR
Springfield, IL 62761-0001
E-mail complaints to: email@example.com
- If you are a Medicare patient and feel that you are being discharged too soon, you can talk to the hospital staff, your doctor and your managed care plan (if you belong to one) about your concerns. You also have the right to an appeal, that is, a review of your case by a Quality Improvement Organization (QIO). The QIO is an outside reviewer hired by Medicare to look at your case to decide whether you are ready to leave the hospital. All of this will be explained to you upon admission and within 24 hours of your planned discharge at which time you will be given “An Important Message from Medicare about Your Rights’ which explains your rights in detail as well as the number to call for appeal.
Iowa Foundation for Medical Care 1-800-647-8089
Harrisburg Medical Center maintains a system to track, trend and respond to patient complaints and grievances to support the hospital mission “to maintain and improve the health of the community we serve”. The Risk Manager, who reports to the Chief Operations Officer, serves as a liaison between the patient, the healthcare provider, Grievance Committee, and the Board of Trustees to provide the means by which patients and families can seek solutions to problems, concerns, and unmet needs. He or she acts in patients’ behalf with administration or any department to improve care and service. The Risk Manager acts in response to patient grievances as per the “Patient Bill of Rights”. Harrisburg Medical Center will cooperate with any investigating agency authorized through the State of Illinois, CMS or the Joint Commission and will not threaten, intimidate or retaliate against any individual filing a complaint. The Board of Trustees has delegated the oversight of the Patient Complaint/Grievance Process to the Grievance Committee and the Risk Manager.
PUBLIC NOTICE REGARDING SAFETY AND QUALITY OF CARE AT HARRISBURG MEDICAL CENTER
The Joint Commission periodically conducts an accreditation survey of Harrisburg Medical Center. The purpose of the survey is to evaluate the organization’s compliance with nationally established Joint Commission standards. The survey results are used to determine whether, and the conditions under which, accreditation should be awarded to Harrisburg Medical Center.
The Joint Commission’s standards deal with organization and safety quality-of-care issues and the safety of the environment in which care is provided.
As a patient, family member, community representative, employee, or medical staff member of Harrisburg Medical Center you have the right to notify the Joint Commission regarding any concern about the quality of care provided, safety of the care provided, or safety of the environment in which care is provided. Anyone believing that he or she has pertinent and valid information about such matters should notify the Joint Commission.
The Joint Commission
Division of Accreditation Operations
Office of Quality Monitoring
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
This notice is communicated and posted in accordance with the Joint Commission’s requirement.
Harrisburg Medical Center Financial Assistance Program
Medical bills can be devastating to anyone, especially to those individuals who have no medical insurance. In an effort to address this growing trend in our service area, Harrisburg Medical Center is pleased to introduce and offer the Financial Assistance Program.
The Financial Assistance Program is provided to help individuals who are uninsured or under-insured with their hospital bills. Each applicant is prescreened by our financial counselor to determine eligibility. This is done by obtaining the applicant’s gross annual income and household size to determine where they fall on the poverty income guideline chart. Harrisburg Medical Center uses the Poverty Income Guideline (PIG) chart published annually by the United States Department of Health and Human Services. To apply, the applicant must complete a financial assistance application, provide verification of all household income and obtain a denial from the State of Illinois Department of Human Services. Once all requested information is obtained the application is processed. The applicant then receives a letter of determination by mail.
Since the programs inception, Harrisburg Medical Center has helped hundreds of individuals and their families all over southern Illinois and the Tri-State region and we look forward to helping many, many more. To request an application or to obtain more information, please call our business office at 618.253.0251 or 618.253.0281.
Harrisburg Medical Center would like to thank you for using good judgment.
We need your help to ensure that our integrity is never compromised by unlawful activity in the workplace. If you witness questionable activity involving Fraud and Abuse or Code of Conduct, call our toll free number anonymously, 24 hours a day, 7 days a week. Use your best judgment and don’t be afraid to stand up for what’s right.
Privacy Statement For Harrisburg Medical Center
Our Commitment to Privacy
Harrisburg Medical Center is committed to respecting and protecting your privacy as a visitor to our Web site at . We take the issue of privacy very seriously and value the trust you place in us each time you use our services and access this Web site. This Privacy Statement describes the practices and policies we have put into place to safeguard your personal and health-related personal information that may be gathered and used as you visit our Web site.
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.
The policy may change from time to time so please check back periodically. If you have any questions about our privacy policies, we encourage you to contact us using any of the methods outlined at the end of our Privacy Statement.
Who Is Collecting the Information?
Harrisburg Medical Center is collecting information on this Web site as outlined in this privacy statement.
What Information Do We Collect?
Automatic Collection of Information:
If you do nothing during your visit but browse through the web site or download information, our system will automatically gather and store certain information about your visit. This information does not identify you personally and is used in an aggregate way to help us improve our web site and tell us the number of visitors to our site each day.
- No information is automatically collected at this Web site.
Permission-based Collection of Information:
At different places on our site depending upon the feature you use, you may be asked to volunteer personal and health-related information such as your name, email, mailing address, telephone number, and health history.
- No voluntary (opt-in) information is collected from visitors at this Web site.
How Do We Use the Information We Collect?
The information we gather automatically and with your permission during your visit to our Web site is used in the following ways:
- Monitor, review, measure, and analyze Web site utilization
- Modify and enhance the Web site
- Improve the content and design of our Web site
- Determine the need for new programs and services
- Monitor the changing health information needs of site visitors
With Whom Will the Information Be Shared?
The personally identifiable information gathered during your visit to this Web site is not shared with any organization for any purpose. We do not rent, sell, exchange or in some way provide personally identifiable information to any third-party organization.
Access and Correction of Personal Information
Review of Personal Information
Site visitors may not access information we have collected and maintain about them
Many Web sites now use “cookies” to provide useful features to their visitors by providing customizable and personalized services.
Your browser software can be set to reject all cookies, or to ask you if you would like to accept or decline a cookie from a particular site before it is set. Most browsers offer instructions on how to reset the browser to reject cookies in the Help section of the toolbar. You should know, however, that if you reject a cookie, certain functions and conveniences of a site may not work properly.
We do not use any cookies to store or collect information on our Web site.
Registration for Access
Some Web sites require you to provide some personal information through a registration process in order to take advantage of certain Web site features and to access content areas. For example, a registration form might request your name, telephone number and e-mail address. You might also be asked to voluntarily provide a list of health topics that you are interested in so your Web site experience
Visitors can use this entire Web site anonymously, without registration.
We are especially concerned about protecting children’s privacy. We hope parents and teachers are involved in children’s Internet explorations. It is particularly important for parents to guide their children when children are asked to provide personal information on line.
Our site does not feature information and services of interest to children 13 and under
Interactive Services and Tools
Interactive services tools such as health risk assessments, health-related calculators, and other technology-based features provide Web site users with a richer and more valuable experience. The tools can provide you with information that is customized according to your personal health background and needs.
Some interactive tools may request identifying personal and health-related information in order to function. It is important for you to know how your information will be used when it is requested, for what purposes it may also be used, and if it will be shared with any other party.
This site does not use interactive tools that ask you for identifying and health-related personal information.
Security of Communications
We recognize that many people are concerned about the privacy and protection of information as it is transmitted over the Internet. You should keep in mind that the possibility exists for unauthorized individuals to intercept any email message you send over the Internet. In some cases, information can be encrypted (scrambled or encoded) to make it very difficult to read if it is intercepted during communication. Certain technology and practices allow Web sites to provide an increased level of security for your personal and health-related information when appropriate.
We use the following practices on our Web site to enhance the level of security for communication and the transmission of personal information:
- We are not responsible for the privacy of e-mail messages except those stored in our system.
E-Commerce, On-line Donations, and Online Shopping
Purchasing items or making donations over the Internet usually requires you to provide your personal identifying information and credit card information on a Web site. Many people have become accustomed to on-line commerce as a time-saving and useful convenience. There are a number of practices that can make providing your sensitive credit card information more secure and therefore make you feel more comfortable about doing so.
At this time, we do not process credit card payments for donations, merchandise, or services on our Web site.
At this time, we do not partner with or have special relationships with any advertising server companies.
Links to Other Sites
This site includes links to non-affiliated external Web sites. We have the following practices:
From time to time, we may use customer information for new, unanticipated uses not previously disclosed in our privacy notice. If our information practices change at some time in the future, we have the following practices:
- We will contact you before we use your data for these new purposes to notify you of the policy change and to provide you with the ability to opt out of these new uses
Preference for Future Use of Information
You may prevent your information from being used for purposes other than those for which it was originally collected by:
Web Site Contact Information
Harrisburg Medical Center
100 Dr. Warren Tuttle Drive
Harrisburg, IL 62946
Contact: Courtney Drone
This privacy statement was last modified on September 23, 2013. [HOME]
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