Notice of Privacy Practices

University Medical Center Corporation
University Physicians Healthcare
University of Arizona Health Sciences Center

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.

This page provides a brief summary of your privacy rights. Please read Pages 1 – 9 for a full description of your rights. If you need more information, you may call the Alertline at (800) 726-0713.

This notice describes the privacy practices of the University Medical Center Corporation, University Physicians Healthcare and the University of Arizona Health Sciences Center, which consists of the Colleges of Medicine, Nursing, Pharmacy and Public Health. These organizations are allowed to share medical information with each other for treatment, payment, and operational activities. We will use this information in order to provide our patients with complete and comprehensive health care services.

Our Commitment to You

We are committed to protecting your medical information. We are required by law to keep medical information about you private, to give you this Notice about our privacy practices and to follow the practices outlined in this Notice.

How We May Use and Disclose Your Medical Information

We may use your medical information for treatment (such as sending medical information about you to your referring physician), payment (such as sending a bill to your insurance company), and for health care operations (such as teaching students or evaluating the performance of our staff).

Under certain circumstances we are allowed to use or disclose your medical information without your written permission. We may give out information about you for public health purposes, reports of abuse, neglect, or domestic violence, health oversight audits or inspections, research studies, funeral arrangements and organ donations, government programs, workers compensation, and emergency situations. We also disclose patient information when required by law, such as in response to a request from law enforcement or in response to judicial orders.

We also may contact you for appointment reminders, to tell you about possible treatment options and health services, or for fundraising efforts. If you are a hospital inpatient, we will put your name in our facility directory unless you tell us otherwise. We may disclose medical information about you to a friend or family member who is involved in your care.

Your Rights Concerning Your Medical Information

You have the right to inspect or receive copies of your medical information. There may be a fee for this service. You may ask us to amend the medical information you believe is incorrect or incomplete. You may have a list of non-routine disclosures we have made about you. You may request special confidential communications. You may request restrictions on information disclosed about you. You have the right to complain to us and to the federal government if you believe your privacy rights have been violated. You have a right to a paper copy of this notice.

We reserve the right to make changes to this Notice. We will post a copy of the current Notice in the locations where you receive services.

Notice of Privacy Practices

Effective: April 14, 2003

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 call the Alertline at (800) 726-0713.

Who will follow this notice

This notice describes the privacy practices of the University Medical Center Corporation, University Physicians Healthcare and the University of Arizona Health Sciences Center. To better serve you, we jointly provide you with this Notice regarding our privacy practices and your privacy rights established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The health care organizations that participate in this joint Notice, including their separate sites of services, have each agreed to follow the terms of this Notice as permitted by HIPAA. Upon request, we will provide you with a list of sites and locations that apply to this Notice. The organizations mentioned above include employees, staff, trainees, volunteer groups and other health care personnel. These organizations, sites and locations may share your medical information with each other for treatment, payment or health care operations purposes described in this Notice and are allowed to do so by law for the benefit of providing you with efficient health care services.

Important Disclaimer

The organizations participating in this joint notice are participating only for the purposes of providing this joint notice and sharing health information as permitted by applicable law and are not in any way providing heatlh care services mutually or on each other's behalf. Each organization participating in this joint notice is an individual health care provider and each is individually responsible for its own activities, including compliance with privacy laws, and all health care services it provides.

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 University Medical Center and in the clinics and physician offices. We need these records to provide you with complete and comprehensive care and to comply with certain legal requirements. This Notice applies to all of the records your care generates at our various sites and locations.

This notice tells you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information.

We are required by law to:

• make sure that medical information that identifies you is kept private;
• give you this notice of our legal duties and privacy practices with respect to medical information about you; and
• follow the terms of this Notice currently in effect.

How we may use and disclose medical information about you

The following categories describe different ways that we use and disclose medical information. 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 these 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, students, or other University Medical Center, University Physicians Healthcare or University of Arizona Health Sciences Center personnel. For example, different departments of University Medical Center may share medical information about you in order to coordinate elements of your care, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people outside University Medical Center such as referring physicians and home health care nurses in connection with your health care treatment.
• For Payment. We may use and disclose medical information about you to your insurance plan, or other parties who help pay for your care. For example, we may tell your health plan about a treatment you are going to receive to determine whether your plan will pay for that treatment.
• For Health Care Operations. We may use and disclose medical information about you for our operations. These uses and disclosures are necessary to run our organizations and to 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 disclose information to doctors, nurses, technicians, students, and other health care personnel for teaching purposes.
• Business Associates. There may be some activities provided for our organizations through contracts with outside businesses. Examples include transcription services and collection agencies. Under such contracts, we may disclose your health information to these businesses to perform the job we have asked them to do. These contracts also require the businesses to protect the health information we disclose to them.
• Appointment Reminders. We may contact you to remind you about your appointment for medical care.
• Treatment Alternatives. We may use and disclose medical information to tell you about possible treatment options or alternatives that may be of interest to you and other health related benefits and services.
• Hospital Directory. We may include certain limited information about you in the hospital directory while you are an inpatient at the hospital. This information may include your name, location in the hospital, your general condition (fair, stable, etc.) and your religious affiliation. The directory information, except for your religious information, may also be disclosed to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, even if they don't ask for you by name. We provide this service so your family, friends and clergy can visit you in the hospital and generally know how you are doing. If you are admitted to the hospital, we will not provide this information or even acknowledge your presence in the Hospital at your written request. Contact the UMC Transition Management administrative office at 520 694-2823 if you do not want this information provided.
• Individuals Involved In Your Care. Unless you object, we may disclose medical information about you to a friend or family member who is involved in your medical care and 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 location and condition. If you are not present or able to object, then we may, using our professional judgment, determine whether the disclosure is in your best interest.
• Research. As an academic medical center, we may use and disclose medical information about you for research purposes. We will only use and disclose your information for a research project if we obtain your permission, or if the need to obtain your permission has been waived by a designated review committee that meets Federal requirements.
• Information Not Personally Identifiable. We may use or share your health information when is has been de-identified. Health information is considered to be de-identified when it does not personally identify you. We may also use a limited data set that does not contain any information that can directly identify you. This limited data set may only be used for purposes of research, public health or health care operations. For example, a limited data set may include your city, county and zip code, but not your name or street address.
• As Required by Law. We will disclose medical information about you when required to do so by federal, state or local law.
• Fundraising Activities. We may use information about you to contact you in an effort to raise funds for University Medical Center, University Physicians Healthcare and the University of Arizona Health Sciences Center and its operations. We may disclose information about you to a foundation related to us so that the foundation may contact you in raising funds, including, for example, mailing you invitations to fundraising events, mailing you annual financial reports, and other types of mailings related to fundraising activities. We would only disclose contact information, such as your name, address and phone number and the dates you received treatment or services. If you do not wish to be contacted for fundraising purposes, contact the Alertline at (800) 726-0713.
• 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 others. Disclosure would only be to persons who could help prevent the threat.

How we may use and disclose medical information about you - Special Situations

• Organ and Tissue Donation. We may disclose medical information to organizations that handle and monitor organ donation and transplantation.
• Military. If you are a member of the armed forces, we may disclose medical information about you as required by military command authorities. We may also disclose medical information about foreign military personnel to the appropriate foreign military authority.
• Workers Compensation. We may disclose medical information about you for workers compensation or similar programs to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law. These programs provide benefits for work-related injuries or illness.
• Public Health Risks. As required by law, we may disclose medical information about you for public health activities. For example, we may undertake these activities:
  •  to prevent or control disease, injury or disability;
  •  to report births and deaths;
  •  to report child abuse or neglect;
  •  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 subject to certain requirements when mandated or authorized by law.
• Health Oversight Activities and Registries. We may disclose medical information to a health oversight agency for activities authorized by law and to patient registries for conditions such as tumors, traumas and burns. These oversight activities include, for example, audits, investigations, inspections and licensure surveys. These activities are necessary for the government to monitor the health care system, the outbreak of disease, government programs, compliance with civil rights laws, and to improve patient outcomes.
• 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.
• Law Enforcement. We may disclose medical information if asked to do so by a law enforcement official
  • for the reporting of certain types of wounds
  • 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 suspected criminal conduct on the premises and
  • in emergency circumstances to report a crime; the location of the crime or victims; or the identity,description or location of the person who committed the crime.
• Coroners, Medical Examiners and Funeral Directors. We may 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. We may also disclose medical information about patients of the hospital to funeral directors as necessary to carry out their duties.
• National Security. We may disclose medical information about you to authorized federal officials for purposes of national security.
• Inmates. An inmate does not have the right to this notice.

Your Rights Regarding Medical Information About You

You have the following rights regarding medical information we maintain about you:

• Right To Inspect and Copy. You have the right to inspect and have copied medical information used to make decisions about your care. Usually, this includes medical and billing records, but does not include some records such as psychotherapy notes.
  To inspect and have copied medical information used to make decisions about you, you must submit your request in writing. Call Release of Information at (520) 694-7310 for further details. We may charge a fee for the costs of processing your request.
  Under very limited circumstances, your request may be denied, such as a request for psychotherapy notes. You may request that a denial be reviewed by contacting the Alertline at (800) 726-0713.
• 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 of your record for as long as the information is kept by or for our organizations.
  To request an amendment to your record, your request must be made in writing and submitted to HIM/ROI, 1501 N. Campbell Avenue, Box 245008, Tucson, Arizona 85724. In addition, you must provide a reason that supports your request.
  We may deny your request for an amendment to your record if it is not in writing or does not include a reason to support the request. We also 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 records used to make decisions about you;
  • is not part of the information which you are permitted to inspect and copy; or
  • is accurate and complete.
• Right To an Accounting of Disclosures. You have the right to receive a list of the disclosures we made of your medical information. This list will not include all disclosures made. For example, this list will not include disclosures we made for treatment, payment, health care operations, disclosures made prior to April 14, 2003, or disclosures you specifically authorized.
  To request this list or account of disclosures, you must submit your request in writing on the authorized form we will provide to you upon request. Contact Release of Information at (520) 694-7310 for more information.
• 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 also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or in the payment for your care, like a family member or friend. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing on a form that will be provided to you, upon 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.

Call Release of Information at (520) 694-7310 for further information.

• 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 certain locations. You must make your request in writing on a form that will be provided to you upon request. We will accommodate all reasonable requests. Call the UMC Transition Management administrative office at (520) 694-2823 for further information.
• 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 print a copy of the Privacy Notice from this website.

Revisions to This Notice

We may revise this notice to reflect any changes in our privacy practices. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as for any information we receive in the future. We will post a copy of the current Notice in the locations where you receive services. The effective date of this notice is found on the second page, in the top right hand corner.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, contact the Alertline at (800) 726-0713. 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 by other laws that apply to us will be made only with your written authorization. If you provide authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. We are unable to retract any disclosures we have already made with your authorization. We are required to retain records of the care that we provided to you.