Our Legal Duty: Our Health System has a duty to protect the privacy of medical information about you. This is a brief summary of our Notice of Privacy Practices. We are required to provide you with Notice explaining ways we may use and disclose your medical information and describing your legal rights and our obligations regarding the use and disclosure of your medical information.
Parties Following The Notice: The Notice will be followed by the Health System and its affiliates, their health care professionals, staff and volunteers; members of the Medical Staff (doctors) and those participating in managed care networks with the Health System; and other companies that provide services to the Health System. This Notice is for the following entities: Hospital Authority of Upson County, Georgia; Upson County Hospital, Inc. d/b/a Upson Regional Medical Center; Upson County Health Resources, Inc.; Upson Health Care, Inc.; Upson Medical Associates, LLC; Upson Regional Wellness Center, LLC; Upson Family Physicians, LLC; Upson Family Physicians, LLC d/b/a Barnesville Internal Medicine; Upson Women’s Services, LLC; URMC Health Foundation, Inc.; Upson Surgical Associates, LLC; Upson Surgical Associates, LLC d/b/a Upson Urology Associates; Upson Surgical Associates, LLC (b/d/a Upson ENT, Ear, Nose and Throat) and Orthopedics Sports Medicine and Surgery LLC.
How We May Use and Disclose Medical Information About You: We may use or disclose medical and personal information about you for many important reasons, including but not limited to the following:
- To treat you as a patient, to bill and collect for services, and to run our business,
- Activities of managed care networks in which we participate,
- To send appointment and refill reminders and patient portal information,
- For health oversight activities,
- For fundraising activities (unless you opt out),
- For public health and safety purposes,
- For blood, organ and tissue donation,
- To audit our business,
- To avert a serious threat to health or safety,
- For national security and protective services,
- To work with coroners, medical examiners and funeral directors,
- To research,
- For workers’ compensation,
- To military command authorities,
- To handle lawsuits, government requests, administrative hearings/reviews, & disputes.
- For law enforcement purposes,
- To comply with the law and as further explained in our Full Notice of Privacy Practices.
We may use or disclose certain limited information about you, unless you object or request a limitation of the disclosure, for facility patient directories, to individuals involved in your care or payment and for disaster relief purposes.
HIE: We participate in a health information exchange that will share your medical information with other treating providers across the country. These providers will use the same common electronic medical record to document and review services they provide to you. If you do not want your information in the HIE, please let us know by telling our registration clerk and by completing GRAChIE’s (Georgia Regional Academic Community Health Information Exchange) brochure located in Registration and Hospital Information Management Department and mailing it to the following address: GRAChIE, P. O. Box 470, Sandersville, Georgia 31082. You can also Opt-Out online at www.GRAChIE.org. Please do not hesitate to call their contact number (478) 533-2498 for further information.
Patient Portal: We may use and disclose information through a patient portal which allows you to view certain parts of your medical (e.g. lab results) and billing information securely.
Authorizations: In general, other uses and disclosures of your medical information not described in our full Joint Notice of Privacy Practices will require your written authorization. For example, most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes (particularly if we were to get paid money for your information) and disclosures that involve the sale of PHI will require your written authorization.
Your Privacy Rights:You have rights with respect to your health information, such as
- The right to ask confidential communications and to ask us to use different ways of communicating with you.
- The right to ask for limits on certain uses or disclosures of your medical information (including limiting the information we send to your insurance company when you have paid in full, if we are allowed to limit by law.
- The right to look at and get a copy of your paper and electronic medical record (including completed lab reports). (We may charge a cost-based fee.)
- The right to ask us to fix mistakes in your medical record and have a written statement of disagreement placed in your record.
- The right to a list of certain types of disclosures of your medical information that were not for treatment, payment or business purposes.
- The right to get notice of a breach of your unsecured health information.
Changes to the Notice: We reserve the right to change the Notice. Changes will apply to all information we have about you. We will post any revised Notice in our facilities and on our website at www.urmc.org.
Complaints: If you believe your privacy rights have been violated, you may file a written complaint with the Health System, by calling the HIPAA Privacy Officer at 706-647-8111 Extension 1240 or writing a letter to Attn: HIPAA Privacy Officer, 801 W. Gordon Street, P. O. Box 1059, Thomaston, GA 30286. You can also file a complaint with the U.S. Department of Health and Human Services Office by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov. We will not retaliate against you for filing a complaint.
Right to a Copy of Our Complete Notice: Copies of our full Notice of Privacy Practices are available within our facilities at primary registration sites and on our website at www.urmc.org. We will be happy to give you a copy upon your request. If you have any questions about this Summary Notice, please contact the HIPAA Privacy Officer at 706-647-8111 Extension 1240 or writing a letter to Attn: HIPAA Privacy Officer, 801 W. Gordon Street, P. O. Box 1059, Thomaston, GA 30286. For more information, see: www.hhs.gov.
If you have any questions about this Notice, please contact HIPAA Privacy Officer at 801 W. Gordon Street, P. O. Box 1059, Thomaston, GA 30286 or by phone at706-647-8111 Extension 1240.
We are required to abide by the terms of this Notice as Revised Effective: October 01, 2014.