Privacy Statement

NOTICE OF PRIVACY PRACTICES

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.

Your protected health care information is used or may be disclosed for purposes of treatment, payment, and operations to:

  • Other health care professionals or providers for the purpose of providing you with quality health care.  (Example:  Another hospital, a nursing home, home health agency, or consults or referrals between physicians or reference laboratories.)
  • Your insurance provider for the purpose of receiving payment for your needed health care services. (Example: to complete a claim form to obtain payment from an insurer.)
  • Health care professionals for the purposes of ensuring we are providing quality health care services.  (Example: Our quality assurance committee reviews patient records to monitor performance and quality.)
  • Business associates who perform services such as billing, coding, consulting, transcription, and accounts receivable management. (Example: to complete a claim form to obtain payment for services)
  • Training, certification, and licensing programs.  (Example:  Medical students and nursing students participate in training programs at WGH.)
  • Customer service staff, medical or legal reviews, and auditors.  (Example: Patients receive a questionnaire about the service they received and these are used to improve our service to you.)
  • Public health or law enforcement when the law requires it. (Example: for legal proceedings and law enforcement: Workers’ Compensation: PHI related to Inmates; Military, National Security and Intelligence Activities; for the Protection of the President; certain approved research purposes: and any other reason such a disclosure would be required by law)
  • State or federal agencies for purposes of health care cost containment, determining medical necessity, or appropriateness of services. (Example: For Federal and State health care statistics regarding medically necessary patient care and if patient care was appropriate.)
  • Report a defective device or problematic event regarding a biological product (food or medication). (Example:  The FDA requires reporting of defective equipment).
  • Public Health, Abuse or Neglect, and Health Oversight (Example: to alert a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease)
  • Send you appointment reminders, treatment alternatives, or information regarding other health related benefits and services. (Example: to send follow up reminders of appointments or testing)
  • Visitors, callers, clergy, and room deliveries, if you agree to be in our hospital directory and these people ask for you by name.
  • Other situations where Warren General Hospital may use or disclose your protected health information include:  organ and tissue donations, workers compensation, coroners, medical examiners, and funeral directors.
  • Certain uses of your medical data, such as use of patient information in marketing, require prior disclosure and your authorization. Use and disclosures not described in this notice will be made only with your authorization.
  • If you pay in cash in full (out of pocket) for your treatment, you can instruct WGH not to share information about your treatment with your health plan, except where WGH is required by law to make a disclosure.

You have the right to:

  • Receive a copy of this Privacy Notice.
  • To be notified of a data breach.
  • Request a restriction of the use of your health care information unless the restriction conflicts with providing your health care or in the event of an emergency. The Hospital will review each restriction request, but reserves the right to deny any restriction request received.
  • Make reasonable requests to receive communications about your health care at an alternate address or by means other than by mail.
  • Make a written request to review and/or photocopy your health care information (Copies may be subject to reasonable charges.)
  • Request a copy of your electronic medical record in an electronic form.
  • Request changes to your health care information.  These requests must be made in writing.
  • To opt out of fundraising communications from WGH, and WGH cannot sell your health information without your permission.
  • Know who has received your health care information for purposes other than treatment, payment, and operations of the hospital, and for what purpose, with some exceptions as defined by law.

If you believe your rights to privacy have been violated, you may file a complaint with our privacy officer or notify the Department of Health and Human Services.  All complaints will be investigated.  No action will be taken against you for filing a complaint with the hospital.

You may mail a complaint to:
Attn:  Privacy Officer
Warren General Hospital
Two Crescent Park West, PO Box 68
Warren PA 16365

You may also submit your complaint directly to the Department of Health at:
Attn: Secretary
Pennsylvania Department of Health
Acute & Ambulatory Care Services
Health & Welfare Building, Room 532
625 Forster Street
Harrisburg PA 17180-0090
Phone:  (717)783-8980
Fax:  (717)705-6663
Hotline:  (800) 254-5164

http://www.portal.state.pa.us/portal/server.pt/community/complaint_form/20164

Normally, we will require your signed authorization before disclosing your medical information outside the hospital, unless it is required by law.  You may revoke your permission to release confidential information at any time.  The hospital abides by the terms of this notice.  The hospital may make changes to the Privacy Notice.  Changes will be effective for all protected health information kept by the hospital. The revised Privacy Notice will be available at the point of service.

Effective date of this notice:   September 23, 2013
Reviewed and updated :         April 19, 2016

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