CHRISTUS SOUTHEAST TEXAS PHO

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.

If you have any question, please contact our Privacy Office at the address or phone number on this Notice.

The CHRISTUS Southeast Texas PHO provide a network of physicians, hospitals, and other professionals and organizations. The information privacy practices in this Notice will be followed by:

· All departments and units of our organization.
· All employed associates, staff or volunteers of our organization, and CHRISTUS Health, our parent organization, with whom we may share information as permitted within our organized health care arrangement.
· Any business associate or partner of the CHRISTUS Southeast Texas PHO with whom we share health information.

We understand that medical and billing information about you is personal. We are committed to protecting the privacy of your medical and billing information. Your personal doctor may have different policies or Notices regarding the doctor’s use and disclosure of your medical and billing information created in the doctor’s office. We are required by law to:

· Keep medical and billing information about you private;
· Give you this Notice of our legal duties and privacy practices with respect to your protected health information;
· Follow the terms of the Notice currently in effect.

We may change our policies and privacy practices at any time. Changes will apply to your protected health information we already hold, as well as new information obtained after the change occurs. When we make a significant change in our policies, we will change our Notice and post the new Notice in our office, and on our Web site at www.stestmpho.org or you can receive a copy of the current Notice at any time. The effective date is listed just below the title.

· We may use or disclose medical and billing information about you without your prior authorization for several other reasons. Subject to certain requirements, we may give out protected health information about you without prior authorization to insure proper payment of claims submitted to a CHRISTUS Southeast Texas PHO contracted payor. We may also disclose protected health information when required by law, such as in response to a request from law enforcement officials in specific circumstances, or in response to valid judicial or administrative orders.

· In any other situation not covered by this Notice, we will ask for your written authorization before using or disclosing your protected health information. If you choose to authorize our use or disclosure of your protected health information, you can later revoke that authorization by notifying us in writing of your decision.

· You have the right to a list of those instances where we have disclosed medical and billing information about you, other than for treatment, payment, health care operations or where you specifically authorized a disclosure. When you submit a written request, the request must state the time period desired for the accounting, which must be less than a six (6)-year period and starting after April 14, 2003. You may receive the list in paper or electronic from. The first disclosure list request in a 12 month period will be provided to you at no cost; other requests will be charged in accordance with our cost of produce the list. We will inform you of the cost before you incur any charges.

· If this Notice was sent to you electronically, you have the right to a paper copy of the Notice.

· You have the right to request that your medical and billing information be communicated to you in a confidential manner, such as sending mail to an address other than your home. You must notify us in writing of the specific way or location for us to use to communicate with you.

· You may request, in writing, that we not use or disclose protected health information about you for treatment, payment or healthcare operations or to persons involved in your care except when specifically authorized by you, or when required by law, or in an emergency. We will consider your request but we are not legally required to accept it. We will inform you of our decision.

· If you are concerned that your privacy rights may have violated or you disagree with a decision we made about access to your records. You may contact our CHRISTUS Health Integrity Line, available 24-hours, at 1-888-728-8383.

· You may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights. Our Privacy Office will provide you the address upon request.

· Under no circumstance will you be penalized or retaliated against for filing a complaint.