Effective Date: April 14, 2003
Revised Effective Date: February 17, 2010
Click here to read previous versions.
What patients should know about their medical information:
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.
Why are you receiving this Notice?
The Health Insurance Portability and Accountability Act’s Privacy Rule (“HIPAA”) is a regulation that requires Loyola: 1) to make sure medical information that identifies you is kept private, 2) to give you this Notice of our legal duties and privacy practices with respect to your medical information and 3) to follow the terms of the Notice that are currently in effect.
What is your medical information?
Your medical information is any health information that can be used to identify you. It is information that is needed to provide health-care services or to obtain payment for those services.
How does Loyola use and disclose your medical information?
• To help diagnose, treat and coordinate your care. We may disclose your medical information within Loyola to the physicians, nurses, technicians and students who are taking care of you. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. The doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. Different departments may share your medical information to coordinate the different things you need, such as prescriptions, lab work and X-rays. We may disclose your medical information to people outside Loyola who are or will be involved in your medical care. This may be done verbally, in writing or electronically through Loyola’s electronic medical record system.
• To obtain payment for our services. We may use and disclose your medical information so we can collect payment from you, an insurance company or a third party (including collection agencies) for the services you receive. For example, we may need to give your health plan information about your surgery at Loyola so it will pay us or reimburse you for the surgery. We also may tell your health plan about a treatment you are going to receive to obtain prior approval for your plan to cover the treatment.
• To conduct our health-care operations. We may share your medical information amongst the Loyola entities, our workforce
or business associates to run Loyola’s operations and to provide quality care to our patients. For example, we may use medical information to review our treatment and services, to evaluate the performance of our staff, to decide what additional services Loyola should offer, or to teach students. We also may share a limited amount of your medical information with other health-care providers to compare Loyola with others so we can make improvements in the care and services we offer.
• To business associates that perform services on our behalf. Examples include vendors who provide us with medical record correspondence services or caregivers who are not employed by Loyola but assist in your care at any of our facilities.
• To you at your request unless denial of access is required or permitted by law.
• To send you appointment reminders or to contact you by phone to remind you about an upcoming appointment.
• To tell you about other treatments, health-care related benefits or services that may be of interest to you.
• To use your demographic information to enlist your support of our fundraising programs unless you object. If you want to have your name removed from our fundraising mailing lists, write to the Department of Healthcare Development at the address on the back of this Notice.
• To include you, as an inpatient, in the LUMC Directory. We may include your name, room number, general condition (e.g., stable) and religious affiliation in the inpatient (or hospital) directory. The directory information, except for your religious affiliation, may be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a visiting priest or rabbi or a member of the LUMC Pastoral Care Department. This directory is available so your family, friends and clergy can visit you, send flowers and generally know how you are doing. To opt-out of the directory, contact the Admitting Department by dialing 6-5115 within Loyola or (708) 216-5115. If you opt-out, you will need to give your LUMC room and phone numbers to anyone you want to visit or call you because we will not be able to disclose that information.
• To a friend or family member involved in your care or to someone who helps pay for your care.
• To an entity assisting in a disaster relief effort during an emergency so that your family can be notified about your condition, status and location.
• To be included in research projects. As an academic medical center, Loyola has active research programs that include studies
that may involve your current care or a review of your medical history. We generally ask for your written authorization before using your medical information or sharing it with others in order to conduct research. Under limited circumstances, we may use and disclose your medical information without your authorization. Information is only used without your approval if we obtain an independent review to ensure that research conducted without your authorization poses minimal risk to your privacy. Otherwise, only limited information, falling within the government privacy protections guidelines, is used.
• To avert a serious threat to health or safety to you, another person or the public.
• To carry out your request to donate organs or tissue, we provide information to organizations that handle organ and tissue procurement, donations or transplantations.
• To military command authorities if you are in the armed forces.
• To entities, as required by workers’ compensation laws.
• To public health and government agencies.
• To health oversight agencies, for activities authorized by law.
• To social service or protective service agencies or departments, to report abuse, neglect or domestic violence.
• To an officer of the court, a member of an administrative tribunal or an attorney in response to a court order, an administrative order or a subpoena.
• To law enforcement officials.
• To coroners, medical examiners and funeral directors.
• To the government for national security and intelligence activities.
• To authorized persons, for special government functions such as for protective services for the President.
• To correctional institutions in certain situations, if you are an inmate.
• To others, as required by federal, state or local law.
In some instances, your medical information may be given greater protection under Illinois state law or federal laws other than HIPAA (e.g., mental health records, certain genetic and HIV testing results).
In all other situations, except for incidental disclosures (e.g., calling out your name in a waiting room), we may only share information with your specific written authorization. You may revoke that authorization, in writing, at any time. If you revoke your permission, we will no longer use or disclose your medical information for the reasons covered by the authorization. Of course, we are unable to take back any disclosures we have already made with your authorization, and we are required to retain our records of the care that we provided to you.
What are your rights under HIPAA?
You have a right to inspect, copy and to request amendments to your medical information (as permitted or required by law). To the extent that your medical information is contained in an electronic health record, you have a right to obtain a copy of that information in an electronic format. Requests should be made as follows: 1) For medical records to the Medical Records Department; 2) For LUMC hospital billing records to the Patient Financial Services Department; and 3) For physician billing records to the LUMC Physician Billing-Customer Service Call Center. These requests should be sent to the appropriate department’s attention at the applicable addresses listed at the end of this Notice. There may be a charge for copies.
You have a right to request restrictions or limitations on the medical information we use or disclose about you (e.g., that we bill you instead of your insurance company for services Loyola provides) and a right to confidential communications (e.g., that we only contact you in a certain manner or at a certain location). We will not ask the reason for your request. Loyola is generally required to honor your request to restrict disclosure of your medical information to your health plan for payment or health care operations purposes. If you would like to request this restriction, you will be required to register as a self-pay patient and pay out-of-pocket in full for the services rendered. Loyola is not required to agree to any other particular restriction request or limitation but if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment, to comply with the law or if you request that we do so. To make these requests:
• If you are an inpatient, tell your nurse and she will initiate the request; or
• If you are not currently an inpatient but you obtain care periodically at Loyola on an outpatient basis, write to the Corporate Compliance Department at the address at the end of this Notice.
You have a right to an “accounting of disclosures” (i.e., a list describing how we have shared your medical information with certain parties on and after April 14, 2003). To obtain an accounting, write to the Patient Relations Department at the address listed at the end of this Notice. Reports will only list disclosures made since your last request. Only one request per year will be honored free of charge.
You have a right to a copy of this Notice. You may obtain a copy of this Notice (and any revised Notices) by visiting one of our locations, or at http://www.LoyolaMedicine.org or by writing to the Corporate Compliance Department at the address at the end of this Notice. We are required to abide by the terms of the Notice currently in effect. Therefore, we reserve the right to change the terms of our Notice and to make new Notice provisions effective for all the medical information that we maintain.
You have a right to complain if you believe your privacy rights have been violated. You may file a complaint by writing to the Loyola Patient Relations Department at the address listed at the end of this Notice. You also may file a complaint with the Secretary of the Department of Health and Human Services. We will not retaliate or take action against you for filing a complaint.
In some instances, you have a right to be informed when your medical information has been improperly used or disclosed, unless an exception under HIPAA applies.
Who is giving you this Notice?
This notice describes the privacy practices of Loyola University Medical Center (LUMC) including its employed physicians, nurses, allied health personnel and other personnel, including non-employed consulting physicians who provide services at the LUMC facilities on the LUMC Maywood campus, its Home Care and Hospice Program and at the following sites of care within the Loyola University Health System (“LUHS”): Darien, Elmhurst, Hickory Hills, Homer Glen, LaGrangePark, Maywood, Niles, North Riverside, Oakbrook Terrace,Oak Park, Orland Park, Park Ridge, Wheaton and Woodridge . You will receive a separate notice from LUHS at Melrose Park (including but not limited to Gottlieb Memorial Hospital ), Loyola Ambulatory Surgery Centerat Oakbrook, Loyola Cancer Care & Research Center at Central DuPage Hospital or RML Specialty Hospital, if you receive care at any of these locations.
Questions: If you have any questions about this Notice, please contact Loyola’s Corporate Compliance Department at the address below or (708) 216-2036 or (800) 424-6309.
Loyola’s address for purposes of physician billing records:
Loyola University Medical Center
Physician Billing - Customer Service Call Center
2 Westbrook Corporate Center - Suite 600
Westchester, IL 60154
Loyola’s address for all other purposes of this Notice:
Loyola University Medical Center
2160 South First Avenue
Maywood, IL 60153
LOYOLA UNIVERSITY HEALTH SYSTEM
