Site Information

This notice covers:

• Information about your health condition, healthcare treatment or payment for healthcare treatment that could reasonably identify who you are.
• Information in the possession of any Cincinnati Children’s department or division. This applies to our personnel, volunteers, contractors or anyone working here who might have access to your health information.

 We have an Organized Health Care Arrangement Agreement with our medical staff that makes this notice, and the rights and obligations contained herein, applicable to both Cincinnati Children’s and to our medical staff when they are providing services to patients here.

We are permitted to use or disclose to others outside Cincinnati Children’s your health information without permission from you for three basic types of activities:

• Treatment − To provide proper medical care to you. This means we can provide your health information to nurses, technicians, doctors, medical students or outside laboratories involved in your care.
  
  For example, the dietitian may need to know your condition if it requires special meals; X-ray and laboratory technicians may need to know your condition to conduct the proper test; other physicians may need to have your information to advise those providing your care.
  
  In some circumstances we may require you to complete an authorization form for disclosure of your protected health information to an outside healthcare provider.
  
• Payment − To submit bills for the care and services you receive.
  
  For example, information about your care or services may be sent to your insurance company, a government insurance program or another company that processes the information and submits it for payment.
  
  We may also provide information to your health plan about treatment you may receive so they may approve or disapprove whether you are covered for that care.
  
• Healthcare operations − To run the hospital and ensure high-quality care.
  
  For example, we may use your information to review how we provide care to you; we may disclose it to consultants to help us improve how we operate the hospital; we may disclose it to certain organizations to meet compliance or licensing requirements; we may use information about you in our performance improvement software system.

There are situations where we may use your information or disclose it to others outside Cincinnati Children’s without your permission, and there are specific circumstances where we must obtain your authorization before using or disclosing your protected health information. They are described below:

• Appointment reminders − We may use or disclose your health information to send you reminders that you have an appointment for treatment or medical care.
  
• Treatment alternatives − We may use or disclose your health information to tell you about or recommend possible treatment-related options, activities or alternatives that may be helpful to you.
  
• Health-related benefits and services − We may use or disclose your health information to tell you about health-related benefits or services that may be of interest to you.
  
• Fundraising activities − We may use or disclose your health information to contact you for fundraising activities for Cincinnati Children’s, by Cincinnati Children’s or on our behalf by others.
  
  In our fundraising, we would disclose only certain information, such as your name, address, phone number and the dates you received treatment or services at the hospital.
  
  If you do not want to be contacted for fundraising efforts, you must notify the director of business operations in writing at Department of Development, MLC 9002, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039.
  
• Patient directory − We may include certain limited information about you in our patient directory while you are a patient at the hospital, such as your name, location in the hospital and your religious affiliation.
  
  This directory information, except for your religious affiliation, may be disclosed to people who ask for you by name.
  
  Your religious affiliation may be given only to a member of the clergy. During registration you will be given an opportunity to withhold your information from our patient directory.
  
  Any time you wish to remove your information from the patient directory, you must notify the registration desk or a customer service representative.
  
• Individuals involved in your care or payment for your care − During times of treatment, we disclose your health information only to you or your personal representative.
  
  We may also disclose your health information to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
  
• Research − Under certain circumstances, we may use and disclose your health information for research purposes.
  
  For example, we may disclose your information to researchers preparing to conduct an investigation to help them look for patients with specific medical conditions.
  
• As required by law − We will disclose your information when required by law.
  
• To avoid a serious threat to health or safety − We may use and disclose your health information to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would be only to someone able to help prevent the threat.
  
• Organ and tissue donation − If you are an organ donor or recipient, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank to support the process.
  
  These entities include, but are not limited to, Ohio Solid Organ Transplant Consortium, United Network for Organ Sharing (UNOS) and Ohio Valley Life Center.
  
• Marketing − We are not permitted to use your information in marketing activities unless you specifically authorize the communication.

•  Authorization to use or disclose your information − For us to use or disclose your information, other than as described above, we will generally need to obtain your written authorization, which you may revoke at any time to stop future uses and disclosures.
  
• Right to have access to your information − You have the right to look at or have a copy of your health information.
  
  Exceptions include psychotherapy notes; information that may be used in a civil, criminal or administrative action or proceeding; or where prohibited by law.
  
  The request must be in writing and directed to Health Information Management (MLC 5015) or Professional Billing Services / Patient Financial Services (MLC 9013). We will charge a fee for copying costs.
  
• Right to amend your information − If you believe the information we have about you is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information. The request must be in writing and directed to Health Information Management.
  
• Right to request confidential information be provided in a certain way − You may request that when we send your information to you, we do so in a specific way that is convenient for you, such as using only a work number or by mail. We are not required to follow your request, but we will make every reasonable effort to do so, or find a mutually satisfactory alternative.
  
• Right to an accounting of our disclosures of your information − You also have the right to receive a list of instances where we have disclosed your health information to others for reasons other than treatment, payment or healthcare operations, or as authorized by you. The request must be in writing and directed to Health Information Management (MLC 5015).
  
• Right to limit our use or disclosure of your information − You may request in writing that we not use or disclose your information for treatment, payment, operations or any other purpose except when specifically authorized by you, when required by law or in emergency circumstances. We will consider your request and respond, but we are not legally required to accept it.

Cincinnati Children’s may deny you access to your protected health information if a licensed healthcare provider determines that:

• Releasing it could endanger you or someone else
• Your protected health information refers to a third party and releasing it could harm that person
• Providing access to a personal representative could harm you or another person

If you are denied access under these circumstances, you may appeal. Under certain circumstances, Cincinnati Children’s may deny your request for access to your protected health information without giving you an opportunity to appeal.

Cincinnati Children’s is required to protect the privacy of your information, establish policies and procedures that do so, provide this notice about our privacy practices and follow the practices described in this notice.

We reserve the right to change our policies and procedures for protecting health information. When we make a significant change in how we use or disclose your health information, we will also change this notice and post the new notice in waiting rooms and registration areas. You can request a written copy of the most recent version of this notice or access it on the Cincinnati Children’s website.

If you believe we have not properly protected your privacy, have violated your privacy rights or you disagree with a decision we made about access to your protected health information, you may contact our privacy officer.  Click on the link, “How to Get More Information About Our Privacy Practices.”

You also may send a written complaint to the US Department of Health and Human Services. Our privacy officer can provide you with the appropriate address upon request.

To act on any of the information provided in this notice or for more information about our privacy practices, you may contact our privacy officer.

Phone: 1-800-344-2462 or 513-636-4707

Fax: 513-636-4076

Email: privacyofficer@cchmc.org

Mail:
Privacy Officer
Risk Management / Corporate Compliance, MLC 9010
Cincinnati Children’s Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH 45229-3039

This notice was reviewed October 2011.