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.

Understanding your health information

Each time you visit a University of Tennessee Health Science Center office or see a University of Tennessee Health Science Center provider in a hospital, surgical care center, university health clinic, faculty practice clinic, doctor’s office, nursing home or other facility, a record of your visit is made.This record contains information about your symptoms, examinations, test results, medications you take, your allergies and the plan for your care.This information we refer to as your health or medical record and is an essential part of the healthcare we provide for you. Your health record contains personal health information and there are state and federal laws to protect the privacy of your health information.

Uses and Disclosures of Health Information

*  We will use your information for treatment.

All the physicians, nurses and clinical staff involved in your care will document in your record about your examination and the care planned for you.If you were referred to us from another provider, your University of Tennessee Health Science Center provider may send copies of your medical record to the provider who refereed you to us so your provider will have updated treatment information about your care.

*  We will provide another physician or a subsequent healthcare provider, who is treating you, with copies of various reports from your medical record that should assist him or her in treating you.

*  We may also use health information about you to call you or send you a letter to remind you about an appointment, to follow up with diagnostic tests results, or to provide you with information about other treatment and care that could benefit your health.

*  We will use your health information for payment.

A bill will be sent to you or your Insurance.We may include information that identifies you, as well as your diagnoses, procedures, healthcare providers and supplies used.We also may contact your insurance company to determine if they will pay for your medical care as part of their certification process.

*  We will use your health information for regular healthcare operations.

The University of Tennessee Health Science Center physicians, nurses, managers and staff may look at your health information to complete a quality review to assess the care and results in your case and others like yours.The University is a teaching facility so we may use your information in the process of educating and training students and resident physicians.

Other Disclosures

*  Business Associates

There are some services provided in our organization through contacts with business associates. Examples include radiology and certain lab tests, copy service we use when making copies of your health record and the transcription service that types reports for us.To protect your health information, however, we require the business associate to protect your information.

*  Communication with others

We may disclose to a family member, or other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.

The disclosure will only be made if you agree, or are silent when given the opportunity, to disagree or if we believe, based on the circumstances and our professional judgment that you do not object.

If you are incapacitated or in an emergency circumstance, we may disclose to a family member, or other relative, close personal friend, or any other person accompanying you health information directly relevant to the person’s involvement in your care or payment for your care.

Research

Under certain circumstances, we may use and disclose medical information about you for research purposes.All research projects, however, are subject to a special approval process designed to protect the privacy of your health information.

As required by Law

We may also disclose health information to the following types of entities but not limited to:

*  Food and Drug Administration
*  Public Health or legal authorities charged with disease prevention
*  Correctional institutions
*  Workers Compensation Agents
*  Organ and Tissue Donation Organizations
*  Military Command Authorities
*  Health Oversight Agencies
*  Funeral Directors, Coroners and Medical Examiners
*  National Security and Intelligence Agencies
*  Law enforcement as required by law or in accordance with a valid subpoena
*  To avoid a serious threat to the health and safety of a person or the public
Marketing

We will not use information in your records for marketing.

Patient Rights and Responsibilities
Patient Bill of Rights

You have the right to considerate and respectful care that includes consideration of the psychosocial, spiritual, and cultural variables that influence the perceptions of illness.

You or your legally designated representative has the right to be informed about your illness, possible treatment, and likely outcome(s) and to discuss this information with your providers.

You have the right to know the names and roles of people treating you.

You have the right to have an advance directive, such as a living will or health care proxy. These documents express your choices about your future care or name someone to decide if you cannot speak for yourself. If you have a written advance directive, you should provide a copy to your family and your provider.

You have the right to privacy. The University, your provider, and others caring for you will protect your privacy.

You have the right to expect that treatment records are confidential unless you have given permission to release information, or reporting is required or permitted by law. When UHS releases records to others, such as insurers, it emphasizes that the records are confidential.

You have the right to review your medical records in the company of a professional, but they remain the property of University Health Services.

You or your legally designated representative has the right to review your medical records and to have the information explained, except when restricted by law.

You have the right to expect that UHS will give you necessary health services to the best of its ability.

You have the right to be informed of the effectiveness of treatment, and to know of possible risks, side effects or alternate methods of treatment.

You have the right to have the choice of a clinician and to change clinicians if desired.

You have the right to refuse treatment, or to ask for a second opinion, or an alternative course of treatment, and to be informed of the medical consequences of your actions.

You have the right to consent or decline to take part in research affecting your care. If you choose not to take part in research or investigational treatments and procedures, you will receive the most effective care UHS otherwise provides.

You have the right to express a complaint concerning your care and receive a response without your care being compromised.

You have the right to access in internal grievance process and also to appeal to an external agency. You are able to express your comments or concerns through the Zoomerang Patient Satisfaction Survey or through the UHS website.

You have the right to receive care in a safe setting, free from abuse or harassment including access to protective services.

Patient Responsibilities

To complete and accurate information to the best of his/her ability about his/her health, any medications, including over-the-counter products and dietary supplements and any allergies or sensitivities.

To present details of illness or complaint in a direct and straightforward manner.

To cooperate responsibly with all persons involved in the health care process.

To keep appointments on time.

To cancel appointments only when absolutely necessary, and far enough in advance so that other patients might utilize that time.

To comply with the treatment plan provided by the health professional.

To ask for clarification whenever information or instructions are not understood.

To provide both positive and negative feedback to the health professional responsible for care. Provide a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider. Inform his/her provider about any living will, medical power of attorney, or other directive that could affect his/her care.
Accept personal financial responsibility for any charges not covered by his/her insurance.
Be respectful of all the health care providers and staff, as well as other patients.

To exercise any of these rights, your request must be in writing. Please obtain the required form from the Privacy Official at 901.448.4900 or by fax at 901.448.6726.UTHSC is not required to act immediately and will investigate our abilities to comply with all requests prior to agreeing to the request.

Note: The University of Tennessee College of Nursing reserves the right to change this Notice of Privacy Practices and its policies and procedures for privacy practices at any time and to make the changes effective for all protected health information created or received prior to the new effective date and then currently maintained by the College of Nursing. The revised Notice will be posted in the University Health Service’s waiting room or patient lobby and reasonable efforts will be made to advise you of the change(s) in the Notice, policies and procedures at your next service visit. You may also obtain a copy of the revised Notice upon request.

For More Information or to Report a Problem

If you have any questions about your rights, our duties, or our practices and procedures regarding protected health information, please call the University of Tennessee Health Science Center’s Privacy Officer at the number below.You may also obtain a copy of this notice on our website at www.uthsc.edu.

If you believe your privacy rights have been or are being violated, you may complain to the University of Tennessee Health Science Center and to the Secretary of the Department of Health and Human Services.Complaints to the Secretary must be filed in writing on paper or electronically and must be made within 180 days of when you became aware of, or should have been aware of, the incidents giving rise to your complaint.

At the University of Tennessee Health Science Center, you may contact our privacy officer at 901.448.4900. By law, you cannot be penalized for filing a complaint.

The University of Tennessee Health Science Center does not discriminate on the basis of race, sex, color, religion, national origin, age, disability or veteran status in provision of educational programs and services or employment opportunities and benefits. This policy extends to both employment by and admission to the University. The University does not discriminate on the basis of race, sex or disability in the education programs and activities pursuant to the requirements of Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act (ADA) of 1990. Inquires and charges of violation concerning Title VI, Title IX, Section 504, ADA, or the Age Discrimination in Employment Act (ADEA) or any other referenced policies should be directed to the Office of Equity and Diversity (OED), 62 South Dunlap, Suite 200, Memphis, TN 38163, 901.448.5558, or TDD 901.448.7382. Requests for accommodation of a disability should also be directed to the Director of Equity and Diversity, 62 South Dunlap, Suite 200, Memphis, TN38163, 901.448.5558 or TDD 901.448.7382 or log on to our website at: www.uthsc.edu.