Notice of Privacy Practices

This notice is required by law under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  HIPAA is a federal law.  One of its primary purposes is to make certain that information about your health is handled with special respect for your privacy.  HIPAA includes number provisions that are designed to maintain the privacy and confidentiality of your protected health information (PHI).

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information.  This notice applies to all of the records of your care generated by the hospital, whether made by hospital personnel, agents of the hospital, or your personal doctor.  Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your health information created in the doctor’s office or clinic.

Our Responsibilities

We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices.  We will abide by the terms of this notice.

Uses and Disclosures

How we may use and disclose Health Information about you.

The following categories describe examples of the way we use and disclose health information:

For Treatment:  We may use health information about you to provide you treatment or services.  We may disclose health information about you to doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you at the hospital.  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.  Different departments of the hospital also may share health information about you in order to coordinate the different things you may need, such as prescriptions, lab work, meals, and x-rays.

We may also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you’re discharged from this hospital.

For Payment:  We may use and disclose health information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer.  For example, we may need to give your insurance company information about your surgery so they will pay us or reimburse you for the treatment.  We may also tell your health plan about treatment you are going to receive to determine whether your plan will cover it.

For Health Care Operations:  Your health information may be used or disclosed for health care operations.  For example, we may disclose information in your health record to individuals conducting quality of care reviews.

As Required by Law:  We will disclose health information about you when required to do so by federal, state, or local law, such as laws that require the reporting of certain types of wounds or other injuries.

Workers Compensation:  We may release health information about your for workers’ compensation or other similar programs established by law.  These programs provide benefits for work-related injuries or illness without regard to fault.

Law Enforcement:  We may disclose your health information for law enforcement purposes, such as in response to a request from a law enforcement official for purposes of identifying or locating a missing person.

Lawsuits and Disputes:  If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order.  We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute but only if efforts have been made to tell you about the request (which may include written notice to you) or to obtain an order protecting the information requested.

For Public Safety or Health Purposes:  We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of others, such as purposes of preventing or controlling disease, injury or disability; to report the abuse or neglect of children, elders, dependent adults, or others; to persons subject to the jurisdiction of the Food and Drug Administration for purposes of product safety or effectiveness; or to a person who may have been exposed to a communicable disease or may otherwise be a risk of contracting or spreading the disease of condition.

Health Oversight Activities:  We may disclose your health information to a health oversight agency for activities authorized by law.  These activities which are necessary for the government to monitor the health care system, may include audits, investigations, inspections and licensure.

Friends and Family Involved in Your Care and Emergencies:  If you need emergency treatment and we are unable to obtain your consent, we may share your health information with a family member or other person who is involved with your care.

Directory:  We may include certain limited information about you in the hospital directory while you are a patient at the hospital.  The information may include your name, location in the hospital, your general condition (e.g., good, fair) and your religious affiliation.  This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name.  If you would like to opt out of being in the facility directory please request the Opt-Out Form from the Patient Access staff or Hospital Privacy Officer.

Future Communications:  We may communicate to you via newsletters, mail outs or other means regarding treatment options, health related information, disease-management programs, wellness programs, or other community based initiatives or activities our facility is participating in.

Specialized Government Functions:  We may disclose your health information for specialized government purposes, including military and veteran activities, national security and intelligence activities, protective service of the President and others, medical suitability determinations for Department of State officials, correctional institutions and law enforcement custodial situations, or for the provision of public benefits.

Coroners and Funeral Directors:  We may disclose protected health information to a coroner or medical examiner to identify a deceased person, determine cause of death, or permit the coroner or medical examiner to fulfill their legal duties.  We may also disclose information to a funeral director to allow them to carry out their duties.

Organ or Tissue Donation:  We may use of disclose protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes or tissue.

Research:  We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research and granted a waiver of the authorization requirement.

Fundraising:  We may use your demographic information, insurance status, and dates of service to contact you regarding any fundraising activities in which we may engage.

Disaster Relief:  In the event of a disaster, we may provide your health information to disaster relief organizations.

Prohibitions on the Sale of Health Information:  We will not exchange your health information for payment without your valid written authorization unless permitted by law.

Your Health Information Rights

This section describes your rights regarding the health information we maintain about you.  Unless noted otherwise below, your requests relating to Conway Medical Center must be submitted in writing to:

Conway Medical Center
ATTN:  Privacy Officer
300 Singleton Ridge Road
Conway, SC 29526
(843) 347-7111

 Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the Right to:

  • A Paper Copy of This Notice:  You have the right to a paper copy of this notice.  You may ask us to give you a copy of this notice at any time.  You may also download an electronic copy of this document by going to the following website: www.conwaymedicalcenter.com.  Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
  • Inspect and Copy:  You have the right to inspect and obtain a copy of the health information that may be used to make decisions about your care.  Usually, this includes medical and billing records, but does not include psychotherapy notes.  We may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to health information, you may request that the denial be reviewed.  Another licensed health care professional chosen by the hospital will review your request and the denial.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome of the review.
  • Amend:  If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information.  You have the right to request an amendment for as long as the information is kept by or for the hospital. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial.
  • An Accounting of Disclosures:  You have the right to request an accounting of disclosures.  This is a list of certain disclosures we make of your health information for purposes other than treatment, payment or health care operations where an authorization was not required.
  • Right to Revoke Authorizations:  If you authorize us to disclose your health information, you may revoke that authorization in writing at any time.  If you revoke your authorization, we will stop any further use or disclosure of your health information for the purposes covered by your written authorization except if we have already acted in reliance on your permission.  You understand that such revocation will not impact any uses or disclosures that occurred while your authorization was in effect.
  • Request Restrictions:  You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations.  You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.  For example, you could ask that we not use or disclose information about a surgery you had.
  • Request Confidential CommunicationsYou have the right to request that we communicate with you about medical matters in a certain way or at a certain location.  For example, you may ask that we contact you at work instead of your home.  The facility will grant reasonable requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing and the written request includes a mailing address where the individual will receive bills for services rendered by the facility and related correspondence regarding payment for services.  Please realize, we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response.  We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.
  • Right to Receive Notification in the Event of a Breach:  You have a right to receive notification if there is a breach of your health information that poses a significant risk of financial, reputational, or other harm to you.  After learning of a breach, we must provide to you without unreasonable delay and in no event later than 60 calendar days after our discovery of the breach, unless a law enforcement official requires us to delay the breach notification
  •  For More Information or to Report a Problem:  If you have questions or would like additional information, you may contact the Hospital Privacy Officer at (843) 347-8204 or our confidential Hot Line at (888) 398-2633.  If you believe your privacy rights have been violated, you may file a formal complaint with us by contacting our Hospital Privacy Officer and/or with the Office of for Civil Rights, Department of Health and Human Services.  You will not be penalized for filing a complaint.

Changes to This Notice

We reserve the right to change the terms of this notice of privacy practices.  We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future.  We will post a copy of the current notice at www.conwaymedicalcenter.com.  The effective date of this notice is listed below.

Other Uses of Health Information

Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission.  If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization.  You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

Download this form.