Joint Notice of Privacy Practices
notice describes how medical information about you may be used and
disclosed and how you can get access to this information. Please review
This notice applies to all members of Benefis
Health System’s work force and members of the Professional Staff
including physicians, dentists, podiatrists and other independent health
care providers accorded privileges to practice at Benefis Health
System. The Professional Staff agree to abide by the terms of this
notice and to share information as necessary to carry out treatment,
payment or health care operations related to Benefis Health System. This
notice applies to all service locations owned and/or operated by
Benefis Health System, including but not limited to, East Campus, West
Campus, Benefis Quick Care, Benefis Extended Care and Peace Hospice of
Your Health Information Rights
your health record is the physical property of Benefis Health System,
the information belongs to you. You have the right to:
in writing a restriction on certain uses and disclosures of your
information as provided by 45 CFR §164.522. Benefis Health System is not
required to grant your request. Benefis Health System will comply with
any request granted.
- Obtain a paper copy of the notice of information practices upon request.
- Inspect and obtain a copy of your health record upon written request as provided for in 45 CFR §164.524.
your health record upon written request as provided for in 45 CFR
§164.528 and Montana Uniform Health Care Information Act (MCA
- Obtain an accounting of disclosures of your health information upon written request as provided for in 45 CFR §164.528.
- Request in writing communications by alternative means or at alternative locations.
your authorization to use or disclose health information except to the
extent that action has already been taken. Your request must be
submitted to us in writing.
Understanding Your Health Record/Information
what is in your record and how your health information is used helps
you to ensure its accuracy and better understand who, what, when, where,
and why others may access your health information. Each time you visit a
hospital, physician, or other health care provider, a record of your
visit is made. Typically, this record contains your symptoms,
examination and test results, diagnoses, treatment, and a plan for
future care or treatment. This information, often referred to as your
health or medical record, serves as a:
- Basis for planning your care and treatment.
- Means of communication among the many health professionals who contribute to your care.
- Legal document describing the care you received.
- Means by which you and/or your insurance company can verify that services billed were actually provided.
- A tool in educating health professionals.
- A source of data for medical research.
- A source of information for public health officials charged with improving the health of the nation.
- A source of data for facility planning and marketing.
- A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Benefis Health System Responsibilities
Benefis Health System is required to:
- Maintain the privacy of your health information.
you with a notice as to our legal duties and privacy practices with
respect to information we collect and maintain about you.
your written acknowledgment of receipt of our notice of privacy
practices at your first date of service. If your acknowledgment cannot
be obtained, we must document our efforts to obtain your acknowledgment
and the reasons why it was not obtained.
- Post our notice of
privacy practices in a clear and prominent location where it is
reasonable to expect individuals seeking service will be able to read
- Abide by the terms of our notice of privacy practices.
- Notify you if we are unable to agree to a requested restriction.
reasonable requests you may have to communicate health information by
alternative means or at alternative locations.
Health System reserves the right to change this notice. We reserve the
right to make the revised or changed notice effective for medical
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 in the
hospital. The notice will contain the effective date. In addition, each
time you register at or are admitted to the hospital for treatment or
health care services, we will offer you a copy of the current notice in
For More Information or to Report a Problem
you believe your privacy rights have been violated, you can file a
complaint with Benefis Health System's Privacy Officer or with the
secretary of Health and Human Services. There will be no retaliation for
filing a complaint. If you have questions and/or would like additional
information, please contact our Privacy Officer at 406-455-5837.
Examples of Disclosures for Treatment, Payment and Health Operations
Health System will use your health information for treatment. For
example, information obtained by a nurse, physician, or other member of
your health care team will be recorded in your record and used to
determine the course of treatment that should work best for you. Your
physician will document in your record his or her expectations of the
members of your health care team. Members of your health care team will
then record the actions they took and their observations. In that way,
the physician will know how you are responding to treatment. Benefis
Health System will also provide your physician or a subsequent health
care provider with copies of various reports that will assist him or her
in treating you once you're discharged.
We will use your health
information for payment. For example, Benefis Health System will send a
bill to you and/or your insurance company. The information on or
accompanying the bill may include information that identifies you, as
well as your diagnosis, procedures and supplies used.
We will use
your health information for regular health operations. For example,
members of the medical staff or the departments that provided your care
may use information in your health record to assess the care and
outcomes in your case and others like it. This information will then be
used in an effort to continually improve the quality and effectiveness
of the healthcare and service we provide.
We will use your health
information for treatment, payment and health operations of other
covered entities. For example, Benefis Health System may release
information to your physician so that he or she may send a bill to you
and/or your insurance company. In addition, Benefis Health System may
provide your physician or referring hospital with information required
to perform quality improvement, peer review, compliance review and
Other Permitted Uses and Disclosures
Unless you notify us in writing that you object, we will use your name,
location in the facility, general condition, and religious affiliation
for directory purposes. This information may be provided to members of
the clergy and, except for religious affiliation, to other people who
ask for you by name.
Notification of family: We
may use or disclose information to notify or assist in notifying a
family member, personal representative, or another person responsible
for your care.
Communication with family: Health
professionals, using their best judgment, may disclose to a family
member, 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.
Communication of Plan of Care:
Your provider(s) may write relevant care information on a white board
in your room. This is a form of communication to patients and families
regarding their care. Please notify your provider(s) if you do not want
information written on the board.
Communicating appointment reminders and healthcare alternatives:
We may contact you to provide appointment reminders or provide you with
information about treatment alternatives or other health-related
benefits and services that may be of interest to you.
Fund raising: We may contact you as part of a fund-raising effort.
We may disclose information to researchers when their research has been
approved by an institutional review board that has reviewed the
research proposal and established protocols to ensure the privacy of
your health information.
There are some services provided in our organization through contacts
with business associates. Examples include physician services in the
emergency department and radiology, certain laboratory tests and a copy
service we use when making copies of your health record. When these
services are contracted, we may disclose your health information to the
business associate so that they can perform the job we've asked them to
do and bill you or your insurance company for services rendered. To
protect your health information, we require the business associate to
appropriately safeguard your information.
Required Uses and Disclosures
Food and Drug Administration (FDA):
We may disclose to the FDA health information relative to adverse
events with respect to food, supplements, product and product defects,
or post marketing surveillance information to enable product recalls,
repairs or replacement.
Public health: As
required by law, we may disclose your health information to public
health or legal authorities charged with preventing or controlling
disease, injury, or disability.
We may disclose health information to the extent authorized by and to
the extent necessary to comply with laws relating to workers'
compensation or other similar programs established by law.
Law enforcement and correctional institutions:
We may disclose health information for law enforcement purposes as
required by law or in response to a valid subpoena. Should you be an
inmate of a correctional institution, we may disclose to the institution
or their agents health information necessary for your health and the
health and safety of other individuals.
Military and Veterans:
We may release medical information about you as required by military
command authorities. In addition, Federal law makes provision for your
health information to be released to an appropriate health oversight
agency, public health authority or attorney, provided that a work force
member or business associate believes in good faith that Benefis Health
System may have engaged in unlawful conduct or have otherwise violated
professional or clinical standards and are potentially endangering one
or more patients, workers or the public.
Consistent with applicable law, we may disclose health information to
organ-procurement organizations or other entities engaged in the
procurement, banking, or transplantation of organs for the purpose of
tissue donation and transplant.
Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Printed Date: March 17, 2003
Effective Date: April 14, 2003