Notice of Privacy Practices
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.
1. Purpose: The UTSA Student Health Services (SHS) and its professional staff, employees, and volunteers follow the privacy practices described in this notice. SHS maintains your treatment records in a confidential manner as required by law. Treatment records consists of medical and mental health information. SHS must use and disclose your treatment records to the extent necessary to provide you with quality health care. To do this, SHS must share your treatment records as necessary for treatment, payment, and health care operations.
2. What are Treatment, Payment, and Health Care Operations? Treatment may include sharing information among health care providers and/or mental health clinicians involved in your care. For example, your physician may share information about your condition with the pharmacist to discuss appropriate medication or with a radiologist or other consultants in order to make a diagnosis. SHS may use your treatment records as required by your insurer to obtain payment for your treatment. We also may use and disclose your treatment records to improve the quality of care, e.g., for review and training purposes.
3. What Are Other Ways SHS May Use Your Treatment Records? Unless you ask for restrictions on a specific use or disclosure, your treatment records may be used for the following purposes:
Appointment Reminders and Treatment calls- SHS may contact you to provide appointment reminders or information about treatment plans, medication or test results, other health-related benefits and services that may be of interest
To inform you of treatment alternatives or benefits or services related to your health. (You will have an opportunity to refuse to receive this information)
Business Associates- To carry out health care treatment, payment, and operations functions through business associates, e.g., to install a new computer system. SHS may disclose your health information to such business associates so that they can perform their respective job functions. To protect your health information, however, SHS requires the business associate to safeguard your information.
Public Health Purposes- such as reporting reactions to medications; infectious disease control; reporting child or elder abuse or neglect; notifying authorities of suspected abuse, neglect, or domestic violence (if you agree or as required by law). 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
To inform a family member, other relative, personal friend or other individual involved in your care if we obtain your verbal agreement to do so
Decedents-Health Information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties
Organ/Tissue Donations-Your health information may be used or disclosed for organ or tissue donation purposes
Workman’s Compensation- Your health information may be used or disclosed in order to comply with laws and regulations related to Workman’s Compensation
Physician Board Certification-SHS may use your health information to submit to the Professional Certification Board for purposes required for physicians’ qualification to complete their specialty board examination
Health Care oversight activities, e.g., audits, inspections, investigations, and licensure
To prevent a serious threat to health or safety
Law Enforcement (e.g., in response to a court order or other legal process; to identify or locate an individual being sought by authorities; about the victim of a crime under restricted circumstances; about a death that be the results of criminal conduct; circumstances relating to reporting information about a crime)
Disaster relief agency if injured in a disaster
National security and intelligence activities-Specialized government functions such as protection of public officials or reporting to various branches of the armed services that may require use or disclosure of your PHI
Protection of the President or other authorized persons for foreign heads of states, or to conduct special investigations
As required by law
Other uses- Other uses and disclosures will be made only with your written authorization and you may revoke the authorization except to the extent SHS has taken action in reliance on such
Certain research projects
Lawsuits and disputes. (We will attempt to provide you advance notice of a subpoena before disclosing the information)
Alcohol and drug abuse information has special privacy protections. SHS will not disclose any treatment records relating to a client’s substance abuse assessment and/or treatment unless: (1) the client consents in writing; (2) a court order signed by a judge requires disclosure of the information; (3) medical personnel need the information to meet a medical emergency; (4) qualified personnel use the information for the purpose of conducting research, management audits, or program evaluation; or (5) it is necessary to report a crime or a threat to commit a crime or to report abuse or neglect at required by law
4. Your Authorization is required for other disclosure-Except as described above, we will not use or disclose our medical information unless you authorize (permit) SHS in writing to disclose your information. Your written authorization is required for each request for the disclosure of medical information.
5. You have Rights Regarding your Medical Information- You have the following rights regarding your treatment records, provided that you make a written request to invoke the right on the form provided by SHS.
Right to request restrictions-you may request limitations on the medical information we use or disclose for health care treatment, payment, or operations (e.g., you may ask us not to disclose that you have had a particular surgery), we are not required to agree to your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency services
Right to confidential communications-you may request communication in a certain way or at a certain location, but you must specify how or where your wish to be contacted
Right to inspect and request a copy- You have the right to inspect a copy of your medical information regarding decisions about your care. We charge a fee for copying, mailing and supplies. Under limited circumstances, your request may be denied; you may request review of the denial by another licensed health care professional chose by SHS. SHS will comply with the outcome of the review
Right to accounting disclosures- You may request a list of the disclosures of your medical information that have been made to persons or entities other than for health care treatment payment or operations in the past six (6) years
Right to a copy of this Notice-You may request a paper copy of this Notice at any time, even if you have been provided with an electronic copy.
Right to request an amendment-If you believe that the treatment records we have about you are incorrect or incomplete, you may request an amendment on the form provided by SHS, which requires certain specific information. SHS is not required to accept the amendment
6. Requirements regarding this Notice-We will be governed by this notice for as long as it is in effect. SHS may change this Notice and these changes will be effective for medical information already in our possession as well as any information we receive in the future. Each time your register at SHS for health care services, you may review a copy of the Notice in effect at the time.
7. Complaints-If you believe your privacy rights have been violated, you may file a complaint with SHS or with the Secretary of the United States Department of Health and Human Services. You will not be penalized or retaliated against in any way for making a complaint to SHS or the Department of Health and Human Services.
8. Contact-Call the SHS Director at 210-458-4142 if:
You have a complaint
You have any questions about this Notice.
You wish to request restrictions on uses and disclosures for health care treatment, payment or operations.
You wish to obtain a form to exercise your individual rights described in paragraph five (5).
Obligations of Student Health Services
SHS is required to:
Maintain the privacy of treatment records
Provide you will this notice of its legal duties and privacy practices with respect to your health information
Abide by the terms of this notice
Notify you if we are unable to agree to a requested restriction on how your information is disclosed
Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations
SHS reserves the right to -change its privacy practices and to make the new provisions effective for all treatment records in maintains. Revised notices will be made available to you upon request at your next visit to our practice.
If you have questions or complaints, please contact:
UTSA Student Health Services
One UTSA Circle
San Antonio, TX 78249
Telephone: (210) 458-4142
Updated July 17, 2013