Hospice of Charles County Admissions Packet

Page 24

HIPAA Notice of Privacy Practices Hospice of the Chesapeake/Hospice of Charles County 2505 Davis Road, Waldorf, MD 20603 301-861-5317 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. This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health condition and related health care services. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice, and any other use required by law. Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission. Healthcare Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your physician’s practice. These activities include, but are not limited to, quality assessment, employee review, training of medical students, licensing, fundraising, and conducting or arranging for other business activities. For example, we may disclose your protected health information to medical school students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment, and inform you about treatment alternatives or other health-related benefits and services that may be of interest to you. CRISP: We have chosen to participate in the Chesapeake Regional Information System for our Patients (CRISP), a regional health information exchange serving Maryland and D.C. As permitted by law, your health information will be shared with this exchange in order to provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions. You may “opt-out” and disable access to your health information available through CRISP by calling 1-877-952-7477 or completing and submitting an Opt-Out form to CRISP by mail, fax or through their website at www.crisphealth.org. Public health reporting and Controlled Dangerous Substances information, as part of the Maryland Prescription Drug Monitoring Program (PDMP), will still be available to providers. HIPAA Privacy Rule – 12/11/2020

Provided by HOC/HOCC


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Reminder

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page 47

Wash Your Hands Flyer

3min
pages 42-44

Medication Management Policy

3min
pages 38-39

Be Red Cross Ready Flyer

5min
page 46

Healthcare Decision Making Worksheet and MOLST

19min
pages 30-37

Discrimination is Against the Law Notice Flyer

4min
page 28

HIPAA Notice of Privacy Practices

7min
pages 24-26

HIPAA Notice of Privacy Practices Acknowledgement Form

1min
page 27

Election of Hospice Benefit

2min
page 21

Patient Notification of Hospice Non-Covered Items, Services and Drugs

1min
page 23

Basic Home Safety Standards

2min
pages 18-19

Ethics Committee Mission Statement

0
page 17

Admissions Checklist and Consent Form

1min
page 22

Spiritual Care

1min
page 16

Volunteers and Guidelines for Medication Administration

3min
pages 14-15

Complaints and Grievances

1min
page 8

Your Interdisciplinary Team Detailed Description

2min
pages 12-13

Patient and Hospice Agreement

2min
page 11

Interdisciplinary Team, Care Coordinator, Withdrawal from Hospice

1min
page 4

Covered Services and Services which Require Pre-Authorization

1min
page 5

Patient and Family Rights and Responsibilities

3min
pages 6-7

Patient Self-Determination Policy

2min
pages 9-10

Purpose of Hospice, Choice of Care, Levels of Care

2min
page 3
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