Notice of Privacy Practices

Stack of folders


Your Information.
Your Rights.
Our Responsibilities.

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.

Your Rights

 

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.


Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.


Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing within 60 days.


Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.


Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations.
– We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
– We will say “yes” unless a law requires us to share that information.


Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.


Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.


Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action. 


File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us using the information at the bottom of this page.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.

Your Choices

 

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.


In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care.
Share information in a disaster relief situation.
Include your information in a hospital directory.
Contact you for fundraising efforts.
(If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.)


In these cases we never share your information unless you give us written permission:

Marketing purposes.
Sale of your information.
Most sharing of psychotherapy notes.


In the case of fundraising:

We may contact you to raise funds for our hospital.
You may opt out of receiving such communications at any time by notifying the Columbus Regional Health Foundation at (812) 376-5100 or by emailing your opt out to CRHFoundation@crh.org.

Our Uses and Disclosures

 

How do we typically use or share your health information? We typically use or share your health information in the following ways.


Treat you

We can use your health information and share it with other professionals who are treating you.
(Example: A doctor treating you for an injury asks another doctor about your overall health condition.)


Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.
(Example: We use health information about you to manage your treatment and services.)


Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.
(Example: We give information about you to your health insurance plan so it will pay for your services.)


How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
For more information see: www.hhs.gov


Help with public health and safety issues

We can share health information about you for certain situations such as:
Preventing disease.
Helping with product recalls.
Reporting adverse reactions to medications.
Reporting suspected abuse, neglect, or domestic violence.
Preventing or reducing a serious threat to anyone’s health or safety.


Do research

We can use or share your information for health research.


Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.


Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.


Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.


Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:
For workers’ compensation claims.
For law enforcement purposes or with a law enforcement official with health oversight agencies for activities authorized by law.
For special government functions such as military, national security, and presidential protective services.


Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.


Organized Health Care Arrangements

Members of the hospital’s medical staff participate in the Columbus Regional Hospital Organized Healthcare Arrangement (OHCA). An OHCA is an arrangement that involves clinical and/or operational integration among legally separate covered entities in which it is often necessary to share protected health information for the joint management and operations of the OHCA. By participating in the OHCA, the hospital’s medical staff will use this Notice of Privacy Practices. The medical staff may also share your protected health information for treatment, payment, and healthcare operations without obtaining a written authorization for you. The medical staff are required to use all appropriate safeguards when using your protected health information or disclosing it to other providers.

Our Responsibilities

 

We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing.
If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov


Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.


This Notice of Privacy Practices applies to the following organizations:
Columbus Regional Hospital, 2400 E. 17th Street, Columbus, IN 47201, (812) 376-5011
Columbus Regional Health Physicians, 2400 E. 17th Street, Columbus, IN 47201, (812) 373-3055
Columbus Diagnostic Imaging, 790 Creekview Drive, Columbus, IN 47201, (812) 376-1000

 

Privacy Officer
Work phone: 812-376-5011

Information Security Officer
Work phone: 812-375-3398

Mailing Address:
2400 East 17th Street, Columbus, IN 47201

 

This Notice of Privacy Practices applies to all Columbus Regional Health locations. A complete list of locations follows:

Columbus Adult Medicine
2326 18th Street Suite 210, Columbus, IN 47201

Columbus ENT and Allergy
2326 18th Street Suite 230, Columbus, IN, 47201

Columbus Family Medicine
3581 Central Avenue, Columbus, IN 47201

Columbus Gynecology
2326 18th Street Suite 210, Columbus, IN 47201

Columbus Internal Medicine Associates
4050 Central Avenue Suite 100, Columbus, IN 47203

Columbus Pediatric Associates
1120 North Marr Road, Columbus, IN 47201

Columbus Regional Hospital Wound Center
3015 10th Street, Columbus, IN 47201

Columbus Regional Physiatry
2400 17th Street, Columbus, IN, 47201

DaVita Dialysis
2430 North Highway 7, North Vernon, IN 47365

Doctors Park Family Medicine
3201 Middle Road, Columbus, IN 47201

Fresenisus Medical Care Bartholomew
2325 18th Street Suite 120, Columbus, IN 47201

Fresenisus Medical Care Franklin
1159 Jefferson Street Suite 201, Franklin, IN 46131

Fresenisus Medical Care Seymour
200 East Third Street, Seymour, IN 47274

Fresenisus Medical Care Tree City
999 North Michigan Avenue, Greensburg, IN 47240

Hospital Care Physicians
2400 17th Street, Columbus, IN 47201

Kavelman Family Medicine
2326 18th Street Suite 120, Columbus, IN 37201

Nashville Family Medicine
103 Willow Drive Suite B, Nashville, IN 47448

Neurology and Sleep Sciences
1655 North Gladstone Avenue Suite A, Columbus, IN 47201

Neurology and Sleep Sciences
225 South Pine Street Suite 330, Seymour, 47274

Neurology and Sleep Sciences
55 East Willow Street, Nashville, IN 47448

Obstetrics and Gynecology Associates of Columbus
3183 North National Road, Columbus, IN 47201

PromptMed BCSC Clinic
1950 Doctors Park Drive Suite C, Columbus, IN 47203

PromptMed Urgent Care
2502 25th Street, Columbus, IN 47201

PromptMed WellConnect
237 Washington Street, Columbus, IN 47201

Rau Family Medicine
2326 18th Street Suite 220, Columbus, IN 47201

Sandcrest Family Medicine
3203 Middle Road, 3203 Middle Road, Columbus, IN 47203

Skin Deep
3183 North National Road, Columbus, IN 47201

Southeastern Indiana Behavioral Services
2400 17th Street, Columbus, IN 47201

Southeastern Indiana Cancer Care
2400 E 17th Street, Columbus, IN, 47201

Southeastern Indiana Respiratory and Critical Care
2400 17th Street, Columbus, IN 47201

Southern Indiana Heart and Vascular
2325 18th Street Suite 130, Columbus, IN 47201

Southern Indiana Heart and Vascular
955 North Michigan Avenue Specialist Suite II, Greensburg, IN 47240

Southern Indiana Heart and Vascular
1810 Commercial Drive, North Vernon, IN 47265

Southern Indiana Heart and Vascular
225 South Pine Street Suite 330, Seymour, IN 47274

Southern Indiana OBGYN
2450 North Park Drive Suite A, Columbus, IN 47203

Southern Indiana OBGYN
213 East Main Street, Greensburg, IN 47240

Southern Indiana OBGYN
31 East Poplar Drive, North Vernon, IN, 47265

Southern Indiana Nephrology and Hypertension
2400 17th Street, Columbus, IN 47201

Southern Indiana Nephrology and Hypertension
1159 Jefferson Street Suite 201, Franklin, IN 46131

Southern Indiana Nephrology and Hypertension
2325 18th Street Suite 210, Columbus, IN 47201

Southern Indiana Nephrology and Hypertension
301 Henry Street Bld 2, North Vernon, IN 47265

Southern Indiana Nephrology and Hypertension
200 East Third Street, Seymour, IN 47274

Southern Indiana Nephrology and Hypertension
999 North Michigan Avenue, Greensburg, IN 47240

VIMCare
2400 17th Street, Columbus, IN 47201