This notice describes how your medical information may be used and disclosed (provided to others) and how you can get access to this information. Please review this notice carefully.
This Notice of Privacy Practices explains how Cardiovascular Consultants of Southern Delaware (CVCSD), its medical staff members, employees, volunteers, and clinics may use and provide your Protected Health Information (called PHI) to others for treatment, payment, and health care “operations” as described below, and for other purposes allowed or required by law.

I. OUR RESPONSIBILITIES:
CVCSD takes the privacy of your health information seriously. We are required by law to keep your health information private and provide you with this Notice of Privacy Practices. We will act according to the terms of this Notice. We reserve the right to change this Notice of Privacy Practices and to make any new practices effective for all Protected Health Information that we keep. Any changes made to the Notice of Privacy Practices will be posted in the Patient Registration area, posted on our Web site (www.cvcde.com) and given to you at your next appointment.

II. WHAT IS “PROTECTED HEALTH INFORMATION” (PHI)?
Protected Health Information (PHI) is information about a patient’s age, race, sex, and other personal health information that may identify the patient. The information relates to the patient’s physical or mental health in the past, present, or future, and to the care, treatment, and services needed by a patient because of his or her health.

III. WHAT DOES “HEALTH CARE OPERATIONS” INCLUDE?
“Health care operations” includes activities such as discussions between hospital staff and other health care providers; evaluating and improving quality; making travel arrangements to and from CVCDE; reviewing the skills, competence, and performance of health care staff; training future health care staff; dealing with insurance companies; carrying out medical reviews and auditing; collecting and studying information that could be used in legal cases; and managing business functions.

IV. HOW IS MEDICAL INFORMATION USED?
CVCSD uses medical records to record health information, to plan care and treatment, and to carry out routine health care functions. For example, your insurance company may need us to give them procedure and diagnosis information to bill for patient treatment we provide. Other health care providers or health plans reviewing your records must follow the same privacy laws and rules that CVCSD is required to follow.

V. EXAMPLES OF HOW MEDICAL INFORMATION MAY BE USED FOR TREATMENT, PAYMENT, OR HEALTH CARE OPERATIONS

• Medical information may be used to show that a patient needs certain care, treatment, and services (such as lab tests, prescriptions, treatment plans, and research study requirements).
• We will use medical information to plan treatment.
• We may disclose Protected Health Information to another provider for treatment (such as, referring doctors, specialists, and providers at the Beebe Medical Center).
• We may send claims to your insurance company containing medical information. We might also contact their utilization review department to receive precertification (approval for treatment in advance).
• We may use the emergency contact information you gave us to contact you if the address we have on record is no longer correct.
• We may contact you to remind you of the patient’s appointment by calling you or mailing a postcard.
• We may contact you to discuss other possible treatments or benefits related to health that might interest you.
• We may use information to schedule testing or implantable devices.

VI. WHY DO I HAVE TO SIGN A CONSENT FORM?
When you sign the Consent for Release of Information, you are giving CVCDE permission to use and disclose (provide to others) Protected Health Information for treatment, payment, and health care operations, as described above. This permission does not include psychotherapy notes, psychosocial information, alcoholism and drug abuse treatment records, and other privileged categories of information, all of which require a separate permission. You will need to sign a separate consent form to have Protected Health Information given out for any reason other than treatment, payment, or health care operations or as required or permitted by law.

VII. WHY DO I HAVE TO SIGN A SEPARATE PERMISSION FORM?
To provide patient Protected Health Information to other people for any reason other than treatment, payment, and health care operations (described above) or as required or permitted by law, we must have a permission form known as an Authorization Form signed by the patient or the patient’s parent or legal guardian. This form clearly explains how they wish the information to be used and disclosed. The following are some examples of information that require separate permission before we can release it:

• Psychotherapy notes
• Information and photographs shared with outside parties for its fundraising and public relations activities
• Information used in scientific and educational publications, presentations, and materials related to the work at CVCDE
• Information shared with other clinical and scientific cooperative groups that CVCDE works with in carrying out its mission to advance cures, and means of prevention, for catastrophic diseases through research and treatment.

VIII. CAN I CHANGE MY MIND AND WITHDRAW PERMISSION FOR CVCDE TO DISCLOSE PHI?
You may change your mind and withdraw (revoke) permission, but we cannot take back information that has been released up to that point. Permission cannot be withdrawn if (1) the information is needed to maintain the integrity of the research study, or (2) if the permission was originally given to obtain insurance coverage. All requests to withdraw permission for uses and disclosures of PHI should be made in writing. The request should be submitted to Patient Registration, which will then forward this information to the Privacy Officer and the Director of Health Information Management.

IX. BEING LISTED IN THE HOSPITAL DIRECTORY
CVCDE may include certain limited information about the patient in our hospital directory while the patient is in the hospital. This information may include the patient’s name, location in the hospital, general condition (for example, good, fair, etc.). If you do not wish to be in the Hospital Directory, please inform our Privacy Practices Officer.

X. SHARING INFORMATION WITH CVCDE BUSINESS ASSOCIATES
Some services at CVCDE are provided through contracts with business associates or business partners. Examples include billing transcription, Cardiac Holter Monitors, or implantable devices. When these services are contracted, we may disclose the minimum necessary amount of your health information to the business partner that they need to perform the job we have hired them to do. To protect your health information, we legally require our business associates and business partners to follow the same privacy laws that CVCDE must follow.

XI. WHEN IS MY CONSENT NOT REQUIRED?
The law requires that some information may be disclosed without your permission during the following times:

• In an emergency
• When communication or language is very limited
• When required by law
• When there are risks to public health
• To conduct health oversight activities
• To report suspected child abuse or neglect
• To certain government agencies who monitor activity
• In connection with court or government cases
• For law enforcement purposes
• To coroners and funeral directors and for organ donation
• If health or safety is seriously threatened

XII. YOUR PRIVACY RIGHTS
The following explains your rights with respect to your Protected Health Information (called PHI) and a short description of how you may use these rights.
1. You have the right to review and to ask for a copy of your health information.
This means that except as explained below, you may review and get a copy of your PHI that is contained in a “designated record set” as long as we keep the PHI. A designated record set contains medical and billing records and any other records that CVCDE uses to make decisions about your health care. You may not read or be given a copy of psychotherapy notes; information collected for use in a civil, criminal, or administrative action, or court case; and certain PHI that is protected by law. In some situations, you may have the right to have this decision reviewed. Please contact the Health Information Management Services (HIMS) Department if you have questions about access to your medical record.
If needed and at your request, CVCDE may provide an electronic copy of your record if CVCDE is able to do so. A fee will be charged for requesting a copy of your health or medical records.
2. You have the right to request that access to your health information be limited.
This means you may ask us to restrict or limit the medical information we use or disclose for treatment, payment, or health care operations (described above). CVCDE is not required to agree to a restriction that you ask for. We will tell you if we reject your request. If we do agree to the requested restriction, we will not violate that restriction unless it must be violated to provide emergency treatment. You may request a restriction by contacting the CVCDE Privacy Officer.
3. You have the right to request to receive private communications in another way or at other locations.
We will agree to reasonable requests. To carry out the request, we may also ask you for another address or another way to contact you, for example, mailing to a post office box. We will not ask you to explain why you are making the request. Requests must be made in writing to Patient Registration.
4. You have the right to request changes to your health information.
This means you may ask for changes to be made (amended) in PHI about you in a designated record set for as long as we keep this information. In certain cases, we may deny your request for a change. If we deny your request, you have the right to file a statement with the CVCDE Privacy Officer, stating that you disagree. We may prepare a response to your statement and will provide you with a copy of this response. If you wish to change your PHI, please contact the CVCDE Privacy Officer. Requests for changes must be in writing.
5. You have the right to receive a record of when your health information has been disclosed by CVCDE.
You have the right to request a record (accounting) of when CVCDE has disclosed your PHI. This right applies to any time CVCDE discloses your PHI for purposes other than treatment, payment, or health care operations as described in this Privacy Notice. We are not required to account for information releases: that you requested, that you agreed to by signing an Authorization Form, that are in our Hospital Directory, that are given to family or friends involved in your care, or certain other releases we are allowed to make without your permission. The request for a record must be made in writing to the CVCDE Privacy Officer. The request should state the time period for the list. We are not required to provide a list for information released before March 4, 2011. Requests for records about CVCDE’s disclosures of your PHI may not be made for time periods of more than six (6) years or it could be an earlier time period depending upon what the law requires.
6. You have the right to receive a paper copy of this Notice of Privacy Practices.