SSM Health Kidney CareAuthor: Strive Health
Our practice is committed to providing quality health care. Patients at SSM Health Kidney Care have the following Patient Rights and Responsibilities.
- Considerate and respectful health care treatment, regardless of race, creed, age, sex or sexual orientation.
- Knowledge of the name of the healthcare provider who has primary responsibility of coordinating your care and the names and professional relationships of other physicians who will see you.
- Receive information from your health care provider who has primary responsibility of coordinating your care with other physicians who will see you.
- Receive information from your health care provider about your condition, treatment, and your prospects for recovery in terms that you can understand.
- Receive as much information about any proposed treatment or procedure as you may need in order to give informed consent or to refuse this course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved in this treatment, alternate course of treatment or non-treatment and the risks involved in each, and to know the name of the person who will carry out the procedure or treatment.
- Participate actively in decisions regarding your medical care. To the extent permitted by law, this includes the right to refuse treatment.
- Full consideration of privacy concerning your medical care program. Case discussion, consultation, examination and treatment are confidential and shouldbe conducted discreetly. The patient has the right to be advised as to the reason for the presence of the individual.
- Confidential treatment of all personally identifiable data, communications and medical records pertaining to your care at SSM Health Kidney Care, and know what entities have access to your information. You will receive a separate“Notice of Privacy Practices” that explains your privacy rights in detail and how we may use and disclose your protected health information.
- Leave the clinic/treatment even against the advice of your physician.
- Reasonable continuity of care to know in advance the time and location of appointment, as well as the health care team member providing care.
- Be informed by your physician or a delegate of your physician of your continuing healthcare requirements.
- Examine and receive an explanation of your bill regardless of the source of payment.
- Know which clinic rules and policies apply to your conduct as a patient.
- Have all patient rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient.
- The personal review of your own medical records by appointment and in accordance with applicable State and Federal guidelines.
- Seek a second opinion.
- Obtain a copy of patient medical records.
- Be advised of any conflict of interests your care provider may have in respect to their care.
- Decline participation in or opt out of programs and services offered by SSMHealth Kidney Care.
- Know which staff are responsible for managing your services and from whom to request a change of care team.
- Have all SSM Health Kidney Care personnel observe these rights.
- Access information about SSM Health Kidney Care (including program and services provided on behalf of the client organization), its staff’s qualification and any contractual relationships.
- Be supported by SSM Health Kidney Care to collaborate on decisions with your practitioners and to make healthcare decisions interactively with your care team.
- Be informed of all case management services available or treatment options included or mentioned in clinical guidelines, even if a service is not covered, and to discuss options with your care team..
- Communicate complaints to SSM Health Kidney Care and receive instruction on how to use the complaint process, including SSM Health Kidney Care’s standard of timeliness forresponding to and resolving complaints and issues of quality.
- Receive understandable information.
- Providing information concerning past and present illness, complaints, allergies, hospitalizations and medical history to the best of your ability.
- Providing staff with current and complete insurance information, including any secondary insurance, each time you see your clinician.
- Signing a “Release of Information” form when asked so your clinician can get medical records from other clinicians involved in your care.
- Telling your care provider about all prescription medication(s),alternative, i.e. herbal or other therapies, or over-the-counter medications you take. If possible,bring the bottles to your appointments.
- Telling your care provider about any changes in your condition or reactions to medications or treatment.
- Following the treatment plan recommended by your care provider. This includes responsibility for keeping your appointments and for notifying your care provider if you are unable to do so.
- If you refuse treatment or refuse to follow instructions given by your care provider, you are responsible for any medical consequences.
- Keeping your appointments. If you must cancel your appointment, please call at least 24 hours in advance.
- Meeting your financial responsibilities regarding medical care or discussing financial hardships with your physicians. You should be aware of costs associated with using a limited resource like health care and try to use medical resources judiciously.
- Following the clinic rules and regulations about care and patient conduct; for example, there is no smoking in our office.
- Respecting the rights and property of our staff and other persons in the office.
- Recognizing that a healthy lifestyle can often prevent or mitigate illness and take responsibility to follow preventive measures and adopt health enhancing behaviors.
- Being aware of and refraining from behavior that unreasonably places the health of others at risk. Ask about what you can do to prevent transmission of infectious disease.
- Refraining from being disruptive in the clinical setting.
- Not knowingly initiating or participating in medical fraud.
- Reporting illegal or unethical behavior by care providers to the appropriate medical societies, licensing boards, or law enforcement authorities.
- Participate in the program offered by SSM Health Kidney Care.
- Follow the mutually agreed on case management plan or notify the case manager if you cannot follow the plan offered by SSM Health Kidney Care.
- Provide SSM Health Kidney Care with information necessary to deliver services.
- Notify SSM Health Kidney Care and your usual care provider or treating practitioner if you opt out of the program.
Summary of the Florida Patient’s Billof Rights and Responsibilities(Florida patients only)
- Florida law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider’s or health care facility’s right to expect certain behavior on the part of patients. You may request a copy of the full text of this law from your health care provider or health care facility. A summary of your rights and responsibilities follows:
- A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.
- A patient has the right to a prompt and reasonable response to questions and requests.
- A patient has the right to know who is providing medical services and who is responsible for his or her care.
- A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speakEnglish.
- A patient has the right to bring any person of his or her choosing to the patient-accessible areas of the health care facility or provider’s office to accompany the patient while the patient is receiving inpatient or outpatient treatment or is consulting with his or her health care provider, unless doing so would risk the safety or health of the patient, other patients, or staff of the facility or office or cannot be reasonably accommodated by the facility or provider.
- A patient has the right to know what rules and regulations apply to his or her conduct.
- A patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
- A patient has the right to refuse any treatment, except as otherwise provided by law.
- A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for hisor her care.
- A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facilityaccepts the Medicare assignment rate.
- A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
- A patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have the charges explained.
- A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
- A patient has the right to treatment for any emergencymedical condition that will deteriorate from failure to provide treatment.
- A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
- A patient has the right to express grievances regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
- A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.
- A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.
- A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected ofhim or her.
- A patient is responsible for following the treatment plan recommended by the health care provider.
- A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.
- A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
- A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
- A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.
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. SSM Health Kidney Care is committed to protecting the confidentiality of its patients’ medical information. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose your medical information and your
rights concerning your medical information. This Notice is provided to you pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and its implementing regulations.
— OUR RESPONSIBILITIES —
We are required to (i) maintain the privacy of your medical information as required by law; (ii) provide you with this Notice stating our legal duties and privacy practices with respect to your medical information; (iii) abide by the terms of this Notice; and (iv) notify you following a breach of your medical information that is not secured in accordance with certain security standards.
We reserve the right to change the terms of this Notice and to make the provisions of the new Notice effective for all medical information that we maintain. If we change the terms of this Notice, the revised Notice will be made
available upon request and posted at our office. Copies of the current Notice may be obtained by contacting our Privacy Officer.
— USES AND DISCLOSURES WITHOUT YOUR AUTHORIZATION —
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures, we will explain what we mean and try to give an example. Not every use or disclosure in a category is listed. However, all of the ways we are permitted to use and disclose medical information fall within one of the categories.
Treatment: We may use and disclose your medical information to provide, coordinate and/or manage your treatment, health care, or, other related services. For example, we may disclose medical information about you to your primary care doctor or another provider who is involved in your care. We may also use your medical information to remind you about an upcoming appointment.
Payment: We may use and disclose your medical information as needed to bill or obtain payment for the treatment and services provided. For example, we may contact your health plan to determine whether it will authorize payment for our services or to determine the amount of your co-payment or co-insurance.
Healthcare Operations: We may use or disclose your medical information in order to carry out our general business activities or certain business activities. These activities include, but are not limited to, training and education; quality assessment/improvement activities; risk management; claims management; legal consultation; licensing; and other business planning activities. For example, we may use your medical information to evaluate the quality of care we are providing.
Family and Friends: We may disclose your medical information to a family member or friend who is involved in your medical care or to someone who helps pay for your care. We may also use or disclose your medical information to notify (or assist in notifying) a family member, legally authorized representative or other person responsible for your care of your location, general condition or death. If you are a minor, we may release your medical information to your parents or legal guardians when we are permitted or required to do so under federal and applicable state law.
Third Parties: We may disclose your medical information to third parties with whom we contract to perform services on our behalf. If we disclose your information to these entities, we will have an agreement with them to safeguard
your information. Examples of these third parties include, but are not limited to, accreditation agencies, management consultants, quality assurance reviewers, collection agencies, transcription services, etc.
Required by Law: We may use or disclose your medical information to the extent the use or disclosure is required by law. Any such use or disclosure will be made in compliance with the law and will be limited to what is required by the law.
Public Health Activities: We may disclose your medical information for public health activities. These activities generally include the following:
• To prevent or control disease, injury or disability,
• To report child abuse or neglect,
• To report reactions to medications or problems with products,
• To notify people of recalls of products they may be using,
• To notify a person who may have been exposed to a disease
or may be at risk for contracting or spreading a disease or condition,
• To notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when otherwise required by law to the make the disclosure.
Health Oversight Activities: We may disclose your medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits; investigations, proceedings or actions; inspections; and disciplinary actions; or other activities necessary for appropriate oversight of the health care system, government programs and compliance with applicable laws.
Law Enforcement: We may disclose your medical information to law enforcement in very limited circumstances, such as to identify or locate suspects, fugitives, witnesses or victims of a crime, to report deaths from a crime, and to report crimes that occur on our premises.
Judicial and Administrative Proceedings: We may disclose information about you in response to an order of a court or administrative tribunal as expressly authorized by such order.
To Avert a Serious Threat to Health or Safety: We may use or disclose your medical information when necessary to prevent a serious and imminent threat to your health or safety or the health and safety of the public or another
person. Any disclosure would only be to someone able to help prevent the threat of harm.
Disaster Relief Efforts: We may use or disclose your medical information to an authorized public or private entity to assist in disaster relief efforts. You may have the opportunity to object unless it would impede our ability to respond to
Coroners, Medical Examiners and Funeral Directors: We may disclose medical information consistent with applicable law to coroners, medical examiners and funeral directors only to the extent necessary to assist them in carrying out their duties.
Organ and Tissue Donation: We may disclose medical information consistent with applicable law to organizations that handle organ, eye or tissue donation or transplantation, only to the extent necessary to help facilitate organ or tissue
donation or transplantation.
Research: Under certain circumstances, we may also use and disclose information about you for research purposes. All research projects are subject to a special approval process through an appropriate committee.
Workers’ Compensation: We may disclose your medical information as authorized by law to comply with workers’ compensation laws and other similar programs established by law.
Military, Veterans, National Security and Other Government Purposes: If you are a member of the armed forces, we may release your medical information as required by military command authorities or to the Department of Veterans Affairs. We may also disclose your medical information to authorized federal officials for intelligence and national security purposes to the extent authorized by law.
Correctional Institutions: If you are or become an inmate of a correctional institution or are in the custody of a law enforcement official, we may disclose to the institution or law enforcement official information necessary for
the provision of health services to you, your health and safety, the health and safety of other individuals and law enforcement on the premises of the institution and the administration and maintenance of the safety, security and good order of the institution.
— OTHER USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION —
If we wish to use or disclose your medical information for
a purpose not set forth in this Notice, we will seek your authorization. Specific examples of uses and disclosures of medical information requiring your authorization include: (i) most uses and disclosures of your medical information for marketing purposes; (ii) disclosures of your medical information that constitute the sale of your medical information; and (iii) most uses and disclosures of psychotherapy notes (private notes of a mental health professional kept separately from a medical record). You may revoke an authorization in writing at any time, except to the extent that we have already taken action in reliance on your authorization.
— YOUR MEDICAL INFORMATION RIGHTS —
Inspect and/or obtain a copy of your medical information. You have the right to inspect and/or obtain a copy of your medical information maintained in a designated record set. If we maintain your medical information electronically, you
may obtain an electronic copy of the information or ask us to send it to a person or organization that you identify. To request to inspect and/or obtain a copy of your medical information, you must submit a written request to our Privacy Officer. If you request a copy (paper or electronic) of your medical information, we may charge you a reasonable, cost-based fee.
Request a restriction on certain uses and disclosures of your medical information.
You have the right to ask us not to use or disclose any part of your medical information for purposes of treatment, payment or healthcare operations. While we will consider your request, we are only required to agree to restrict a disclosure to your health plan for purposes of payment or healthcare operations (but not for treatment) if the information applies solely to a healthcare item or service for which we have been paid out of pocket in full. If we agree to a restriction, we will not use or disclose your medical information in violation of that restriction unless it is needed to provide emergency treatment.
We will not agree to restrictions on medical information uses or disclosures that are legally required or necessary to administer our business. To request a restriction, you must submit a written request to our Privacy Officer.
Request confidential communications.
You have the right to request that we communicate with you in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request a confidential communication of your medical information,
you must submit a written request to our Privacy Officer stating how or when you would like to be contacted. We will not require you to provide an explanation for your request. We will accommodate all reasonable requests.
Request an amendment to your medical information.
If you believe that any information in your medical record is incorrect or if you believe important information is missing, you may request that we amend the existing information. To request such an amendment, you must submit a written request to our Privacy Officer.
Request an accounting of certain disclosures.
You have the right to receive an accounting of certain disclosures we have made of your medical information. To request an accounting, you must submit a written request to our Privacy Officer. The first accounting you request within a 12-month period will be provided free of charge. We may charge you for any additional requests in that same 12-month period.
Obtain a paper copy of this Notice.
You have the right to obtain a paper copy of this Notice upon request, even if you agreed to accept this Notice electronically. To obtain a paper copy of this Notice, contact our Privacy Officer.
— STATE LAW —
We will not use or share your information if state law prohibits it. Some states have laws that are stricter than the federal privacy regulations, such as laws protecting HIV/ AIDS information or mental health information. If a state law applies to us and is stricter or places limits on the ways we can use or share your health information, we will follow the state law. If you would like to know more about any applicable state laws, please ask our Privacy Officer.
— QUESTIONS, CONCERNS OR COMPLAINTS —
If you have any questions or want more information about this Notice or how to exercise your medical information rights, you may contact our Chief Privacy
Officer by mail at: 1600 Stout St, Ste 2000, Denver, CO 80202 or telephone at 720–204–5760.
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Office for Civil Rights: Centralized Case
Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201 or
OCRComplaint@hhs.gov. We will not retaliate against you for filing a complaint.