18 Patient Guide health plan (for purposes of payment or health care operations) in cases where you paid out of pocket, in full, for the items received or services rendered. F. Right to Confidential Communications: You have the right to receive confidential communications of your PHI by alternative means or at alternative locations. For example, you may request that MercyOne Siouxland Medical Center only contact you at work or by mail. G. Right to Receive a Copy of this Notice: You have the right to receive a paper copy of this Notice of Privacy Practices, upon request. VI. BREACH OF UNSECURED PHI If a breach of unsecured PHI affecting you occurs, MercyOne Siouxland Medical Center is required to notify you of the breach. VII. SHARING AND JOINT USE OF YOUR HEALTH INFORMATION In the course of providing care to you and in furtherance of MercyOne Siouxland Medical Center’s mission to improve the health of the community, MercyOne Siouxland Medical Center will share your PHI with other organizations as described below who have agreed to abide by the terms described below: A. Medical Staff. The medical staff and MercyOne Siouxland Medical Center participate together in an organized health care arrangement to deliver health care to you at MercyOne Siouxland Medical Center. Both MercyOne Siouxland Medical Center and its medical staff have agreed to abide by the terms of this Notice with respect to PHI created or received as part of delivery of health care to you in MercyOne Siouxland Medical Center. Physicians and allied health care professionals are members of MercyOne Siouxland Medical Center’s medical staff will have access to and use your PHI for treatment, payment and health care operations purposes related to your care within MercyOne Siouxland Medical Center. The MercyOne Siouxland Medical Center will disclose your PHI to the medical staff for treatment, payment and health care operations. B. Membership in CHE Trinity Health. MMercyOne Siouxland Medical Center and other members of MercyOne participate together in an organized health care arrangement for utilization review and quality assessment activities. As a part of MercyOne, a Catholic health care system, MercyOne Siouxland Medical Center and other hospitals, nursing homes, and health care providers in MercyOne share your PHI for utilization review and quality assessment activities of MercyOne, the parent company, and its members. Members of MercyOne also use your PHI for your treatment, payment to MercyOne Siouxland Medical Center and/or for the health care operations permitted by HIPAA with respect to our mutual patients. All members of MercyOne have agreed to abide by the terms of this Notice with respect to PHI created or received as part of utilization review and quality assessment activities. Members of MercyOne will abide by the terms of their own Notice of Privacy Practices in using your PHI for treatment, payment or health care operations. Please go to the MercyOne website for a listing of member organizations at https://www.mercyone.org/. Or, alternatively, you can call MercyOne Siouxland Medical Center’s Privacy Official to request the same. C. Business Associates. MercyOne Siouxland Medical Center will share your PHI with business associates and their Subcontractors contracted to perform business functions on MercyOne Siouxland Medical Center’s behalf, including MercyOne which performs certain business functions for MercyOne Siouxland Medical Center. D. Your Health Care Providers and Care Coordinators. You receive care from MercyOne Siouxland Medical Center delivered in an integrated care setting, where patients are seen by several different providers and in several care settings as part of continuity of care and coordinated care delivery. MercyOne Siouxland Medical Center shares your PHI with other health care providers and care coordinators who work together to provide treatment, obtain payment and conduct health care operations. Your PHI is shared electronically in multiple ways with providers involved in the delivery of care and care coordination. Your PHI may be shared via a direct connection to the electronic health record system of other providers. Your PHI may be shared in a health information exchange or via technology that enables downstream providers and care coordinators to obtain your information. Your PHI may be shared via secure transmission to other providers’ inboxes. VIII. CHANGES TO THIS NOTICE MercyOne Siouxland Medical Center will abide by the terms of the Notice currently in effect. MercyOne Siouxland Medical Center reserves the right to make material changes to the terms of its Notice and to make the new Notice provisions effective for all PHI that it maintains. MercyOne Siouxland Medical Center will distribute / provide you with a revised Notice at your first visit following the revision of the Notice in cases where it makes a material change in the Notice. You can also ask MercyOne Siouxland Medical Center for a current copy of the Notice at any time. IX. COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with MercyOne Siouxland Medical Center’s Privacy Official or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing directly to MercyOne Siouxland Medical Center’s Privacy Official. MercyOne Siouxland Medical Center assures you that there will be no retaliation for filing a complaint. You will not be retaliated against for filing any complaint. X. PRIVACY OFFICIAL – QUESTIONS / CONCERNS / ADDITIONAL INFORMATION If you have any questions, concerns, or want further information regarding the issues covered by this Notice of Privacy Practice or seek additional information regarding MercyOne Siouxland Medical Center’s privacy policies and procedures, please contact MercyOne Siouxland Medical Center’s Privacy Official: 801 5th Street Sioux City, IA 51101. Phone: 712-279-5653
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