Notice of Privacy Practices
Asbury University Student Health Services (SHS) understands that medical information regarding student’s and their health is personal. The physicians and staff of Asbury SHS are committed to protecting medical information about each student. This policy applies to the information and records we have about your health, health status, and the healthcare and service you receive at Asbury SHS. Your health information may include information created and received by Asbury SHS, may be in the form of written records or spoken words, and may include information about your health history, health status, symptoms, examinations, test results, diagnoses, treatments, procedures, prescriptions, related billing activity and similar types of health-related information.
Here is a printable copy of our Notice of Privacy Practices
NOTICE OF PRIVACY PRACTICES
Asbury University Health Service
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!
Asbury University Health Service is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and healthcare operations. Protected Health Information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and any plans for future care or treatment. It also includes billing documents for those services.
Example of use of your health information for treatment purposes:
- Information obtained by your healthcare team of providers (this includes but is not limited to, physicians, nurses, specialists and – as applicable – members of the Asbury University Center for Counseling, or the Asbury University Athletic Trainers) will be recorded in your medical record and used to determine the course of treatment deemed best for you.
Examples of uses of your health information for payment purposes:
- Information may be released to insurance companies or an outside laboratory service in order for payment of services to be made.
- In addition, if you desire, some Health Service charges may be billed to your student account. The Student Account clerk will only have your name, Social Security Number, the amount billed, and the general account to be credited, not specifics of your diagnosis or treatment.
Examples of uses of your health information for health care operations:
- We may obtain services from business associates such as quality assessment, quality improvement, training programs, credentialing, medical review, and insurance. We will share information about you with such business associates as necessary to obtain these services. To protect your health information, however, we require the business associate to appropriately safeguard your information.
- As case managers, the University’s Office of Human Resources may receive specific accident reports from any incidents on campus.
Your Health Information Rights
The health records we maintain are the physical property of Asbury University Health Service. With respect to your Protected Health Information, you have the following rights:
- Obtain a paper copy of this notice of privacy practices upon verbal request,
- Inspect and copy your health record (we may charge you a fee for copying and postage),
- Request that your health care record be amended to correct incomplete or incorrect information (The health care provider is not required to make such amendments, but will give each request careful consideration),
- Obtain an accounting of disclosures of your health information (those made up to six years prior to the date of request). The accounting will not include uses of information for treatment, payment or operations, or disclosures made to you or made at your request,
- Request communications of your health information be made to you by alternative means (e.g., e-mail or fax) or at alternative locations (e.g., only at home or work), and/or
- Request a restriction on certain uses and disclosures of your information – we are not required to grant the request but will accommodate reasonable requests when appropriate
If you want to exercise any of the above rights, please contact Carol Amey, Director of Health Services, (859) 858-3511, x2147. She will provide you with appropriate forms and assistance on the steps to take to exercise your rights. (With the exception of #1, all other requests must be made in writing on the forms our office provides.)
Asbury University Health Service is required to:
- Maintain the privacy of your health information (we retain records for 7 years after graduation, or 7 years from the point of last contact, thereafter all records will be shredded),
- Provide you with this Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you,
- Abide by the terms of this Notice,
- Notify you if we cannot accommodate a requested restriction or request, and
- Accommodate your request for an accounting of disclosures.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the Protected Health Information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy or by picking up a copy at our office.
For More Information or to Report a Problem
If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact the Health Services’ Privacy Official, Carol Amey, Director of Health Services, (859) 858-3511, x2147.
Additionally, if you believe there may have been a violation of your rights, you may file a written complaint, either on paper or electronically, with the Health Services’ Privacy Official within 180 days of the violation. If a satisfactory resolution is not reached at this level, a complaint may then be filed with the Vice President for Student Development. Finally, if a satisfactory resolution cannot be reached with the VPSD, a complaint may be filed with the University President, as Institutional Privacy Official, following investigation at the Vice Presidential level. You also have the right to file a complaint with the Secretary of Health and Human Services (Office of Civil Rights).
We cannot, and will not, require you to waive the right to file a complaint with any of the indicated Officials as a condition of receiving treatment from the Health Service. We also cannot, and will not, retaliate against you for filing a complaint.
Other Uses and Disclosures Allowed by the Privacy Rule
- Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- Notification: Unless you notify us that you object, we will confirm only the dates of illnesses to, Chapel attendance, the Academic Dean or professors who request this information. Absolutely no other Protected Health Information will be released without your specific authorization.
- Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
- Workers’ Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
- Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
- Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
Other uses and disclosures besides those identified in this Notice will be made only as authorized by law or with your written authorization which you may revoke except to the extent that information or action has already been taken.
Updated: October 12, 2016