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BY CLICKING THE SUBMIT BUTTON, YOU HAVE READ, UNDERSTAND AND FULLY AGREE WITH DISCLAIMER/PRIVACY NOTICE BELOW:

Disclaimer/Privacy Notice

Disclaimer

The Universal EHR Web site is intended to share important health information with its users. The site facilitates learning by providing information about Universal EHR physicians and facilities. It is not intended as a substitute for professional medical advice. We may provide links to other medically related sites to offer further access to information. However, we are not responsible for the information on those sites.

Your privacy is important to us. We do record traffic patterns to gain information in order to make our site more efficient. For example, we are able to capture the number of visitors coming to us from participants in our link-sharing program.

We encourage you to e-mail us, providing name, address and other information. We never disclose any of this data to third parties for commercial use.

Privacy Notice

Universal EHR is an organized healthcare arrangement including the following: HealthCare System 2000s

Universal EHR is required by law to maintain the privacy of your personal health information and to provide you with this notice describing Healthcare Systems 2000s legal duties and privacy practices concerning your personal health information. In general, when Universal EHR uses or discloses your health information, Universal EHR is obligated to use or disclose only the minimum amount of information necessary to achieve the purpose of the use or disclosure. However, this minimum necessary rule does not apply if the disclosure is to a provider regarding your treatment to you, or due to a legal requirement. Universal EHR is required to abide by the privacy practices described in this notice.

However, Universal EHR reserves the right to change the privacy practices described in this notice, in accordance with the law. Changes to HealthCare Ssystems 2000s privacy practices would apply to all health information maintained by Universal EHR . If Universal EHR changes its privacy practices, Universal EHR will furnish you with a revised copy of its privacy notice at your next visit or upon request.

The information we have identified that would be considered "medical/health information" would include name, DOB, social security number, sex, marital status, religion, phone numbers, address, insurance/payer information, health history, plan of care, treatment and services provided.

Universal EHR can use your health information for the following purposes:

  1. Treatment. For example, a healthcare professional may use the information in your medical record to determine which treatment option, such as a drug or surgery, best addresses your health needs. The treatment selected will be documented in your medical record, so that other healthcare professionals can make informed decisions about your care.
  2. Payment. In order for an insurance company or other health insurer to pay for your treatment, Universal EHR needs to submit a bill that identifies you, your diagnosis and the treatment provided to you. Universal EHR will pass such health information onto an insurer in order to help receive payment for your medical bills.
  3. Healthcare Operations. Universal EHR may need your diagnosis, treatment and outcome information in order to improve the quality or cost of care delivered by Universal EHR . These quality and cost improvement activities may include evaluating the performance of your physicians, nurses and other healthcare professionals, or examining the effectiveness of the treatment provided to you when compared to similarly situated patients.

In addition, Universal EHR may want to use your health information for appointment reminders, confirmation or cancellation. For example, HealthCare Systems 2000s may view your medical record to determine the date and time of your next appointment with Universal EHR , and then send you a reminder to help you remember the appointment. Or, Universal EHR may review your medical
information and determine that another treatment or a new service offered by Universal EHR may interest you. For example, Universal EHR may contact a cancer patient to notify the patient that Universal EHR has a new cancer research facility, offering new treatment protocols.

Furthermore, Universal EHR may want to use information found in your medical record, such as your name, address, phone number and treatment dates, to contact you for fund development through its Foundations. For example, in order to provide more charity care or otherwise improve the health of your community, Universal EHR may want to seek community support and therefore may contact you to consider a donation and/or to let you know about the improvements made through fund activities. If you do not wish to have this information shared, you must contact the Public Relations Department of Universal EHR .

The covered entities participating in Universal EHR will share protected health information with each other, as necessary to carry out treatment, payment, or healthcare operations relating to Universal EHR .

Without your written consent or authorization,
Universal EHR can use your health information for the following purposes:

  1. As required or permitted by law. In certaincircumstances, Universal EHR may have to report some of your health information to legal entities, such as law enforcement officials, court officials or government agencies. Examples of such circumstances may be to report abuse, neglect, domestic violence or certain physical injuries, or to respond to a court order.
  2. For public health activities. Universal EHR may be required to report your health information to authorities to help prevent or control disease, injury or disability. This may include using your medical record to report certain diseases, injuries, birth or death information, information related to the jurisdiction of the Food and Drug Administration, or information related to child abuse or neglect. Universal EHR may also have to report certain work-related illnesses and injuries to your employer so that workplace medical surveillance activities can be conducted.
  3. For health oversight activities. Universal EHR may disclose your health information to authorities for audit, investigation, inspection, licensure, disciplinary or other purposes related to oversight of the healthcare system or government benefit programs.
  4. For activities related to death. Universal EHR may disclose your health information to coroners, medical examiners and funeral directors so they can carry out their duties related to your death, such as identifying the body, determining the cause of death, or in the case of funeral directors, to carry out funeral preparation activities.
  5. For organ, eye or tissue donation. Universal EHR may disclose your health information to entities involved in obtaining, banking or transplanting organs, eyes or tissue of cadavers for donation or transplantation purposes.
  6. For research. Under certain circumstances, and only after a special approval process, Universal EHR may use and disclose your health information to help conduct research. Such research might involve studies related to evaluating the effectiveness of a treatment.
  7. To avoid a serious threat to health or safety. As required by law and standards of ethical conduct, Universal EHR may use or disclose your health information to the necessary authorities if Universal EHR believes, in good faith, that such use or disclosure is necessary to prevent or minimize a serious and imminent threat to your or the public's health or safety.
  8. For military, national security, or incarceration/law enforcement custody. If you are involved with the military, national security or intelligence activities, or you are in the custody of law enforcement officials or an inmate in a correctional institution, Universal EHR may disclose your health information to the proper authorities so they may carry out their duties under the law.
  9. For workers' compensation. Universal EHR may disclose your health information to the appropriate persons in order to comply with the laws related to workers' compensation or other similar programs. These programs may provide benefits for work-related injuries or illnesses.
  10. Universal EHR directory. Unless you object, Universal EHR may use your health information, such as your name, location in which HealthCare Systems 2000s facility, your general health condition (e.g., "fair," "good," "serious," "critical," or "treated and released"), and your religious affiliation for an Universal EHR directory. The information about you contained in the Universal EHR directory will be disclosed to people or media representatives who ask for you by name. However, the information about your religious affiliation will only be disclosed to clergy. Universal EHR may allow you to object or agree orally regarding the use of your health information for directory purposes.
  11. To those involved with your care or payment of your care. If people such as family members, relatives, or close personal friends are helping care for you or helping you pay your medical bills, Universal EHR may disclose health information about you to those people. The information disclosed to these people may include your location within which Universal EHR facility, your general condition, or death. You have the right to object to such disclosure, unless you are incapacitated or there is an emergency. In addition, HealthCare Systems 2000s may disclose your health information to organizations authorized to handle disaster relief efforts so those who care for you can receive information about your location or health status. Universal EHR may allow you to object or agree orally to such disclosure, unless there is an emergency.

NOTE: Except for the situations listed above, any other use or disclosure of your health information requires Universal EHR to obtain your written authorization. You may withdraw your authorization at any time, as long as your withdrawal is in writing. If you wish to withdraw your authorization, please submit your written withdrawal to the medical records department of the appropriate covered entity of Universal EHR .

Your Health Information Rights

You have several rights with regard to your health information. If you wish to exercise any of the following rights, please contact the medical records department of the appropriate covered entity of Universal EHR . Specifically, you have the right to:
  1. Request restrictions on certain uses and disclosures. You have the right to notify Universal EHR that you want restrictions placed on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment or Universal EHR 's payment or healthcare operation activities. Or, you may want to restrict the health information provided to family or friends involved in your care or payment of medical bills. You may also want to restrict the health information provided to authorities involved with disaster relief efforts. However, it should be noted that Universal EHR is not required to agree in all circumstances to your requested restriction.

    If you receive certain medical devices (for example, life-supporting devices used outside Universal EHR 's facility), you may refuse to release your name, address, telephone number, social security number or other identifying information for purpose of tracking the medical device.
  2. As applicable, receive confidential communication of health information. You have the right to request alternative means or locations when HealthCare Systems 2000s communicates your health information to you. Universal EHR must accommodate reasonable requests.
  3. To inspect and copy your health information. With a few exceptions, you have the right to inspect and obtain a copy of your health information. However, this right does not apply to psychotherapy notes or information compiled for judicial proceedings, for example. In addition, Universal EHR may charge you a reasonable fee if you want a copy of your health information.
  4. To amend your health information. If you believe your health information is incorrect, you may ask Universal EHR to amend the information. You will be asked to make such requests in writing and to give a reason as to why your health information should be changed. However, if Universal EHR did not create the health information that you believe is incorrect, or if HealthCare Systems 2000s disagrees with you and does believe your health information is correct, Universal EHR may deny your request.
  5. To receive an accounting of disclosures of your health information. In some limited instances, you have the right to request an accounting of the disclosures of your health information Universal EHR has made during the previous six years, but the request cannot include dates before April 14, 2003. This accounting must include the date of each disclosure, who received the disclosed health information, a brief description of the health information disclosed, and why the disclosure was made. Universal EHR must comply with your request for an accounting within 60 days, unless you agree to a 30 day extension, and Universal EHR may not charge you for the accounting, unless you request such accounting more than once per year. In addition, HealthCare Systems 2000s will not include in the accounting disclosures made to you, or for purposes of treatment, payment, healthcare operations, the Universal EHR directory, national security, law enforcement/corrections, and certain health
    oversight activities.
  6. To obtain a paper copy of this notice. Upon your request, you may at any time receive a paper copy of this notice, even if you earlier agreed to receive this notice electronically. You can print an electronic copy by accessing the Universal EHR Web site.
  7. To complain. If you believe your privacy rights have been violated, you may file a complaint with Universal EHR and with the federal Department of Health and Human Services (Office of Civil Rights). Universal EHR will not retaliate against you for filing such a complaint. To file a complaint with any Universal EHR entity or if you have questions or concerns regarding your privacy rights or the information in this notice, please contact the appropriate person below:


IMPORTANT WARNING:
CONFIDENTIAL HEALTH INFORMATION ENCLOSED
THIS WEB SITE IS INTENDED FOR THE USE OF THE PERSON OR ENTITY TO WHICH IT IS ADDRESSED, AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL, THE DISCLOSURE OF WHICH IS GOVERNED BY APPLICABLE LAW. IF THE READER OF THIS WEB SITE IS NOT THE INTENDED PERSON, OR THE EMPLOYEE OR AGENT RESPONSIBLE TO DELIVER CARE TO THE INTENDED PATIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS INFORMATION IS STRICTLY PROHIBITED. IF YOU HAVE ENTERED THIS PAGE BY ERROR, PLEASE NOTIFY US IMMEDIATELY AND EXIT THE WEB PAGE. YOU, THE READER/USER, ARE OBLIGATED TO MAINTAIN IT IN A SAFE, SECURE AND CONFIDENTIAL MANNER. RE-DISCLOSURE WITHOUT APPROPRIATE PATIENT CONSENT OR AS PERMITTED BY LAW IS PROHIBITED. UNAUTHORIZED RE-DISCLOSURE OR FAILURE TO MAINTAIN CONFIDENTIALITY COULD SUBJECT YOU TO PENALTIES DESCRIBED IN FEDERAL AND STATE LAW.