Notice of Privacy Practices

How Your Medical Information Is Used

Notice of Privacy Practices

.pdf documents
Notice of Privacy Practices
Notice of Privacy Practices for Visually Impaired
Notice of Privacy Practices - Spanish
Notice of Privacy Practices - Spanish for Visually Impaired
Notice of Privacy Practices for Dental Patients
Notice of Privacy Practices for Dental Patients for Visually Impaired


This Notice applies to the following organizations and clinics:

The organizations listed above will use and distribute this Notice as their Joint Notice of Privacy Practices and follow the information practices described in this Notice when using or disclosing records and information. They will share your health information with each other, as necessary, to carry out treatment, payment, or health care operations as described in this Notice.

Understanding Your Health Information

Each time you visit a hospital, clinic, physician, or other health care provider, a record of your visit is made. Typically, this health record contains your medical history, symptoms, examination and test results, diagnosis, treatment, care plan, insurance, billing, and employment information. This health information, often referred to as your health record, serves as a basis for planning your care and treatment and is a vital means of communication among the many health professionals who contribute to your health care. Your health information is also used by insurance companies and other third-party payers to verify the appropriateness of billed services.

Our Responsibilities

We are required by law to:

We will not use or disclose your health information without your written authorization, except as described in this Notice.

Uses And Disclosures Without Your Written Authorization

We may use and disclose your health information without your written authorization for Treatment, Payment and Health Care Operations

We will use and disclose your health information for treatment purposes
For example: Information obtained by a nurse, physician or other member of your health care team will be recorded in your record and used to determine the course of treatment. Health care team members will communicate with one another personally and through the health record to coordinate care provided. We will also provide your physician or subsequent health care provider with copies of various reports that should assist him or her in treating you in the future.

We will use and disclose your health information for payment purposes
For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. We may disclose health information about you to other qualified parties for their payment purposes. For example, if you are brought in by ambulance, we may disclose your health information to the ambulance provider for its billing purposes.

We will use and disclose your health information for health care operations
For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of health care we provide. In some cases, we will furnish your health information to other qualified parties for their health care operations. The ambulance company, for example, may want information regarding your condition to help them know whether they have done an effective job of stabilizing your condition.

Health Information Exchange
We may make your protected health information available electronically through an information exchange service to other health care providers, health plans and health care clearinghouses that request your information. Participation in information exchange services also lets us see their information about you.

As the primary teaching site for UNMC, residents, fellows, and students in medicine, dentistry, nursing, pharmacy, allied health and graduate studies, may be assisting with your care under the supervision of a licensed health care provider as a part of their professional health care training program.

Other Uses and Disclosures of your health information without your written authorization

We may use or disclose health information to notify or assist in notifying a family member, personal representative, or another person responsible for your care of your location and general condition.

Communication With Family and Others
We may disclose relevant health information to a family member, friend, or other person involved in your care. We will only disclose this information if you agree, are given the opportunity to object and do not, or if in our professional judgment, it would be in your best interest to allow the person to receive the information or act on your behalf.

Unless you notify us that you object, or we are otherwise prohibited by law, we may use your name, location in the facility, general condition, and religious affiliation for directory purposes. This information may be provided to members of the clergy, and, except for religious affiliation, to other people who ask for you by name.

Business Associates
There are some services provided in our organization through contracts with business associates. When these services are contracted, we may disclose your health information to our business associates so that they can perform such services. However, we require the business associate to appropriately safeguard your information.

Appointment Reminders
We may contact you as a reminder that you have an appointment for treatment or medical care.

Treatment Alternatives
We may contact you about treatment alternatives or other health-related benefits and services that may be of interest to you.

We may use and disclose your health information to our business associates and affiliated foundations for fundraising purposes. We may contact you in an effort to raise money for clinical programs, research and education. If you do not want us to contact you for fundraising efforts, you must notify the Development Office by telephone toll-free at 800-647-6216, by email at or in writing at 987430 Nebraska Medical Center, Omaha, Nebraska, 68198-7430.

Research is conducted under strict UNMC Institutional Review Board (IRB) guidelines designed to protect the subjects of research. Health information about you may be disclosed to researchers preparing to conduct a research project. For example, it may be necessary for researchers to look for patients with specific medical characteristics or treatments to prepare a research protocol. For actual research studies we would obtain your specific authorization, if information that directly identifies you is disclosed. The only exception would be circumstances when the IRB grants a waiver of authorization as permitted under federal guidelines.

Public Health
We may disclose health information about you for public health activities. These activities may include disclosures:

Workers’ Compensation
We may disclose health information to the extent authorized and necessary to comply with laws relating to workers’ compensation or other similar programs established by law.

Correctional Institutions
If you are an inmate of a correctional institution or under custody of a law enforcement official, we may disclose to the correctional institution, its agents or the law enforcement official your health information necessary for your health or the health and safety of other individuals.

Law Enforcement
We may disclose your health information for law enforcement purposes:

Health Oversight Activities
We may disclose health information for health oversight activities authorized by law. For example, oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Threats to Health or Safety
Under certain circumstances, we may use or disclose your health information if we believe it is necessary to avert or lessen a serious threat to health and safety and is to a person reasonably able to prevent or lessen the threat or is necessary for law enforcement authorities to identify or apprehend an individual involved in a crime.

Specialized Government Functions
We may disclose your information for national security and intelligence activities authorized by law, for protective services of the president; or if you are a military member, to the military under limited circumstances.

As Required by Law
We will use or disclose your health information as required by federal, State or local law.

Lawsuits and Administrative Proceedings
We may release your health information in response to a court or administrative order. We may also provide your information in response to a subpoena or other discovery request, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Funeral Directors, Medical Examiners, and Coroners
We may disclose your health information to funeral directors, medical examiners, and coroners consistent with applicable law to carry out their duties.

Organ Procurement Organizations
Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Incidental Uses and Disclosures
There are certain incidental uses or disclosures of your health information that occur while we are providing services to you or conducting our business. For example, after surgery the nurse or doctor may need to use your name to identify family members that may be waiting for you in a waiting area. Other individuals waiting in the same area may hear your name called. We will make reasonable efforts to limit these incidental uses and disclosures.

Uses And Disclosures That Require Your Written Authorization

The following uses and disclosures will only be made with your written authorization:

Your authorization may be revoked in writing at any time except with respect to any actions we have taken in reliance on it.

Your Health Information Rights

You have the following rights regarding your health information:

Right to Inspect and Copy
You may request to look at your medical and billing records and obtain a copy. You must submit your medical records request to the Health Information Management Department. Contact the office listed on your billing statement to request a copy of your billing record. If you ask for a copy of your records, we may charge you a copying fee plus postage. If we maintain an electronic health record about you, you have the right to request your copy in electronic format.

Right to Request Amendment
You may request that your health information be amended if you feel that the information is not correct. Your request must be in writing and provide rationale for the amendment. Please send your request to the Health Information Management Department. We may deny your request, and will notify you of our decision in writing.

Right to an Accounting of Disclosures
You may request an accounting of certain disclosures of your health information showing with whom your health information has been shared (does not apply to disclosures to you, with your authorization, for treatment, payment or health care operations, and in certain other cases).

To request an accounting of disclosures, you must send a written request to the Health Information Management Department. Your request must state a time period that may not be longer than six years.

Right to Request Restrictions
You may request restrictions on how your health information is used for treatment, payment or health care operations or disclosed to certain family members or others who are involved in your care. We may deny your request with one exception. If we agree to a voluntary restriction, the restriction may be lifted if use of the information is necessary to provide emergency treatment.

We are required to agree to your request that we not disclose certain health information to your health plan for payment or health care operations purposes, if you pay in full for all expenses related to that service prior to your request and the disclosure is not otherwise required by law. Such a restriction will only apply to records that relate solely to the service for which you have paid in full. If we later receive an authorization from you dated after the date of your requested restriction which authorizes us to disclose all of your records to your health plan, we will assume you have withdrawn your request for restriction.

To request a restriction, you must send a written request to the Health Information Management Department, specifying what information you wish to restrict and to whom the restriction applies. You will receive a written response to your request.

Right to Request Private Communications
You may request that we communicate with you in a certain way in a certain location. You must make your request in writing to the patient registration staff and explain how or where you wish to be contacted.

Right to a Paper Copy of this Notice
You may request an additional paper copy of this Notice at any time from any patient registration area.

You may contact the Health Information Management Department at:

989100 Nebraska Medical Center
Omaha, Nebraska 68198-9100
Phone: (402) 559-4705
Hours: 8:00 a.m. - 4:30 p.m. CST

Changes to this Notice

We reserve the right to change this Notice as our privacy practices change and to make the new provisions effective for all health information we maintain. We will post a current Notice in patient registration areas and on our websites.

For More Information or to Report a Problem

If you have questions or would like additional information, you may contact the Patient Relations Department. If you believe your privacy rights have been violated, you may file a complaint with the Patient Relations Department or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

You may contact the Patient Relations Department at:

982133 Nebraska Medical Center
Omaha, Nebraska 68198-2133
Phone: 800-647-6216 or 402-559-8158
Hours: 8:30 a.m. – 5:00 p.m. CST

Effective Date: 9/13
Version No. 5



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