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.

Last updated: December, 18 2024

For help to understand this, please call 713-332-9507.

NW Indiana ER & Hospital is a Covered Entity as defined and regulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). NW Indiana ER & Hospital is required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices related to your PHI, abide by the terms of the Notice that is currently in effect and notify you in the event of a breach of your unsecured PHI. NW Indiana ER & Hospital may create, receive, or maintain your PHI in an electronic format and that information is subject to electronic disclosure.

This Notice describes how we may use and disclose your PHI. It also describes your rights to access, amend and manage your PHI and how to exercise those rights.

NW Indiana ER & Hospital reserves the right to change this Notice. We reserve the right to make the revised or changed Notice effective for your PHI we already have as well as any of your PHI we receive in the future. NW Indiana ER & Hospital will promptly revise and update this Notice whenever there is a material change to the uses or disclosures, your rights, our legal duties, or other privacy practices stated in the notice. We will make any revised Notices available on our website at nwindianaer.com. You may also request a copy by calling (214) 469-1119.

NW Indiana ER & Hospital protects your PHI. We have privacy and security processes to help.

These are some of the ways we protect your PHI:

• We train our staff to follow our privacy and security processes.
• We require our business associates to follow privacy and security processes.
• We keep our offices secure.
• We talk about your PHI only for a business reason with people who need to know.
• We keep your PHI secure when we send it or store it electronically.
• We use technology to keep the wrong people from accessing your PHI.

The following is a list of how we may use or disclose your PHI without your permission or authorization:

• Treatment – We will use your health information for treatment. Treatment includes the provision, coordination, and management of your health care.
• Payment – 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.
• HealthCare Operations – We will use your health information for regular health operations, including necessary administrative and business functions.
• Affiliated Entities – Our affiliated entities will share your medical information as necessary to carry out treatment, payment, and health care operations.
• Communication with family – Unless your family member is legally authorized to make health care decisions for you, we will not communicate health information with a family member, without your permission. With your permission, we will communicate with a family member only if he/she is legally authorized to make health care decisions for you.
• Administrative and Operational Communications – We may contact you to provide appointment health-related benefits and services that may be of interest to you, and our organization’s health care operations.
• As Required by Law: If federal, state, and/or local law requires a use or disclosure of your PHI, we may use or disclose your PHI information to the extent that the use or disclosure complies with such law and is limited to the requirements of such law.

We are required to obtain your written authorization to use or disclose your PHI, with limited exceptions, for the following reasons:

• Sale of PHI – We will request your written authorization before we make any disclosure that is deemed a sale of your PHI, meaning that we are receiving compensation for disclosing the PHI in this manner.

Example: When a pharmaceutical company pays a physician for a list of patients who suffer from a particular disease, and the pharmaceutical company the uses the list to send discount coupons for a new medication for such disease treatment directly to the patient.

• Marketing – We will request your written authorization to use or disclose your PHI for marketing purposes with limited exceptions.

Example: When we have face-to-face marketing communications with you or when we provide promotional gifts of nominal value.

• Psychotherapy Notes – We will request your written authorization to use or disclose any of your psychotherapy notes that we may have on file with limited exception.

Example: For certain treatment, payment or healthcare operation functions.

The following are your rights concerning your PHI. If you would like to use any of the following rights, please contact us using the information at the end of this Notice.

You have the right to:

• Request a restriction on certain uses and disclosures of your information.
• Request that we not notify your health insurer of your treatment if you pay cash for the treatment.
• Obtain a paper copy of the notice of privacy practices upon request.
• Inspect and copy your health record.
• Request an amendment to your health record.
• Obtain an accounting of certain disclosures of your health information.
• Request communications of your health information by alternative means or at alternative locations.
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
• File a Complaint – If you feel your privacy rights have been violated or that we have violated our own privacy practices, you can file a complaint with us in writing or by phone using the contact information at the end of this Notice. You may also file a complaint with the Office for Civil Rights,  U.S. Department of Health and Human Services. WE WILL NOT TAKE ANY ACTION AGAINST YOU FOR FILING A COMPLAINT.

If you have any questions about this Notice, our privacy practices related to your PHI or how to exercise your rights you can contact us in writing or by phone using the contact information listed below.

Privacy Officer

Pamela Montgomery (Nutex Corporate Legal Officer)

6030 S Rice, Suite C

Houston, TX 77081

Phone: 713-332-9507