Conditions of Treatment Form - Revision history

Mhurlocker: /* Definitions */

2023-08-15T19:38:16Z

Definitions

@@ Line 38: / Line 38: @@
 The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services.
 == Definitions ==
-'''Protected Health Information (PHI)''' is individually identifiable health information.  Health information means any information, whether oral or recorded in any medium, that:
+'''Protected Health Information (PHI)'''
-Records containing PHI, in any form, are the property of UNMC.  The PHI contained in the record is the property of the individual who is the subject of the record.
+Individually identifiable health information including demographic information, collected from an Individual, whether oral or recorded in any medium, that:
 ==Additional Information==
 *Contact [mailto:dbishop@unmc.edu Privacy Officer]

Dpanowic at 22:06, February 18, 2020

2020-02-18T22:06:24Z

← Older revision		Revision as of 17:06, February 18, 2020
Line 52:		Line 52:

	This page maintained by [mailto:dpanowic@unmc.edu dkp]		This page maintained by [mailto:dpanowic@unmc.edu dkp]
	~~This page updated on Monday, February 16, 2004, by dkp.~~

Dpanowic at 22:06, February 18, 2020

2020-02-18T22:06:03Z

← Older revision		Revision as of 17:06, February 18, 2020
Line 28:		Line 28:
	[[Identification Card]] \| [[Secure Area Card Access]] \| [[Privacy/Confidentiality]] \| [[Computer Use/Electronic Information]] \| [[Retention and Destruction/Disposal of Private and Confidential Information]] \| [[Use and Disclosure of Protected Health Information]] \| [[Notice of Privacy Practices]] \| [[Access to Designated Record Set]] \| [[Accounting of PHI Disclosures]] \| [[Patient/Consumer Complaints]] \| [[Vendors]] \| [[Fax Transmissions]] \| [[Psychotherapy Notes]] \| [[Facility Security]] \| [[Conditions of Treatment Form]] \| [[Informed Consent for UNMC Media]] \| [[Transporting Protected Health Information]] \| [[Honest Broker]] \| [[Social Security Number]] \| [[Third Party Registry]] \| [[Information Security Awareness and Training]]		[[Identification Card]] \| [[Secure Area Card Access]] \| [[Privacy/Confidentiality]] \| [[Computer Use/Electronic Information]] \| [[Retention and Destruction/Disposal of Private and Confidential Information]] \| [[Use and Disclosure of Protected Health Information]] \| [[Notice of Privacy Practices]] \| [[Access to Designated Record Set]] \| [[Accounting of PHI Disclosures]] \| [[Patient/Consumer Complaints]] \| [[Vendors]] \| [[Fax Transmissions]] \| [[Psychotherapy Notes]] \| [[Facility Security]] \| [[Conditions of Treatment Form]] \| [[Informed Consent for UNMC Media]] \| [[Transporting Protected Health Information]] \| [[Honest Broker]] \| [[Social Security Number]] \| [[Third Party Registry]] \| [[Information Security Awareness and Training]]
	<br /><br />		<br /><br />
	~~POLICY NO~~: '''6070'''<br />		Policy No.: '''6070'''<br />
	~~EFFECTIVE DATE~~: '''03/17/03'''<br />		Effective Date: '''03/17/03'''<br />
			Revised Date: <br />
			Revised Date: <br /><br />
	<big>'''Conditions of Treatment Form Policy'''</big><br />		<big>'''Conditions of Treatment Form Policy'''</big><br />
			== Basis for Policy ==
	NOTE: These guidelines are provided to assist UNMC workforce, including those in the patient treatment areas of the Munroe-Meyer Institute, the College of Medicine Optical Shop, the Lions Eye Bank and the College of Dentistry, as applicable, comply with HIPAA regulations. Those departments and clinics which fall under the jurisdiction of The Nebraska Medical Center and/or University Medical Associates should consult the policies and procedures of those entities for authoritative guidance.<br />		It is the policy of the University of Nebraska Medical Center (UNMC) to use and disclose protected health information in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and Executive Memorandum No. 27, HIPAA Compliance Policy.
			== Policy ==
	=== Basis for Policy ===		The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services.
	~~<br />~~		== Definitions ==

	It is the policy of the University of Nebraska Medical Center (UNMC) to use and disclose protected health information in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and Executive Memorandum No. 27, HIPAA Compliance Policy.~~<br />~~

	=== Policy ===
	~~<br />~~

	The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services.~~<br />~~

	=== Definitions ===
	~~<br />~~

	'''Protected Health Information (PHI)''' is individually identifiable health information. Health information means any information, whether oral or recorded in any medium, that:		'''Protected Health Information (PHI)''' is individually identifiable health information. Health information means any information, whether oral or recorded in any medium, that:

	* is created or received by UNMC; and		* is created or received by UNMC; and
	* relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.<br />		* relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.<br />

	Records containing PHI, in any form, are the property of UNMC. The PHI contained in the record is the property of the individual who is the subject of the record.		Records containing PHI, in any form, are the property of UNMC. The PHI contained in the record is the property of the individual who is the subject of the record.

	Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.		Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.
			==Additional Information==
			*Contact [mailto:dbishop@unmc.edu Privacy Officer]
			*See Conditions of Treatment Form Procedures

	~~For more information, contact Deb Bishop, Privacy Officer, or see Conditions of Treatment Form Procedures.~~

	~~This is a new UNMC Policy.<br />~~

			This page maintained by [mailto:dpanowic@unmc.edu dkp]
	This page updated on Monday, February 16, 2004, by dkp.		This page updated on Monday, February 16, 2004, by dkp.

Afaylor: add Faculty tab

2019-08-02T18:01:17Z

add Faculty tab

← Older revision		Revision as of 13:01, August 2, 2019
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	<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"		<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
	width="20">[[Intellectual Property]]</td>		width="20">[[Intellectual Property]]</td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Faculty]]</td>
	</tr>		</tr>
	</table>		</table>

Afaylor at 19:02, September 19, 2016

2016-09-19T19:02:23Z

← Older revision		Revision as of 14:02, September 19, 2016
Line 23:		Line 23:
	</table>		</table>
	<br />		<br />
	[[Identification Card]] \| [[Secure Area Card Access]] \| [[Privacy/Confidentiality]] \| [[Computer Use/Electronic Information]] \| [[Confidential Information]] \| [[Protected Health Information ~~(PHI)~~]] \| [[Notice of Privacy Practices]] \| [[Access to Designated Record Set]] \| [[Accounting of PHI Disclosures]] \| [[Patient/Consumer Complaints]] \| [[Vendors]] \| [[Fax Transmissions]] \| [[Psychotherapy Notes]] \| [[Facility Security]] \| [[Conditions of Treatment Form]] \| [[Informed Consent for UNMC Media]] \| [[Transporting Protected Health Information]]		[[Identification Card]] \| [[Secure Area Card Access]] \| [[Privacy/Confidentiality]] \| [[Computer Use/Electronic Information]] \| [[Retention and Destruction/Disposal of Private and Confidential Information]] \| [[Use and Disclosure of Protected Health Information]] \| [[Notice of Privacy Practices]] \| [[Access to Designated Record Set]] \| [[Accounting of PHI Disclosures]] \| [[Patient/Consumer Complaints]] \| [[Vendors]] \| [[Fax Transmissions]] \| [[Psychotherapy Notes]] \| [[Facility Security]] \| [[Conditions of Treatment Form]] \| [[Informed Consent for UNMC Media]] \| [[Transporting Protected Health Information]] \| [[Honest Broker]] \| [[Social Security Number]] \| [[Third Party Registry]] \| [[Information Security Awareness and Training]]
	<br /><br />		<br /><br />
	POLICY NO: '''6070'''<br />		POLICY NO: '''6070'''<br />

Afaylor: /* Definitions */

2016-07-28T18:54:39Z

Definitions

← Older revision		Revision as of 13:54, July 28, 2016
Line 55:		Line 55:
	Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.		Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.

	For more information, contact ~~Sheila Wrobel~~, Privacy Officer, or see Conditions of Treatment Form Procedures.		For more information, contact Deb Bishop, Privacy Officer, or see Conditions of Treatment Form Procedures.

	This is a new UNMC Policy.<br />		This is a new UNMC Policy.<br />

	This page updated on Monday, February 16, 2004, by dkp.		This page updated on Monday, February 16, 2004, by dkp.

Afaylor at 20:23, October 9, 2012

2012-10-09T20:23:16Z

← Older revision		Revision as of 15:23, October 9, 2012
Line 1:		Line 1:
	POLICY NO : 6070<br />		<table style="background:#F8FCFF; text-align:center" width="100%" cellspacing="0" cellpadding="0" border="0">
			<tr>
	EFFECTIVE DATE: 03/17/03<br />		<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Human Resources]]</td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Safety/Security]] </td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Research Compliance]] </td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Compliance]]</td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:white; line-height:0.95em; border:solid 2px #A3B1BF; border-bottom:0; font-weight:bold;" width="20">[[Privacy/Information Security]]</td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Business Operations]]</td>
			<td style="border-bottom:2px solid #A3B1BF" width="3"> </td>
			<td style="padding:0.5em; background-color:#e5e5e5; font-size:90%; line-height:0.95em; border:1px solid #A3B1BF; border-bottom:solid 2px #A3B1BF"
			width="20">[[Intellectual Property]]</td>
			</tr>
			</table>
			<br />
			[[Identification Card]] \| [[Secure Area Card Access]] \| [[Privacy/Confidentiality]] \| [[Computer Use/Electronic Information]] \| [[Confidential Information]] \| [[Protected Health Information (PHI)]] \| [[Notice of Privacy Practices]] \| [[Access to Designated Record Set]] \| [[Accounting of PHI Disclosures]] \| [[Patient/Consumer Complaints]] \| [[Vendors]] \| [[Fax Transmissions]] \| [[Psychotherapy Notes]] \| [[Facility Security]] \| [[Conditions of Treatment Form]] \| [[Informed Consent for UNMC Media]] \| [[Transporting Protected Health Information]]
			<br /><br />
			POLICY NO: '''6070'''<br />
			EFFECTIVE DATE: '''03/17/03'''<br />


	<big>'''Conditions of Treatment Form Policy'''</big><br />		<big>'''Conditions of Treatment Form Policy'''</big><br />



	NOTE: These guidelines are provided to assist UNMC workforce, including those in the patient treatment areas of the Munroe-Meyer Institute, the College of Medicine Optical Shop, the Lions Eye Bank and the College of Dentistry, as applicable, comply with HIPAA regulations. Those departments and clinics which fall under the jurisdiction of The Nebraska Medical Center and/or University Medical Associates should consult the policies and procedures of those entities for authoritative guidance.<br />



			NOTE: These guidelines are provided to assist UNMC workforce, including those in the patient treatment areas of the Munroe-Meyer Institute, the College of Medicine Optical Shop, the Lions Eye Bank and the College of Dentistry, as applicable, comply with HIPAA regulations. Those departments and clinics which fall under the jurisdiction of The Nebraska Medical Center and/or University Medical Associates should consult the policies and procedures of those entities for authoritative guidance.<br />

	=== Basis for Policy ===		=== Basis for Policy ===
	<br />		<br />



	It is the policy of the University of Nebraska Medical Center (UNMC) to use and disclose protected health information in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and Executive Memorandum No. 27, HIPAA Compliance Policy.<br />


			It is the policy of the University of Nebraska Medical Center (UNMC) to use and disclose protected health information in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and Executive Memorandum No. 27, HIPAA Compliance Policy.<br />

	=== Policy ===		=== Policy ===
	<br />		<br />

			The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services.<br />

	The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services.<br />




	=== Definitions ===		=== Definitions ===
	<br />		<br />



	'''Protected Health Information (PHI)''' is individually identifiable health information. Health information means any information, whether oral or recorded in any medium, that:		'''Protected Health Information (PHI)''' is individually identifiable health information. Health information means any information, whether oral or recorded in any medium, that:


	* is created or received by UNMC; and		* is created or received by UNMC; and
	* relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.<br />		* relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.<br />

			Records containing PHI, in any form, are the property of UNMC. The PHI contained in the record is the property of the individual who is the subject of the record.

	~~Records containing PHI~~, ~~in any form, are the property of~~ UNMC~~. The PHI contained~~ in ~~the record is the property of the individual who is the subject of the record~~.		Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.

			For more information, contact Sheila Wrobel, Privacy Officer, or see Conditions of Treatment Form Procedures.

	~~Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.~~



	For more information, contact Sheila Wrobel, Privacy Officer, or see Conditions of Treatment Form Procedures.



	This is a new UNMC Policy.<br />		This is a new UNMC Policy.<br />

	This page updated on Monday, February 16, 2004, by dkp.		This page updated on Monday, February 16, 2004, by dkp.

Nirichardson: Created page with "POLICY NO : 6070
EFFECTIVE DATE: 03/17/03
'''Conditions of Treatment Form Policy'''
NOTE: These guidelines are provided to assist UNMC wo..."

2012-03-14T15:17:51Z

Created page with "POLICY NO : 6070 EFFECTIVE DATE: 03/17/03 <big>'''Conditions of Treatment Form Policy'''</big> NOTE: These guidelines are provided to assist UNMC wo..."

New page

POLICY NO : 6070 

EFFECTIVE DATE: 03/17/03 

<big>'''Conditions of Treatment Form Policy'''</big> 

NOTE: These guidelines are provided to assist UNMC workforce, including those in the patient treatment areas of the Munroe-Meyer Institute, the College of Medicine Optical Shop, the Lions Eye Bank and the College of Dentistry, as applicable, comply with HIPAA regulations. Those departments and clinics which fall under the jurisdiction of The Nebraska Medical Center and/or University Medical Associates should consult the policies and procedures of those entities for authoritative guidance. 

=== Basis for Policy ===
 

It is the policy of the University of Nebraska Medical Center (UNMC) to use and disclose protected health information in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and Executive Memorandum No. 27, HIPAA Compliance Policy. 

=== Policy ===
 

The University of Nebraska Medical Center (UNMC) shall provide information to the patient and obtain general consent using the appropriate Conditions of Treatment Form prior to providing treatment or services. 

=== Definitions ===
 

'''Protected Health Information (PHI)''' is individually identifiable health information. Health information means any information, whether oral or recorded in any medium, that:

* is created or received by UNMC; and
* relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual. 

Records containing PHI, in any form, are the property of UNMC. The PHI contained in the record is the property of the individual who is the subject of the record.

Protected health information excludes education records covered by the Family Educational Rights and Privacy Act (FERPA), and employment records held by UNMC in its role as employer.

For more information, contact Sheila Wrobel, Privacy Officer, or see Conditions of Treatment Form Procedures.

This is a new UNMC Policy. 

This page updated on Monday, February 16, 2004, by dkp.

Conditions of Treatment Form - Revision history

Mhurlocker: /* Definitions */

Dpanowic at 22:06, February 18, 2020

Dpanowic at 22:06, February 18, 2020

Afaylor: add Faculty tab

Afaylor at 19:02, September 19, 2016

Afaylor: /* Definitions */

Afaylor at 20:23, October 9, 2012

Nirichardson: Created page with "POLICY NO : 6070 EFFECTIVE DATE: 03/17/03 '''Conditions of Treatment Form Policy''' NOTE: These guidelines are provided to assist UNMC wo..."

Nirichardson: Created page with "POLICY NO : 6070
EFFECTIVE DATE: 03/17/03
'''Conditions of Treatment Form Policy'''
NOTE: These guidelines are provided to assist UNMC wo..."