Conditions of Treatment Form: Difference between revisions

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[[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 ==
'''Protected Health Information (PHI)'''


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 />
Individually identifiable health information including demographic information, collected from an Individual, whether oral or recorded in any medium, that:


=== Policy ===
* is created or received by UNMC/ACE; and
<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 and identifies the Individual or with respect to which there is a reasonable basis to believe the information can be used to identify the Individual.


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 />
PHI includes genetic information, which includes information about:


=== Definitions ===
* an Individual’s genetic tests;
<br />
* the genetic tests of an Individual’s family members; or
* the manifestation of a disease or disorder in such Individual’s family members (i.e., family medical history).


'''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.<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.
PHI excludes:


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.  
* individually identifiable health information of a person who has been deceased for more than fifty (50) years.
* 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 Deb Bishop, Privacy Officer, or see Conditions of Treatment Form Procedures.
==Additional Information==
*Contact [mailto:dbishop@unmc.edu Privacy Officer]
*See Conditions of Treatment Form Procedures


This is a new UNMC Policy.<br />


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

Latest revision as of 14:38, August 15, 2023

Human Resources   Safety/Security   Research Compliance   Compliance   Privacy/Information Security   Business Operations   Intellectual Property   Faculty


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

Policy No.: 6070
Effective Date: 03/17/03
Revised Date:
Revised Date:

Conditions of Treatment Form Policy

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)

Individually identifiable health information including demographic information, collected from an Individual, whether oral or recorded in any medium, that:

  • is created or received by UNMC/ACE; 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 and identifies the Individual or with respect to which there is a reasonable basis to believe the information can be used to identify the Individual.

PHI includes genetic information, which includes information about:

  • an Individual’s genetic tests;
  • the genetic tests of an Individual’s family members; or
  • the manifestation of a disease or disorder in such Individual’s family members (i.e., family medical history).


PHI excludes:

  • individually identifiable health information of a person who has been deceased for more than fifty (50) years.
  • 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


This page maintained by dkp

Retrieved from "https://wiki.unmc.edu/index.php?title=Conditions_of_Treatment_Form&oldid=14228"