Notice of Privacy Practices

This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review carefully.

Each time you visit a hospital, physician or other healthcare provider, a record of your visit is made. These records contain personal information and medical information and are used for your direct care and treatment. It’s also used to produce an accurate bill for the services you receive, helps improve the care we give and strengthens the operations of our organization.

Your Health Information Rights

Although your medical record is the physical property of Carilion Clinic, the information in it belongs to you. You have the following rights with respect to your health information:

  • You can inspect and get a copy of your health information that may be used to make decisions about your care, subject to a few limited exceptions. You may request copies of your health information, in writing, from medical records personnel at the Carilion Clinic facility providing your treatment. We may charge a fee for the costs of copying, mailing or other supplies associated with your request.
  • If you feel the health information is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by, or for, our organization. Your request must be made in writing and include the reason for your request. We may deny your request if you ask us to amend information that was not created by us. We may also deny your request to amend information if we believe the information to be accurate and complete.
  • You may request a restriction or limitation on the health information we use or disclose about you for treatment, payment or our operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. We are not required to agree to your request. In your request, you must tell us:
    • What information you want to limit.
    • Whether you want to limit our use, disclosure or both.
    • Who you want to receive your medical information.
  • You can request an accounting of your health information disclosures, except for those needed to carry out treatment, payment or our operations. Other exceptions include, but are not limited to:
    • Use in facility directories.
    • For national security and intelligence.
    • Use by law enforcement officials or correctional institutions.
  • Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free.
  • You can request communications of your health information by alternative means, at alternative locations or in a confidential manner. For example, you can ask that we contact you only at work or by mail. We will accommodate all reasonable requests.
  • You can revoke your authorization to use or disclose health information, unless disclosure has already occurred. You can request a paper copy of this notice even if you have agreed to receive the notice electronically. An online copy of this notice is available at www.CarilionClinic.org.

This Notice of Privacy Practices Covers:

  • Carilion Clinic-owned hospitals, clinics and pharmacies.
  • Departments and units within our organization.
  • Any physician, provider, staff or consultant who treats you at any of our locations.
  • Carilion Clinic Community Based Services: Home Health Services, Private Duty, Hospice and DME.

Our Responsibilities

Carilion Clinic is required by law and is committed to:

  • Maintain the privacy of your health information.
  • Provide you with this notice of our legal duties and privacy practices with respect to health information we collect and maintain about you.
  • Abide by the terms of this notice.
  • Notify you if we are unable to agree to a requested restriction and, in most cases, allow you to request a review of our decision.

We reserve the right to change our privacy practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will amend this notice and post a copy of the revised notice on our website at www.CarilionClinic.org. The notice will contain on the first page, the effective date. In addition, the first time you register at or are admitted to a facility for treatment or healthcare services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact Judie Snipes, Carilion Clinics’s privacy officer, at 540-981-7000. If you believe your privacy rights have been violated, you can file a complaint with Carilion Clinic’s information privacy officer, Carilion Clinic’s Compliance Department or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

Permitted Uses and Disclosures Which do not Require Your Written Consent or Authorization

  • We will use your health information for treatment, which means the provision, coordination or management of the healthcare services we provide. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Different departments of this facility may share medical information about you in order to coordinate the different things you need, such as prescriptions, lab work and X-rays. We will also provide your physician with copies of reports that may assist in treating you once you are discharged from this facility.
  • We will use your health information for payment, an activity necessary for us to receive reimbursement for the services we provide to you. For example: a bill may be sent to you, an insurance company or other payer. The information on, or accompanying, the bill may include information that identifies you as well as your diagnosis, procedures and supplies used.
  • We will use your health information for regular healthcare operations, such as quality assessments, evaluating practitioner performance, cost management and general administrative activities. 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 the healthcare and services we provide, and provide training to our staff and medical students.
  • Some services are provided in our organization through contracts with business associates. We may disclose your health information to our business associates so they can perform the job we’ve asked them to do. Our contracts require business associates to appropriately protect the privacy and security of your health information.
  • Unless you notify us that you object, we will 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.
  • We may disclose health information relevant to your care or payment for your care to a family member, other relatives, a close personal friend or any other person you identify. During the initial visit, we may ask you to identify those who you would like to receive information about you.
  • 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 about your location and general condition.
  • We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the facility. In leaving a message on an answering machine, we will only leave our name, and the appointment’s time and date.
  • We may use sign-in sheets in certain locations to check you into the facility. We also may call your name in the waiting area. If you do not wish to sign the sign-in sheet or have your name called, please tell the receptionist and we will make adjustments to meet your request.
  • We may contact you to provide information about treatment alternatives or other health related benefits and services that may be of interest to you.
  • We may contact you as part of our fund-raising effort. You are not required to participate.
  • We may also disclose health information as permitted or required by law, such as in the following circumstances:
    • to the extent required by workers compensation or other similar programs.
    • to a health oversight agency for audits, investigations and inspections.
    • to public health or legal authorities charged with maintaining health records and preventing or controlling disease, injury or disability.
    • to the FDA relative to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs or replacement.
    • to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
    • to research, public health and healthcare operations in a limited, non-identifiable, data set.
    • to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs for the     purpose of tissue donation and transplant. Organs will only be procured with written authorization.
    • to a coroner or medical examiner and to funeral directors as necessary to carry out their duties.
    • to a law enforcement official or in response to a court order, subpoena, warrant, summons or similar process.
    • to authorized federal officials for intelligence, counterintelligence and other national security activities.
    • if you are a member of the armed forces, as required by military command authorities.
    • to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct investigations.
    • If you are an inmate of a correctional institution, to the institution or agents for your health and the health and safety of other individuals.
    • Group Health Plan may disclose protected health information to a plan sponsor.

Other uses and disclosures of medical information not covered by this notice, required for emergency treatment or permitted by the laws that apply to us will be made only with your written authorization. If you authorize disclosure, you may revoke that, in writing, at any time. If you revoke your authorization, we will not use or disclose your medical information for the reasons covered by your prior written authorization. Please understand we are unable to take back disclosures we already made with your prior authorization, and that we are required to retain our records of the care that we provide to you.