Effective Jan. 1, 2020
This notice describes how medical information about you may be used and disclosed. Please review it carefully. If you have any questions, please contact our Office at the address or telephone number at the bottom of this Notice.
The Delta State University Student Health Services provides health care to the students enrolled at DSU in partnership with physicians and other professionals and organizations. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) in this Notice will be followed by all departments and all employed associates, staff or volunteer. In addition, we are a clinically integrated care setting, and we have doctors and other providers giving care to students. For convenience of our students, the University Health Center, all members of our medical staff and all other health care professionals who treat you at any of our medical facilities are covered by this “organized health care arrangement” (“OHCA”) and may share protected health information with each other, as necessary to carry out your treatment, payment for treatment, and health care operations relating to OHCA. This arrangement does not mean that the persons participating in the OHCA are involved in a joint business arrangement, or that they are responsible for the acts of one another.
As a student at DSU, you have the right to privacy concerning your medical plan of care. The medical record information and your relationship with the medical staff are considered private. Your diagnosis and course of treatment are available only to those directly involved with your care. Unless you tell us otherwise, we will make every effort to give you medical updates as appropriate. We create a record of the care and services and only share this information with your family with your written permission. This record of the care and service you receive provides quality care and complies with legal requirements. This Notice applies to all of the records of your care that we maintain, whether created by our medical staff or your doctor. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office. We are required by law to keep medical information about you private, give you this Notice of our legal duties and privacy practices with respect to medical information about you and follow the terms of the Notice that is currently in effect.
We may use and disclose medical information about you for treatment (such as sending medical information about you to a specialist as part as a referral); to obtain payment for treatment (such as sending billing information to your insurance company or Medicare); and to support our health care operations (such as comparing patient data to improve treatment methods). We may disclose medical information and/or participation status to athletic coaches and/or, athletic trainers for your health and safety. With your permission we may disclose information to university administrators and academic counselors to support your academic progress.
Regarding your medical information, you have the right to look at or get a copy of medical information that we use to make decisions about your care. You have the right to a personal representative to assist you in reviewing your medical information. If you believe that information in your records is incorrect or incomplete, you have the right to request that we amend the records. You have the right to a list of those instances where we have disclosed medical information about you, other than for treatment, payment, health care operations or where you specifically authorized a disclosure. You may request, in writing, that we do not use or disclose medical information about you for specific cases or circumstances.
We reserve the right to change the terms of this Notice at any time. Changes will apply to medical information we already hold, as well as new information we receive after the change occurs. If we change our Notice, we will post the new Notice in our facility. You can receive a copy of the current Notice at any time. The effective date is listed just below the title above.
If you have questions regarding your privacy rights, you may contact our department at this address:
DSU Health Services
DSU Box 3315
Cleveland, MS 38733
or call at (662) 846-4630
