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To make an appointment, call 952.831.TRIA (8742)
Mon-Fri 8:00 am to 5:00 pm
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At TRIA, we are very sensitive to privacy issues and respect your right to privacy.
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TRIA operates in full compliance with the privacy requirements under the Health
Insurance Portability and Accountability Act (HIPAA).
Please feel free to contact us via e-mail, but note that the e-mail functionality
provided on our site does not provide a completely secure and confidential means
of communication. It is possible that your e-mail communication may be accessed or
viewed inappropriately by another Internet user while in transit to us. If you wish
to keep your information completely private, you should not use e-mail.
From time to time, we may send e-mail communications to you related to TRIA news
and information, website updates and other general health topics. To opt out of
e-mail communications you're receiving, click on the opt-out button associated with
the specific communication.
TRIA Notice of Privacy Practices
Effective 1/1/06
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.
In this notice, the words "we," "us" and "TRIA" mean any or all of the following:
- TRIA Orthopaedic Center Clinic - A Park Nicollet clinic
- TRIA Ambulatory Surgery Center
- TRIA Orthopaedic Center Research Institute
- Methodist Hospital (including its medical staff)
- Park Nicollet Clinic
- Park Nicollet Institute (including International Diabetes Center at Park Nicollet)
- Park Nicollet Health Care Products
- Other parts of the Park Nicollet system that provide healthcare, and independent
providers or contractors who participate in our organized healthcare arrangement
"You" means anyone who receives healthcare services or products from us. "Health
information" means any information that we create or receive relating to your health
or healthcare payment, whether oral, written or recorded in any form.
How we may use and disclose your health information
Required disclosures permitted without your authorization
Your rights to your health information
Our legal rights and duties
Complaints
How we may use and disclose your health information
The law requires us to inform you that we use and disclose your health information
for the following purposes.
TREATMENT
We will use your health information to provide you with healthcare services or
products. We may share your health information with doctors, nurses or other healthcare
providers (such as X-ray, lab and pharmacy) who are involved in your care and who
are part of the entity providing your care. With your consent, we may disclose certain
health information specified by you to your family, others involved in your care
or organizations outside of Park Nicollet providing healthcare to you.
PAYMENT
We may use and disclose health information to bill:
- your insurer
- Medicare
- any other payer or programs
- your health plan
- Medical assistance
- you
If your insurer or health plan requires prior approval or other notice to determine
whether they will pay for those services or products, we may disclose parts of your
health information to them, unless you have asked that we not bill your insurer
or plan.
HEALTHCARE OPERATIONS
We may use and disclose information about you within Park Nicollet to manage and
improve our healthcare service. This includes:
- quality assessment
- licensing and accreditation
- business planning and management
- evaluating health professionals
- legal and accounting services
We may provide services with the help of people who are not our employees, and companies
that are not our affiliates. This includes equipment technologists, computer hardware
and software providers or maintenance personnel. We call these people or companies
our “business associates.” We may give our business associates some access to your
health information so they can perform their job duties. We minimize their access
as much as possible. They are required to safeguard your information.
APPOINTMENT REMINDERS, TREATMENT ALTERNATIVES
We may use and disclose your health information to provide you with:
- appointment reminders
- information about treatment options and services
- other health-related products or services
HOSPITAL DIRECTORY
If you are a patient at Methodist Hospital, we may include the following limited
information about you in the hospital directory.
- Name
- Location
- General condition (fair, stable and others)
PEOPLE INVOLVED IN YOUR CARE
Unless you object, we may release health information to a family member or friend.
We also may disclose your health information if you are incapacitated, or in an
emergency, if we feel it is in your best interest. We may disclose information about
you to a disaster-relief organization if there is a disaster, so that your family
can be notified.
RESEARCH
We will not use or disclose any health information that can be used to identify
you for research purposes without first obtaining your written authorization or
following state law procedures for trying to notify you. When you register with
us, we will ask to use and disclose your health information within Park Nicollet
for medical or scientific research. You will be asked to sign additional authorizations
for clinical research trials involving treatment.
FUNDRAISING ACTIVITIES
We may use your health information and disclose your contact information to Park
Nicollet Foundation so it can contact you about raising money for one or more nonprofit
parts of Park Nicollet. The information we would disclose is limited to your name,
address and telephone number, plus the dates you received services from us. We do
not sell your information. Any fundraising communication addressed to you will contain
instructions describing how you may "opt out" from receiving further similar communications.
If you do not wish to be contacted, please write to:
Park Nicollet Foundation, 6500 Excelsior Blvd.,
St. Louis Park, MN 55426
Required disclosures permitted without your authorization
We will release health information about you as required for workers' compensation
or similar programs to comply with related laws. Plus, we may need to use or disclose
your health information without your authorization:
- to the government for public health activities as permitted or required by law to
report disease exposures and statistics, births and deaths, abuse or neglect, reactions
to medication and problems with products
- to a health oversight agency for audits, investigations, inspections and licensure
activities
- to prevent a serious and imminent threat to the health or safety of a person or
the public, or to help the police apprehend a person involved with a violent crime
that may have seriously harmed someone
- to organ donation organizations to assist with organ or tissue donation and transplantation,
consistent with applicable law
- to a law enforcement official in response to a court or administrative order, subpoena,
warrant, summons or similar process; to identify or locate a suspect, witness or
missing person; to identify a victim of crime if, under certain limited circumstances,
we are unable to obtain the victim's agreement; or in emergency circumstances to
report the location and perpetrator of a crime
- to a private party in litigation in response to a valid court order or administrative
order
- to a coroner or funeral director as permitted or required by law to identify a deceased
person, determine the cause of death or to carry out their necessary duties
- to a correctional institution if you are an inmate, as necessary for your health
and the health and safety of other people
- for military, national security or lawful intelligence activities
- otherwise as permitted or required by law
Other uses and disclosures of your health information will be made only with your
written authorization. You may revoke that authorization at any time for future
uses and disclosures by writing to Park Nicollet Health Information Management at
the address at the end of this notice.
Your rights to your health information
You have the following rights regarding the health information we maintain about
you.
RIGHTS TO INSPECT AND COPY
With some exceptions, you have the right to see and request a copy of records that
include your health information and are maintained or used by us (the designated
record set). To request a copy, write to Health Information Management at the address
listed at the end of this notice. We charge a fee for copying or mailing costs.
In some cases, we may deny your request. If you are denied access to records, you
may request that another licensed healthcare professional chosen by us review the
denial. We will comply with the outcome of the review.
RIGHT TO REQUEST AN AMENDMENT
You may ask us to amend a record containing your health information if you feel
it is incorrect or incomplete. Your request must be submitted in writing to Health
Information Management at the address listed at the end of this notice. You must
provide a reason for your request. We may deny your request if, among other reasons,
the information was not created by us; is not included in your medical, billing
or other records; or is otherwise accurate and complete.
RIGHT TO AN ACCOUNTING OF DISCLOSURES
You have the right to request a written report of where we sent your health information
for up to a six-year period. This does not include disclosures to or authorized
by you or disclosures for treatment, payment and healthcare operations as described
in this notice. You must submit your request in writing to Health Information Management
at the address listed at the end of this notice. Your request must state a time
period of six years or less, and may not include dates before April 14, 2003. The
first report you request within a 12-month period will be free. After that, we may
charge you for the cost of providing the report.
RIGHT TO REQUEST RESTRICTIONS
You may request that we restrict or limit the health information we use or disclose
about you for treatment, payment or healthcare operations. We may not be able to
agree with your request. If we agree, we will honor your request unless the information
is needed to provide emergency treatment. You must make your request in writing
to Health Information Management at the address listed at the end of this notice.
In your request, you must tell us: 1) what information you want to limit; 2) how
you want to limit our use or disclosure; and 3) to whom you want the limits to apply.
RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS
You have the right to request that we communicate your health information in a certain
method or place (such as at work or by mail). You must make your request in writing
when you register with us, or to Health Information Management at the address listed
at the end of this notice. We will try to meet all reasonable requests.
Our legal duties and rights
The law requires us to protect the privacy of your health information and to provide
this notice of our practices. We reserve the right to change our health information
practices and the terms of this notice. We reserve the right to make the changed
notice effective for health information we already have about you and for new information.
The notice will contain an effective date on the first page, in the top right-hand
corner. The notice will be placed in a prominent place at each of our patient care
sites, and it will be posted on our website, www.parknicollet.com. We will replace
the notice on our website with updated notices as they become available. In addition,
you may request a paper copy of this notice by contacting Patient Relations at the
address at the bottom of this page. Notices will be available whenever we
provide you with healthcare.
Complaints
If you believe your privacy rights have been violated, you may file a complaint
with Park Nicollet Health Services Patient Relations at the address shown below.
You also may file a complaint with Region V, Office for Civil Rights, U.S. Department
of Health and Human Services, 233 N. Michigan Ave., Suite 240, Chicago, IL 60601,
or fax 312-886-1807. All complaints must be made in writing. You will not be penalized
for filing a complaint. If you have any questions, contact:
Park Nicollet Health Services
Patient Relations
P.O. Box 650 Minneapolis, MN 55440
Park Nicollet Clinic: 952-993-3014
Methodist Hospital: 952-993-5541
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