provide consent for North Eastern Community Hospital to collect my/the patient's personal and health information on behalf of the various clinicians practicing at North Eastern Community Hospital.
I consent to North Eastern Community Hospital and the clinicians to use and disclose my/the patient's personal and health information for the following purposes:
HOSPITAL CHARGES
Insured Patients
If you are an insured patient you should check with your Health Fund to confirm the following:
- That you are (or will be) covered for the Hospital charges in connection with your admission.
- What (if any) excess applies to your level of cover from the Health Fund as this is paid by you to the Hospital prior to or on admission.
Insured patients will be asked to sign a Certificate of Hospitalisation prior to discharge so that the account can be forwarded direct to the Health Fund for payment. Patients are responsible for any excess not covered by the fund and will be required to pay the excess prior to or on admission.
Self Insured Patients
Will be required to pay charges prior to or on admission. Our Accounts Department can inform patients of anticipated costs.
All patients are admitted on the understanding that they are personally liable for their own HOSPITAL ACCOUNTS. An estimate of the Hospital Account can only be provided by our Hospital Staff and a payment of the anticipated fee is payable on admission unless prior arrangements have been made.
WORKER'S COMPENSATION PATIENTS / THIRD PARTY INSURANCE PATIENTS
Patients are admitted on the condition that they, like all others, are personally responsible for payment of the Hospital�s account on presentation, notwithstanding any claims they have for compensation or damages. Accounts cannot be held in abeyance pending settlement of such claims. If any person or organisation (e.g. an employer or insurance company) has agreed to accept responsibility for payment on presentation of any account, the patient should arrange for that person or organisation to send to the Hospital, before admission date, a written undertaking to this effect. If no such undertaking is received, the patient will be regarded as personally responsible for prompt payment.
PRIVACY INFORMATION
North Eastern Community Hospital (NECH) and North Eastern Community Nursing Home (NECNH) respects and upholds patients and residents rights to privacy protection under the Australian Privacy Principles (APPs) contacted in the Privacy Act 1988. The APPs replace the National Privacy Principles effective form the 12 March 2014.
WHAT PERSONAL INFORMATION DOES NECH AND NECNH HOLD?
NECH / NECNH may hold the following information about you:
- Name
- Street
- Telephone Number(s)
- Date of Birth
- Email Address
- Occupation
- Health Information
- Health Fund Information
- General Practitioner
- Referring Doctor
- Return Service Organisation
- Religious Beliefs or Affiliations
- Transaction details associated with services provided to patients/residents
- Any addition information provided by patients or residents
- Any information provided to NECH / NECNH through patient surveys
NECH / NECNH will destroy or de-identify personal information due to redundancy after its legal obligations to retain the information have expired.
WHAT DOES NECH / NECNH DO WITH MY PERSONAL INFORMATION?
NECH / NECNH uses personal information obtained from patients and residents in relation to the following:
- To provide medical treatment and care;
- To assist treating doctors, nursing staff and other allied health professionals in providing medical treatment and care;
- To assist with any enquiries made by patients/residents;
- For internal administrative requirements;
- To process private health fund claims;
- To provide information to Medical Practitioners, Registered Nurses and other Allied Health Professionals who provide necessary follow up treatment and ongoing care;
- For benchmarking and clinical indicator reporting in a de-identified form;
- To provide data in both an identified and de-identified form to State Government agencies in compliance with numerous legislative requirements;
- To provide data in a de-identified form to the Private Hospital Data Bureau;
And with the consent of patients/residents:
- Research & Development
- Service Planning
- Provision of Pastoral Care
- Fundraising and/or Marketing
STORAGE AND SECURITY
NECH/NECNH stores personal information:
- Contained in paper based and other hard copy documents in a dedicated and secure storage facility located within the Hospital; and
- Contained in electronic records in a secure environment; and
- Such records are only accessible by those staff members of NECH / NECNH who have bona fide need to access the personal information for the purpose of carrying out their specific duties of employment.
OPENNESS
Patients/residents may request access to personal information that NECH / NECNH holds by completing a 'Request to access a patient/resident information form' available on the website www.northeasternhospital.com.au and forwarding this to the Chief Executive Officer.
If a patient/resident believes that personal information held is incorrect, incomplete or inaccurate, then the patient or resident may request an amendment to be made. Hospital management will consider if the information requires amendment. If management does not agree that there are grounds for amendment, then a note will be added to the personal information stating that the patient or resident disagrees with it.
Any questions or any complaint regarding treatment of privacy by NECH / NECNH should also be made in writing to the address below.
North Eastern Community Hospital |
580 Lower North East Road, Campbelltown, SA, 5074 |
Phone: |
08 8366 8111 |
Fax: |
08 8365 1139 |
Email: |
exec@nech.com.au |