Medical Records

A: The information in your health record belongs to you. However, UnityPoint Health maintains the permanent record of the care provided to you. 

A: Individuals participating in your care have access to your records to help them best provide for your health-care needs. After you receive treatment, other UnityPoint Health personnel performing the record-keeping duties also have access to your record. In either case, access is limited to the team members who need the information to perform their job.

A: Yes, records can be faxed to a patient’s home or office. Patients should be aware that faxing to a shared or public fax machine may not be secured and protected. Records could be viewed or subject to access by third-party individuals or others who may have access to the fax machine. This could result in the sharing or further disclosure of your health information.

UnityPoint Clinic partners with a third-party vendor for release of information services. To request medical records from your clinic, submit an Authorization/Request for Release of Health Information form to your local UnityPoint Clinic location or contact the clinic directly.

A: Submit a completed “Authorization to Disclose Protected Health Information” form to have copies of your medical record mailed to that provider free of charge. Include the name and address of the healthcare provider. There’s no charge for copies of your medical record for continuity of care.

Records are not released to a third party unless you've signed an authorization to allow this to occur. However, physicians involved with your care are allowed access to your record.

How to request a listing of where UnityPoint Health has disclosed your medical information

You have the right to receive an Accounting of Disclosures, which is a list of certain disclosures of your or your child’s health information made by UnityPoint Health or on your behalf over the past six years. The first list in any 12-month period will be provided free of charge; you may be charged a fee for each subsequent list you request within the same 12-month period.

Please note that our listing will not include the following disclosures:

1. To you,
2. To carry out treatment, payment, or health care operations,
3. Included as part of the patient directory, including directory information provided to members of the clergy or to other persons who ask for a patient by name,
4. “Incident to” an otherwise permitted use or disclosure,
5. Pursuant to an authorization that you completed,
6. To notify people identified to be involved in your care, including, but not limited to, family members, other relatives and close personal friends,
7. For disaster relief efforts,
8. To authorized federal officials for national security or intelligence purposes,
9. To a Correctional Institution or a Law Enforcement Official having Lawful Custody of an inmate,
10. As part of a Limited Data Set (limited information used for research, public health, or health care operations purposes).

If you would like to request an Accounting of Disclosures, please submit a request in writing using one of the methods described below:

Email: UPH_PrivacyOfficer@unitypoint.org

Mail:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266

A: The patient or the patient's representative would need to consent to release of their medical records. However, if you have Power of Attorney (POA), or you're the executor of the patient's estate, you must submit an Authorization/Request for Release of Health Information form along with a copy of the legal document designating POA or executor rights.

A: You must contact your physician's office for assistance. We don't keep private physician office medical records. However, if your physician specifically ordered a test in the hospital to determine your blood type (pregnancy, surgery, organ donation, or for a blood transfusion), your blood type may be in your hospital medical record and in this instance, we could release it.

A: The administrator or executor of individual’s estate or the individual’s personal representative may authorize release of protected health information (PHI) pertaining to the decedent. The following documentation must be received to release the decedent’s records:

• Death certificate
• Name of Next of Kin/Executor of Estate
• Authorization Relative Form (Illinois Only)
• Signed authorization (if directing to a third-party)

If there is no administrator, executor, or personal representative, the order of priority for information release will be:

1. A court-appointed guardian;
2. The individual’s spouse;
3. Adult children of the individual;
4. Either parent of the individual;
5. Adult siblings of the individual;
6. Other immediate or extended family members

A: The only information HIS releases verbally is the patient's date of admission and/or date of discharge.

A: No. Another person may not receive copies of your medical record without a consent form authorizing UnityPoint Health to release copies.

A: Keeping key documents from your health record is the best way to ensure your medical information is accessible when you need it. Although it’s not necessary to get copies every time you visit your doctor, you should consider getting copies of operative reports, discharge summaries and significant tests from any hospital visit. 

A: At UnityPoint Health, we have a compliance program that includes policies implementing patient privacy and security requirements mandated under all applicable federal and state law. We provide training to our team members on the importance of complying with these policies and regularly conduct audits to confirm the effectiveness of our privacy and security compliance policies.

You may request that we amend or change certain health information that we keep in your or your child’s medical records if you believe that it is incorrect or incomplete.

Processing your amendment request may take up to 60 to 90 days. We are not required to make all requested amendments. For example, if the clinician who drafted a note in your medical record believes the note to be accurate, then we will not change it. If we deny your request, we will provide you with a written explanation of the reasons and your rights. More information is provided on the request form.

To request an amendment to your medical record, please complete a Request for Amendment of Protected Health Information form and submit it using one of the methods described below.

Email: UPH_PrivacyOfficers@unitypoint.org

Mail:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266

It is important that you keep information in your health record up-to-date. Please tell us about the following:

• A change to your address or phone number.
• A change to your emergency contact.
• Establishment of a guardianship by submitting the court order setting up the guardianship.
• Finalization of an adoption by submitting an Adoption Decree/Decree of Adoption, Order on Petition for Adoption, or Finding and Order for Judgement and Decree of Adoption.
• Any healthcare Power of Attorney documents.

If a family member who was a patient has passed away. Please include the patient’s full name, date of birth, date of death, relationship to patient and your phone number in case we have questions.

You have the right to request a restriction or limitation on how we use or disclose your or your child’s health information for treatment, payment, or health care operations or to people involved in your care or payment for your care.

We are not always required to agree to your request. However, if you pay out-of-pocket for your care, then then we will not share your health information with your insurer or health plan for payment or healthcare operations purposes. Note: If you pay for services out-of-pocket, you must make a separate restriction request at each UnityPoint Health location where you receive services.

To request a restriction, please complete a Request to Restrict/Limit Use and Disclosure of Protected Health Information form and submit it using one of the methods described below.

Email: UPH_PrivacyOfficers@unitypoint.org

Mail:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266

You have the right to receive an Accounting of Disclosures, which is a list of certain disclosures of your or your child’s health information made by UnityPoint Health or on your behalf over the past six years. The first list in any 12-month period will be provided free of charge; you may be charged a fee for each subsequent list you request within the same 12-month period.

Please note that our listing will not include the following disclosures:

1. To you,
2. To carry out treatment, payment, or health care operations,
3. Included as part of the patient directory, including directory information provided to members of the clergy or to other persons who ask for a patient by name,
4. “Incident to” an otherwise permitted use or disclosure,
5. Pursuant to an authorization that you completed,
6. To notify people identified to be involved in your care, including, but not limited to, family members, other relatives and close personal friends,
7. For disaster relief efforts,
8. To authorized federal officials for national security or intelligence purposes,
9. To a Correctional Institution or a Law Enforcement Official having Lawful Custody of an inmate, or
10. As part of a Limited Data Set (limited information used for research, public health, or health care operations purposes).

If you would like to request an Accounting of Disclosures, please complete a Request for Accounting of Disclosure of Protected Health Information form and submit it using one of the methods described below.

Email: UPH_PrivacyOfficers@unitypoint.org

Mail:
UnityPoint Health
System Privacy Officer
1776 West Lakes Parkway
West Des Moines, Iowa 50266