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HIPAA NOTICE OF PRIVACY PRACTICES
TAOS
ORTHOPAEDIC INSTITUTE
Effective Date: OCTOBER 4, 2005
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION IN COMPLIANCE
WITH FEDERAL LAW. PLEASE REVIEW IT CAREFULLY. WE WILL REQUEST THAT YOU
SIGN A SEPARATE FORM ACKNOWLEDGING THAT
YOU HAVE BEEN GIVEN THE OPPORTUNITY TO READ THIS NOTICE AND THE OPTION
TO TAKE A COPY WITH YOU OR TO VIEW IT ON OUR WEBSITE AT
www.taosortho.com. THE ACKNOWLEDGEMENT WILL BE FILED WITH YOUR
RECORDS.
This Notice of Privacy Practices
describes how we may use and disclose your protected health information
to carry out treatment, payment, or healthcare operations and for other
purposes that are permitted or required by law. It also describes your
right to access and control your protected health information.
Protected Health Information (PHI) is information about you, including
demographic information that may identify you and relates to your past,
present, or future physical or mental health condition and related
health care services.
NOTICE
OF PRIVACY PRACTICES
We are required by law to maintain the privacy of your
protected health information and to provide you with this Notice of
Privacy Practices. We are required by law to abide by the terms of this
Notice of Privacy Practices.
We may change the terms of our
notice at any time. The new notice will be effective for all protected
health
information that we maintain at
that time. If you wish to obtain a revised Notice of Privacy Practices
you may do so by accessing our website at www.taosortho.com, calling the
office and requesting that a revised copy be sent to you in the mail, or
by requesting a revised copy at the time of your next appointment.
1. Uses and Disclosures of
Protected Health Information (PHI)
Your PHI may be used and
disclosed by your physician, our office staff and others outside of our
office that are involved in your care and treatment for the purpose of
providing health care services to you. Your PHI may also be used and
disclosed to pay your health care bills and to support the operations of
the physician�s practice.
Following are examples of the
types of uses and disclosures of your health care information that the
physician�s office is permitted to make.
Treatment:
We will use and disclose your PHI to provide, coordinate, or manage your
health care and any related services. This includes the coordination or
management of your health care with a third party that has already
obtained your permission to have access to your protected health
information. For example, we would disclose your PHI, as necessary, to a
home health care agency that provides care to you. We may disclose PHI
to other physicians who may be treating you. For example, your PHI may
be provided to a physician to whom you have been referred to ensure that
the physician has the necessary information to diagnose or treat you.
In addition, we may disclose your PHI to another physician or health
care provider (e.g. specialist or laboratory) who, at the request of
your physician, becomes involved in your care by providing assistance
with your health care diagnosis or treatment to your physician.
Payment:
Your PHI will be used, as needed, to obtain payment for your health care
services. This may include certain activities that your health insurance
plan may undertake before it approves or pays for the health care
services we recommend for you such as; making a determination of
eligibility or coverage for insurance benefits, reviewing services
provided to you for medical necessity, and undertaking utilization
review activities. For example, obtaining approval for a hospital stay
may require that your relevant PHI be disclosed to the health plan to
obtain approval for the hospital admission.
Healthcare Operations:
We may use or disclose, as needed, your PHI in order to support the
business activities of your physician�s practice. These activities
include, but are not limited to, quality assessment activities, employee
review activities, training of medical students, licensing, certain
types of marketing and fundraising activities, research studies as
permitted by law, and conducting or arranging for other business
activities.
For example, we may disclose your
PHI to medical school students that see patients at our office. In
addition, we may use a sign-in sheet at the registration desk where you
will be asked to sign your name and indicate your physician. We may also
call you by name in the waiting room when your physician is ready to see
you. We will share your PHI with third party �business associates� that
perform various activities (e.g. billing, transcription services, and
medical supply vendors) for the practice. Whenever an arrangement
between our office and a business associate involves the use or
disclosure of your PHI, we will have a written contract that contains
terms that will protect the privacy of your PHI.
Information about
treatments: We may
use or disclose your PHI, as necessary, to provide you with information
about treatment alternatives or other health-related benefits and
services that may be of interest to you.
Appointment Reminders:
We may use or disclose your protected health information, as necessary,
to contact you to remind you of your appointment.
Education and Fundraising
Activities: We may disclose PHI to
entities or to Taos Orthopaedic Research Foundation and you may be
contacted for fundraising or educational purposes. You will be given the
opportunity to opt out of any fund-raising efforts and may do so by
contacting Myna Ayala at our office.
2. Uses and Disclosures of Protected Health Information
Based Upon Your Written Authorization
Other uses and disclosures of
your PHI will be made only with your written authorization, unless
otherwise permitted or required by law as described below. You may
revoke this authorization, at any time, in writing, except to the extent
that your physician or the physician�s practice has taken an action in
the reliance on the use or disclosure indicated in the authorization.
You have the opportunity to agree
or object to the use or disclosure of all or part of your PHI for the
reasons listed below. If you are not present or able to agree or object
to the use or disclosure of the PHI, then your physician may, using
professional judgment, determine the disclosure is in your best
interest. In this case, only the PHI that is relevant to your healthcare
will be disclosed.
Others Involved in Your
Healthcare: Unless you object, we may
disclose to a member of your family, a relative, a close friend or any
other person you identify, your PHI that directly relates to that
person�s involvement in your health care. If you are unable to agree or
object to such a disclosure, we may disclose such information as
necessary if we determine that it is in your best interest based on our
professional judgment. We may use or disclose PHI to notify or assist in
notifying a family member, personal representative or any other person
that is responsible for your care of your location, general condition,
or death. Finally, we may use or disclose your PHI to an authorized
public or private entity to assist in disaster relief efforts for the
purpose of coordinating with such entities the uses or disclosures to
notify, or assist in the notification of (including identifying or
locating), a family member, personal representative of the individual of
the individuals locations, general condition or death.
Emergencies:
We may use or disclose your PHI in an emergency treatment situation. If
this happens, your physician shall try to obtain your consent as soon as
reasonably practicable after the delivery of treatment.
Communication Barriers:
We may use and disclose your PHI if your physician or another physician
in the practice attempts to obtain consent from you but is unable to do
so due to substantial communication barriers and the physician
determines, using professional judgment, that you intend to consent to
use or disclosure under the circumstances.
3. Other Permitted and
Required Uses and Disclosures That May Be Made Without Your Consent,
Authorization or Opportunity to Object.
We may use or disclose your PHI
in the following situations without your authorization. These situations
include:
As Required by Law:
We may use or disclose your PHI to the extent that the use or disclosure
is required by law. The use or disclosure will be made in compliance
with the law and will be limited to the relevant requirements of the
law. You will be notified, as required by law, of any such uses or
disclosures.
Public Health:
We may disclose your PHI for public health activities and to a public
health authority that is permitted by law to collect and receive the
information disclosed. The disclosure will be made for the purpose of
controlling disease, injury or disability. We may also disclose your
PHI, if directed by the public health authority, to a foreign government
agency that is collaborating with the public health authority.
Communicable Diseases:
We may disclose your PHI, if authorized by law, to a person who may have
been exposed to a communicable disease or may otherwise be at risk of
contracting or spreading the disease or condition.
Health Oversight:
We may disclose PHI to a health oversight agency for activities
authorized by law, such as audits, investigations, and inspections.
Oversight agencies seeking this information include government agencies
that oversee the health care system, government benefit programs, other
government regulatory programs and civil rights laws.
Abuse or Neglect:
We may disclose your PHI to a public health authority that is authorized
by law to receive reports of child abuse or neglect. In addition, we may
disclose your PHI if we believe that you have been a victim of abuse,
neglect or domestic violence to the government entity or agency
authorized to receive such information. In this case, the disclosure
will be made consistent with the requirements of applicable federal and
state laws.
Food and Drug
Administration: We may disclose your PHI
to a person or company as required by the Food and Drug Administration
to report adverse events, product defects or problems, biologic product
deviations, track products, to enable product recalls, to make repairs
or replacements, or to conduct post marketing surveillance, as required.
Legal Proceedings:
We may disclose PHI in the course of any judicial or administrative
proceeding, in response to an order of a court or administrative
tribunal (to the extent such disclosure is expressly authorized), in
certain conditions in response to a subpoena, discovery request or other
lawful process.
Law Enforcement:
We may also disclose PHI, so long as applicable legal requirements are
met, for law enforcement purposes. These law enforcement purposes
include (1) legal processes or other processes required by law, (2)
limited information requests for identification and location purposes,
(3) processes pertaining to victims of a crime, (4) suspicion that death
has occurred as a result of criminal conduct, (5) processes in the event
that a crime occurs on the premises of the practice, and (6) medical
emergency (not on the practice�s premises) when it is possible that a
crime has occurred.
Coroners, Funeral
Directors, and Organ Donation: We may
disclose PHI to a coroner or medical examiner to perform other duties
authorized by law. We may also disclose PHI to a funeral director, as
authorized by law, in order to permit the funeral director to carry out
their duties. We may disclose such information in reasonable
anticipation of death. PHI may be used and disclosed for cadaver organ,
eye or tissue donation purposes.
Research:
We may disclose your PHI 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 PHI.
Criminal Activity:
Consistent with applicable federal and state laws, we may disclose your
PHI if we believe that the use or disclosure is necessary to prevent or
lessen a serious and imminent threat to the health or safety of a person
or the public. We may also disclose PHI if it is necessary for law
enforcement authorities to identify or apprehend an individual.
Military Activity and
National Security: When the appropriate
conditions apply, we may use or disclose PHI of individuals who are
Armed Forces personnel (1) for activities deemed necessary by
appropriate military command authorities; (2) for the purpose of a
determination by the department of Veterans Affairs of your eligibility
for benefits, or (3) to foreign military authority if you are a member
of that foreign military services. We may also disclose your PHI to
authorized federal officials for conducting national security and
intelligence activities, including for the provision of protective
services to the President or others legally authorized.
Workers� Compensation:
Your PHI may be disclosed by us as authorized to comply with workers�
compensation laws and other similar legally-established programs.
Inmates:
We may use or disclose your PHI if you are an inmate of a correctional
facility for your treatment, for the health and safety of you or other
inmates, for the health and safety of the officers of employees or
others at the correctional institution, for the health and safety any
individuals and officers responsible for transporting you from one
institution to another, and for the administration and maintenance of
the safety, security, and good order of the correctional institution.
Required Uses and
Disclosures: When required by law, we must
make disclosures to you and to the Secretary of the Department of Health
and Human Services to investigate or determine our compliance with
requirements of the HIPAA Privacy Act.
4. Your Rights:
Following is a statement of your
rights with respect to your PHI and a brief description of how you may
exercise these rights.
You have the right to
inspect and copy your PHI. You have the
right to inspect and copy your PHI that may be used to make decisions
about your care as long as access is not prohibited by state/federal
law. Usually, this includes health and billing records. To inspect and
copy health information that may be used to make decisions about you,
you must submit your request in writing to our medical records
department. If you request a copy of the information, we may charge a
fee for the cost of copying, mailing or other supplies and services
associated with your request.
You have the right to
request a restriction of your PHI. This
means you may ask us not to use or disclose any part of your PHI for the
purpose of treatment, payment or healthcare operations. You may also
request that any part of your PHI not be disclosed to family members or
friends who may be involved in your care or for notification purposes as
described in this Notice of Privacy Practices. Your request must state
the specific restriction requested and to whom you want the restriction
to apply.
Your physician is not required to
agree to a restriction that you might request. If your physician
believes it is in your best interest to permit use and disclosure of
your protected health information, your PHI will not be restricted. If
your physician does agree to the requested restriction, we may not use
or disclose your PHI in violation of the restriction unless it is needed
to provide emergency treatment. With this in mind, please discuss any
restriction you wish to request with your physician. You may request a
restriction by submitting a written request to our office.
You have the right to
request to receive confidential communications from us by alternative
means or at an alternative location. We
will accommodate reasonable requests. We may also condition this
accommodation by asking you for information as to how payment will be
handled or specification of an alternative address or other method of
contact. We will not request an explanation from you as to the basis for
the request. Please make this request to our Reception Manager.
You may have the right to
have your physician amend your PHI. This
means you may request an amendment of PHI about you in a designated
record set for as long as we maintain this information. To request an
amendment, your request must be made in writing and submitted to our
Privacy Officer. In certain cases, we may deny your request for an
amendment. If we deny your request for amendment, you have the right to
file a statement of disagreement with us and we may prepare a rebuttal
to your statement and will provide you with a copy of any such rebuttal.
Please contact our medical records clerk if you have questions about
amending your medical record.
You have the right to
receive an accounting of certain disclosures we have made, if any, of
your PHI. This right
applies to disclosures for purposes other than treatment, payment or
healthcare operations as described in this Notice of Privacy Practices.
It excludes disclosures we may have made to you, for a facility
directory, to family members or friends involved in your care, or for
notification purposes. It excludes any other disclosures which are not
required to be documented per the Health Insurance Portability and
Accountability Act. You have the right to receive specific information
regarding disclosures that occurred after April 14, 2003. You may
request a shorter timeframe. The right to receive this information is
subject to certain exceptions, restrictions and limitations.
5. Complaints
You may complain to us or the
Secretary of Health and Human Services if you believe your privacy
rights have been violated by us. You may file a complaint with us by
notifying our Privacy Officer of your complaint. We will not retaliate
against you for filing a complaint. You may contact our Privacy Officer
at (505) 758-0009 or by mail at Taos Orthopaedic Institute, 1219-A
Gusdorf Road, Taos, NM 87571.
You have the right to obtain a
paper copy of this notice from us, upon request, even if you have agreed
to accept this notice electronically.
This notice was published and
became effective on October 4, 2005
page updated: July 31, 2010 |
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