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
