Tennessee Orthopaedic Clinics PC
Notice of Privacy Policy
This notice describes how medical informatio about you may be used and disclosed
and how you can get access to this information. Please review it carefully.
This Privacy Notice is being provided to you as
a requirement of a federal law, the Health Insurance Portability and
Accountability Act (HIPAA).
This Privacy Notice describes how we may use and disclose your protected
health information to carry out treatment, payment, or health care 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.
Your “protected health information” means any written or
oral information about you, including demographic data that can be used
to identify you, created or received by your health care provider, which
relates to your past, present, or future physical or mental health or
condition.
Uses and Disclosures of Protected Health Information
for Treatment, Payment, and Health Care Operations. We may use
your protected health information for the purposes of providing treatment,
obtaining payment for treatment, and conduction health care operations.
Your protected health information may be used or disclosed only for
these purposes unless we have obtained your authorization or the use
or disclosure is permitted or required by the HIPAA regulations or
other law. Disclosures of your protected health information for the
purposes described in this Privacy Notice may be made in writing, orally,
or by electronic means.
1. Treatment. We will use and disclose your
protected healthcare information to provide, coordinate, or manage your
health care and related services, including coordination and management
with third parties for treatment purposes.
Here are some examples of how we
may use or disclose your protected health information for treatment:
a. We may disclose your protected health information to a laboratory
to order tests. b. We may disclose your protected health information
to other physicians who may be treating you or consulting with us regarding
your care. c. We may disclose your protected health information to
those who may be involved in your care after you leave here, such as
family members or your personal representative.
2. Payment. We will use your protected health information
to obtain payment for the services we provide to you. We may also disclose
your protected health
information to another provider involved in your care for their payment activities.
Here are someexamples of how we may use or disclose your protected health information
for payment: a. We may communicate with your health insurance company
to get approval for the services we render, to verify your health insurance
coverage, to verify that particular services are covered under your insurance
plan, and to demonstrate medical necessity. b. We may disclose your protected
health information to anesthesia care providers involved in your care
so they can obtain payment for their services.
3. Health Care Operations. We may use and disclose
your protected health information to facilitate our own health care operations
and to provide quality care to all of our patients. Health care operations
include such activities as: quality assessment and improvement; employee
review activities; conduction or arranging for medical review, legal services,
and auditing functions, including fraud and abuse detection and compliance
reviews; business planning and development; and business management and general
administrative activities. In certain situations, we may also disclose your
protected health information to another provider or health plan for their
health care operations.
Here are some examples of how we may use or disclose
your protected health information for health care operations: a. We
may use your protected health information to review our treatment and
services and to evaluate the performance of our staff in caring for
you. b. We may combine protected health information about many patients
to decide what additional services we should offer, what services are
not needed, and whether certain new treatments are effective.c. We
may also disclose information to doctors, nurses, technicians, medical
students, and other personnel for review and learning purposes. d.
We may also use or disclose your protected health information in the
course of maintenance and management of our electronic health information
systems.
4. Other Uses and Disclosures. As part of the functions above, we may
use or disclose your protected health information to provide you with
appointment
reminders, to inform you of treatment alternatives, or to provide you with
information about other health-related benefits and services which may be of
interest to you.
Uses
and Disclosures of Protected Health Information Permitted without Authorization
Required or Opportunity for the Individual to Object. The Federal privacy
rules allow us to use or disclose your protected health information without
your authorization and without your having the opportunity to object to
such use or disclosure in certain circumstances, including:
1. When Required By Law. We will disclose
your protected health information when we are required to do so by federal,
state, or local law.
2. For Public Health Reasons. We may disclose
your protected health information as permitted or required by law for the
following public health reasons: a. For the prevention, control, or reporting
of disease, injury or disability; b. For the reporting of vital events
such as birth or death; c. For public health surveillance, investigations,
or interventions; d. For purposes related to the quality, safety, or
effectiveness of FDA-regulated products or activities, including: • Collection
and reporting of adverse events, product defects or problems, or biological
product deviations • Tracking of FDA-regulated products • Product
recalls, repairs, or lookback, • Post-marketing surveillance;
e. To notify a person who has been exposed to a communicable disease
or who may be at risk of contracting or spreading a disease or condition;
f. Under certain limited circumstances, to report to an employer information
about an individual who is a member of the
employers workforce.
3. To Report Abuse, Neglect, or Domestic Violence. We
may notify government authorities if we believe a patient is a victim of abuse,
neglect, or domestic violence. We will make this disclosure only when specifically
authorized or required by law, or when the patient agrees to the disclosure.
4. For Health Oversight Activities. We
may disclose your protected health information to a health oversight
agency for oversight activities authorized by law, including audits;
civil, administrative, or criminal investigations; inspections; licensure
or disciplinary actions; civil, administrative, or criminal proceedings
or actions; or other activities necessary for appropriate oversight.
5. For Judicial or Administrative Proceedings. We
may disclose your protected health information in the course of any judicial
or administrative proceeding in response to an order of a court or administrative
tribunal as expressly authorized by such order. We may disclose your
protected health information in response to a subpoena, discovery request,
or other lawful process that is not accompanied by an order of a court
of administrative tribunal if we have received satisfactory assurances
that you have been notified of the request or that an effort has been
made to secure a protective order.
6. For Law Enforcement Purposes. We may disclose
your protected health information to a law enforcement official for
law enforcement purposes, including: a. Wound or physical injury reporting,
as required by law. b. In compliance with, and as limited by the relevant
requirements of a court order or court-orderedwarrant, a subpoena,
summons, or similar process. c. Identification or location of a suspect,
fugitive, material witness, or missing person. d. Under certain limited
circumstances when you are the victim of a crime. e. Alerting law enforcement
of the death of an individual where there is suspicion that the death
may have resulted from criminal conduct. f. Reporting criminal conduct
that occurred on the premises of the provider. g. In an emergency to
report a crime.
7. To Coroners, Medical Examiners, and Funeral Directors. We
may disclosed protected health information to a coroner or medical examiner
for the purpose of identifying a deceased person, determining a cause
of death, or other duties as authorized by law. We may disclose protected
health information to funeral directors, consistent with applicable law,
as necessary to carry out their duties with respect to the decedent.
In some cases such disclosures may occur prior to, and in reasonable
anticipation of, the individual’s death.
8. For Organ or Tissue Donation. We may
use or disclose protected health information to organ procurement organizations
or other entities engaged in the procurement, banking, or transplantation
of cadaveric organs, eyes, or tissue for the purpose of facilitating
donation and transplant.
9.
For Research Purposes. We may use or disclose your protected health
information for research purposes when an institutional review board
that has reviewed the research proposal and protocols to safeguard the
privacy of your protected health information has approved such use or
disclosure.
10. To Avert a Serious Threat to Health or Safety. We
may, consistent with applicable law and standards of ethical conduct,
use or disclose your protected health information if we believe, in
good faith, that such use or disclosure is necessary to prevent or
lessen a serious and imminent threat to your health and safety or that
of the public.
11. For Specialized Government Functions. We
may use or disclose your protected health information, as authorized or
required by law, to facilitate specified government functions related to
military and veterans activities; national security and intelligence activities;
protective services for the President and others; medical suitability determinations;
correctional institutions and other law enforcement custodial situations.
12. For Workers’ Compensation. We may use
and disclose your protected heath information, as necessary, to comply
with workers’ compensation laws or similar programs.
Uses and Disclosures of Protected
Health Information Permitted without Authorization Required but with
an Opportunity for the Individual to Object. We may use your
protected health information to maintain a directory of patients in
our facility. The information included in the directory will be limited
to your name, your location in our facility, and your condition described
in general terms. We may disclose your protected health information
to a friend or family member who is involved in your medical care or
payment for care. In addition, if applicable, we may disclose medical
information about you to an entity assisting in a disaster relief effort
so that your family can be notified about your condition, status and
location.
You may object to these disclosures. If you do not object
to these disclosures, or we determine in the exercise of our professional
judgment that it is in your best interest for us to disclose information
that is directly relevant to the persons involvement with your care,
we may disclose your protected health information.
Uses and Disclosures of Protected
Health Information Permitted without Authorization Required but with
an Opportunity for the Individual to Object. We may use your
protected health information to maintain a directory of patients in
our facility. The information included in the directory will be limited
to your name, your location in our facility, and your condition described
in general terms. We may disclose your protected health information
to a friend or family member who is involved in your medical care or
payment for care. In addition, if applicable, we may disclose medical
information about you to an entity assisting in a disaster relief effort
so that your family can be notified about your condition, status and
location. You may object to these disclosures. If you do not object
to these disclosures, or we determine in the exercise of our professional
judgment that it is in your best interest for us to disclose information
that is directly relevant to the persons involvement with your care,
we may disclose your protected health information.
Uses and Disclosures of Protected
Health Information which You Authorize. Other than the uses
and disclosures described above, we will not use or disclose your protected
health information without your written authorization. Authorizations
are for specific uses of your protected health information, and once
you give us authorization, any disclosures we make will be limited
to those consistent with the terms of the authorization.
You may revoke your authorization, by submitting a revocation
in writing, at any time, except to the extent that
we have already taken action in. By law, you do not have a right
to access psychotherapy notes; information compiled in reasonable anticipation
of, or for use in, a civil, criminal, or administrative proceeding; and
protected health information which is subject to a law which prohibits
access to protected health information.
Depending on the circumstance of your request, you may have the right
to have a decision to deny access reviewed. We may deny your request
to inspect or copy your protected health information if, in our professional
judgment, we determine that the access requested is likely to endanger
you or another person, or is likely to cause substantial harm to another
person referenced within the protected health information.
You have a right to request a review of a denial of access. If you request
a copy of your information, we may charge you a fee for the costs of
copying, mailing, or other costs incurred by us as a result of complying
with your request. Requests for access to your protected health information
must be made in writing to the Privacy Officer.
4. The Right to Amend Protected Health Information. You
have the right to request that we amend your protected health information
in a designated record set for as long as we maintain that information.
In certain cases we may deny your request. If we deny your request you
will be notified in writing, and you will have the right to file a statement
of disagreement with us. We may prepare a rebuttal to your statement
of disagreement and if we do so we will provide a copy of our rebuttal
to you. Requests for amendment of protected health information must made
in writing to the Privacy Officer, and must include a reason to support
the requested amendments.
5. The Right to Receive an Accounting of Disclosures
of Protected Health Information.You have the right to request
an accounting of disclosures of your protected health information made
by us. This right applies to disclosures made by us except for disclosures:
to carry out treatment, payment, or health care operations as described
in this Notice or incidental to such use; to you or your personal representatives;
pursuant to your authorization; for our directory, or other notification
purposes, or to persons involved in your care; or for certain other
disclosures we are permitted to make without your authorization. Requests
for disclosure of accounting must specify a time period sought for
the accounting, with the maximum time period being six years prior
to the date of the request. We are not required to provide accounting
for disclosures made before April 14,2003. We will provide the first
disclosure accounting you request during any 12-month period without
charge.
Subsequent disclosure accounting request will be subject to a reasonable
cost-based fee.
6. The Right to Obtain a Paper Copy of this Notice. Upon
request, we will provide a paper copy of this notice.
Your Rights Regarding Your Protected Health Information
We are required by law to maintain the privacy of your health information and
to provide you with this Privacy Notice of our legal duties and privacy practices
with respect to protected health information. We are required to abide by
the terms of the Notice currently in effect. We reserve the right to change
the terms of this Notice and to make any new provisions effective for all
protected health information that we maintain. If we change the Notice, we
will provide a copy of the revised notice through in-person contact.
Your Rights Regarding Your Protected Health Information
You have the right to express complaints to us and to the Secretary of the
Department of Health and Human Services if you believe that your privacy
rights have been violated. If you wish to complain to us, please do so in
writing, and direct your complaint to the Privacy Officer. You will not be
penalized for filing a complaint.
Contact Information
PLEASE CONTACT THE PRIVACY OFFICER AT THE SITE YOUR SERVICES WERE GIVEN
Effective
Date This Notice is effective April 14, 2003. (Signature of patient or responsible
party - Date).
