HIPAA Notice of Privacy Practices
Notice of
Privacy Practices
LAKESIDE ORTHOPAEDIC CENTER, LLC
Privacy
Officer - Telephone (803) 433-5633
Effective Date:
August 2005
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We understand
the importance of privacy and are committed to maintaining the confidentiality
of your medical information. We
make a record of the medical care we provide and may receive such records from
others. We use these records to
provide or enable other health care providers to provide quality medical
care, to obtain
payment for services provided to you as allowed by your health plan and to
enable us to meet our professional and legal obligations to operate this medical
practice properly. We are required by law to maintain the privacy of protected
health information and to provide individuals with notice of our legal duties
and privacy practices with respect to protected health information. This notice
describes how we may use and disclose your medical information. It also describes your rights and our
legal obligations with respect to your medical information. If you have any questions about this
Notice, please contact
our Privacy Officer listed above.
A. How this Medical
Practice May Use or Disclose Your Health Information
B. When This Medical
Practice May Not Use or Disclose Your Health Information
C. Your Health
Information Rights
- Right to Request Special Privacy
Protections
- Right to Request Confidential
Communications
- Right to Inspect and Copy
- Right to Amend or Supplement
- Right to an Accounting of Disclosures
- Right to a Paper Copy of this
Notice
D. Changes to this
Notice of Privacy Practices
E. Complaints
A.
How this Medical Practice May Use or Disclose Your Health
Information
This medical
practice collects health information about you and stores it in a chart and on a
computer. This is your medical
record. The medical record is the
property of this medical practice, but the
information in the medical record belongs to you. The law permits us to use or disclose
your health information for the following purposes:
1.
Treatment. We use
medical information about you to provide your medical care. We disclose medical information to our
employees and others who are involved in providing the care you need. For example, we may share
your medical information with other physicians, or other health
care providers who will provide services which we do not provide. Or we may share this information with a
pharmacist who needs it to dispense a prescription to
you, or a laboratory
that performs a test. We may also
disclose medical information to members of your family or others who can help
you when you are sick or injured.
2.
Payment. We use
and disclose medical information about you to obtain payment for the services we
provide. For
example, we give your
health plan the information it requires before it will pay us. We may also disclose information to
other health care providers to assist them in obtaining payment for services
they have provided to you.
3.
Health Care Operations.
We may use and disclose medical information about you to operate this
medical practice. For
example, we may use and
disclose this information to review and improve the quality of care we
provide, or the
competence and qualifications of our professional staff. Or we may use and disclose this
information to get your health plan to authorize services or referrals. We may also use and disclose this
information as necessary for medical reviews, legal services
and audits, including fraud
and abuse detection and compliance programs and business planning and
management. We may also share your
medical information with our "business associates,” such as our
billing service, that perform
administrative services for us. We
have a written contract with each of these business associates that contains
terms requiring them to protect the confidentiality of your medical
information. We may also share your
information with other health care providers, health care
clearinghouses or health plans that have a relationship with
you, when they
request this information to help them with their quality assessment and
improvement activities, their efforts
to improve health or reduce health care costs, their review of
competence, qualifications
and performance of health care professionals, their training
programs, their
accreditation, certification
or licensing activities, or their health
care fraud and abuse detection and compliance efforts.
4.
Appointment Reminders.
We may use and disclose medical information to contact and remind you
about appointments. If you are not
home, we may leave
this information on your answering machine or in a message left with the person
answering the phone.
5.
Sign in sheet. We may
use and disclose medical information about you by having you sign in when you
arrive at our office. We may also
call out your name when we are ready to see you.
6.
Notification and communication with family. We may disclose your health information
to notify or assist in notifying a family member, your personal
representative or another person responsible for your care about your
location, your general
condition or in the event of your death.
In the event of a disaster, we may disclose
information to a relief organization so that they may coordinate these
notification efforts. We may also
disclose information to someone who is involved with your care or helps pay for
your care. If you are able and
available to agree or object, we will give
you the opportunity to object prior to making these
disclosures, although we may
disclose this information in a disaster even over your objection if we believe
it is necessary to respond to the emergency circumstances. If you are unable or unavailable to
agree or
object, our health
professionals will use their best judgment in communication with your family and
others.
7.
Marketing. We may
contact you to give you information about products or services related to your
treatment, case management
or care coordination, or to direct or
recommend other treatments or health-related benefits and services that may be
of interest to you, or to provide
you with small gifts. We may also
encourage you to purchase a product or service when we see you. We will not use or disclose your medical
information without your written authorization.
8.
Required by law. As
required by law, we will use and
disclose your health information, but we will
limit our use or disclosure to the relevant requirements of the law. When the law requires us to report
abuse, neglect or
domestic violence, or respond to
judicial or administrative proceedings, or to law
enforcement officials, we will further
comply with the requirement set forth below concerning those
activities.
9.
Public health. We
may, and are
sometimes required by law to disclose your health information to public health
authorities for purposes related to:
preventing or controlling disease, injury or
disability; reporting child, elder or
dependent adult abuse or neglect; reporting domestic violence; reporting to the
Food and Drug Administration problems with products and reactions to
medications; and reporting disease or infection exposure. When we report suspected elder or
dependent adult abuse or domestic violence, we will inform
you or your personal representative promptly unless in our best professional
judgment, we believe the
notification would place you at risk of serious harm or would require informing
a personal representative we believe is responsible for the abuse or
harm.
10. Health
oversight activities. We
may, and are
sometimes required by law to disclose your health information to health
oversight agencies during the course of audits,
investigations,
inspections, licensure and
other proceedings, subject to the
limitations imposed by federal and South
Carolina
law.
11. Judicial
and administrative proceedings. We
may, and are
sometimes required by law, to disclose
your health information in the course of any administrative or judicial
proceeding to the extent expressly authorized by a court or administrative
order. We may also disclose
information about you in response to a subpoena, discovery
request or other lawful process if reasonable efforts have been made to notify
you of the request and you have not objected, or if your
objections have been resolved by a court or administrative
order.
12. Law
enforcement. We
may, and are
sometimes required by law, to disclose
your health information to a law enforcement official for purposes such as
identifying of locating a suspect,
fugitive, material
witness or missing person, complying with
a court order,
warrant, grand jury
subpoena and other law enforcement purposes.
13.
Coroners. We
may, and are often
required by law, to disclose
your health information to coroners in connection with their investigations of
deaths.
14. Organ or
tissue donation. We may
disclose your health information to organizations involved in
procuring, banking or
transplanting organs and tissues.
15. Public
safety. We
may, and are
sometimes required by law, to disclose
your health information to appropriate persons in order to prevent or lessen a
serious and imminent threat to the health or safety of a particular person or
the general public.
16.
Specialized government functions. We may disclose your health information
for military or national security purposes or to correctional institutions or
law enforcement officers that have you in their lawful
custody.
17. Worker’s
compensation. We may disclose
your health information as necessary to comply with worker’s compensation
laws. For
example, to the extent
your care is covered by workers' compensation, we will make
periodic reports to your employer about your condition. We are also required by law to report
cases of occupational injury or occupational illness to the employer or workers'
compensation insurer.
18. Change
of Ownership. In the event that
this medical practice is sold or merged with another
organization, your health
information/record will become the property of the new
owner, although you
will maintain the right to request that copies of your health information be
transferred to another physician or medical group.
19.
Research. We may
disclose your health information to researchers conducting research with respect
to which your written authorization is not required as approved by an
Institutional Review Board or privacy board, in compliance
with governing law.]
20.
Fundraising. We may
use or disclose your demographic information and the dates that you received
treatment in order to contact you for fundraising activities. If you do not want to receive these
materials, notify the
Privacy Officer listed at the top of this Notice of Privacy
Practices.
B. When
This Medical Practice May Not Use or Disclose Your Health
Information
Except as
described in this Notice of Privacy Practices, this medical
practice will not use or disclose health information which identifies you
without your written authorization.
If you do authorize this medical practice to use or disclose your health
information for another purpose, you may revoke
your authorization in writing at any time.
C. Your
Health Information Rights
1.
Right to Request Special Privacy Protections. You have the right to request
restrictions on certain uses and disclosures of your health
information, by a written
request specifying what information you want to limit and what limitations on
our use or disclosure of that information you wish to have imposed. We reserve the right to accept or reject
your request, and will notify
you of our decision.
2.
Right to Request Confidential Communications. You have the right to request that you
receive your health information in a specific way or at a specific
location. For
example, you may ask
that we send information to a particular e-mail account or to your work
address. We will comply with all
reasonable requests submitted in writing which specify how or where you wish to
receive these communications.
3.
Right to Inspect and Copy.
You have the right to inspect and copy your health
information, with limited
exceptions. To access your medical
information, you must submit
a written request detailing what information you want access to and whether you
want to inspect it or get a copy of it.
We will charge a reasonable fee, as allowed by
South
Carolina law. We may deny your request under limited
circumstances. If we deny your
request to access your child's records because we believe allowing access would
be reasonably likely to cause substantial harm to your
child, you will have a
right to appeal our decision. If we
deny your request to access your psychotherapy notes, you will have
the right to have them transferred to another mental health
professional.
4.
Right to Amend or Supplement. You have a right to request that we
amend your health information that you believe is incorrect or incomplete. You must make a request to amend in
writing, and include the
reasons you believe the information is inaccurate or incomplete. We are not required to change your
health information, and will
provide you with information about this medical practice's denial and how you
can disagree with the denial. We
may deny your request if we do not have the
information, if we did not
create the information (unless the person or entity that created the information
is no longer available to make the amendment), if you would
not be permitted to inspect or copy the information at
issue, or if the
information is accurate and complete as is. You also have the right to request that
we add to your record a statement of up to 250 words concerning any statement or
item you believe to be incomplete or incorrect.
5.
Right to an Accounting of Disclosures. You have a right to receive an
accounting of disclosures of your health information made by this medical
practice, except that
this medical practice does not have to account for the disclosures provided to
you or pursuant to your written authorization, or as described
in paragraphs 1 (treatment), 2
(payment), 3 (health care
operations), 6 (notification
and communication with family) and 16 (specialized government functions) of
Section A of this Notice of Privacy Practices or disclosures for purposes of
research or public health which exclude direct patient
identifiers, or which are
incident to a use or disclosure otherwise permitted or authorized by
law, or the
disclosures to a health oversight agency or law enforcement official to the
extent this medical practice has received notice from that agency or official
that providing this accounting would be reasonably likely to impede their
activities.
6.
You have a right to a paper copy of this Notice of Privacy
Practices, even if you
have previously requested its receipt by e-mail.
If you would
like to have a more detailed explanation of these rights or if you would like to
exercise one or more of these rights, contact our
Privacy Officer listed at the top of this Notice of Privacy
Practices.
D.
Changes to this Notice of Privacy
Practices
We reserve the
right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is
made, we are required
by law to comply with this Notice.
After an amendment is made, the revised
Notice of Privacy Protections will apply to all protected health information
that we maintain, regardless of
when it was created or received. We
will keep a copy of the current notice posted in our reception
area, and will offer
you a copy at each appointment.
E.
Complaints
Complaints about this Notice of Privacy Practices or how this medical
practice handles your health information should be directed to our Privacy
Officer listed at the top of this Notice of Privacy
Practices.
If you are not
satisfied with the manner in which this office handles a
complaint, you may submit
a formal complaint to: Department of
Health and Human Services, Office of Civil
Rights
You will not be penalized for filing a
complaint.
Complaints submitted to the DHHS Office for Civil Rights should be
directed to:
Office for Civil
Rights/U.S. Department of Health & Human Services
61 Forsyth
Street, SW. - Suite
3B70/Atlanta, GA 30323
(404) 562-7886; (404) 331-2867 (TDD)
(404) 562-7881
FAX