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Reconstructive Orthopedics |
Office Information: HIPAA Notice of Privacy PracticesEffective Date: April 14, 2003 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GER ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. This notice is provided to you pursuant to the Health Insurance Portability and Accessibility Act of 1996, otherwise known as “HIPAA.” It is designed to tell you how Reconstructive Orthopedics may, under federal law, use or disclose your Health information. I. We may use or disclose your health information for purposes of treatment, payment, or healthcare operations [with/without] a consent and here is one example of each:Health care professionals- including but not limited to physicians, physician assistants, technicians, surgical technical representatives, durable medical equipment representatives and physical therapists. Office staff may access your information for purposes of providing you care. These staff members include but are not limited to: front desk receptionists, front desk supervisor, filling and chart personnel, transcriptionists, secretaries, and managers. Our billing department may access your information to send relevant documentation to your insurance company in order to allow the company to pay us for services rendered to you. Examples include worker’s compensation carriers and motor vehicle carriers. We may send your relevant health information to facilities such as Virtua Memorial Hospital, out-patient surgery centers, pain management facilities, anesthesia departments, referring physicians and your primary care physician, and others in order to provide you with medical care or schedule you for a surgical procedure. We may access or send your information to our attorneys and/or malpractice carriers in the event we need to provide these entities with such documentation. 2. We may use or disclose your health information under the following circumstances without obtaining your prior Consent or Authorization:For Treatment, Payment or Healthcare Operations. See page 1To provide it to you. To notify and/or communicate with you or other family members by phone. Unless you object, we may contact you from time to time to advise you of appointments at our facility, or provide you with answers to other types of questions you may have regarding missed or cancelled appointments at our facilities. We may contact you by phone for any reason at your request. As Required by Law: For Public Health Purposes: We may use or disclose your Health Information to provide information to state or federal public health authorities, as required by law to prevent or control disease, injury or disability; to report child abuse or neglect; to report domestic violence; to report to the food and drug administration problems with products and reactions to medications; and to report disease or infection exposure. For Health Oversight Activities: We may use or disclose your Health Information to health agencies during the course of audits, investigations, inspections, licensure, and other proceedings. In Response to Subpoenas or for Judicial and Administrative Proceedings. We may use or disclose your Health Information in the course of any administrative or judicial proceedings. We will, however, make every reasonable attempt to ensure that you have been made aware of the use or disclosure of your Health Information prior to providing it to another person. To Law Enforcement Personnel. We may use or disclose your Health Information to a law enforcement official to identify or locate a suspect, fugitive, material witness or missing person, comply with a court order or subpoena and other law enforcement purposes. To Coroners or Funeral Directors. We may use or disclose your Health Information for purposes of communicating with Coroners, medical examiners and funeral directors. For Purposes of Organ Donation. We may use or disclose your Health Information for purposes of communicating to organizations involved in procuring, banking or transplanting organs and tissues. In order to Conduct Research. We may use or disclose your Health Information in order conduct research that has been approved by our institutional Review Board. For Public Safety. We may use or disclose your Health Information in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public. To Aid Specialized Government Functions. If necessary, we will use or disclose your Health Information for military or national security purposes. For Worker’s Compensation. We may use or disclose your Health Information to the full extent authorized by State or other worker’s compensation laws. To Correctional Institutions or Law Enforcement Officials, if you are an inmate. II. For all other circumstances, we may only use or disclose your Health Information after you have signed an authorization. If you authorize os to use or disclose your Health Information for another purpose, you may revoke your authorization in writing at any time.III. We may also use or disclose your health information for the following purposes:Appointment Reminders. We may use or disclose your Health Information in order to contact you to provide appointment reminders or to give you information about other treatments or health-related benefits and services that you have requested or that may be of interest to you. Change of Ownership. In the event that our facility/practice/entity is sold or merged with another organization, your Health Information/record will become the property of the new owner. IV. Your Health Information Rights:1. Obtain a paper copy of this Notice upon request. You may request a copy of this Notice at any time; even if you have agreed to receive this Notice electronically. You are still entitled to a paper copy. To obtain a paper copy, contact the Physician Practice Privacy Officer 609-267-9400. 2. Request a restriction on certain uses and disclosures of your Protected Health Information (PHI). You have the right to request additional restrictions on our use or disclosure of Health Information about you by sending a written request to the Physician Practice Privacy Office at Tower Medical Building, Suite 6, 737 Main Street, Lumberton, New Jersey 08060. We are not required to comply with your request. 3. Inspect and obtain a copy of your Health Information. You have the right to inspect and obtain a copy of Health Information about you contained in a designated record set. The “designated record set” usually will include treatment and billing records in the form or charge encounter forms. To inspect your records at our Lumberton facility, you must send a written request to the Physician Practice Privacy Officer at Tower Medical Building, Suite 6, 737 Main Street, Lumberton, New Jersey, 08060. Inspections are conducted by appointment only and it is understood that your Health Information will be held confidential and will be reviewed by you and the Privacy Practice Officer. You may request a copy of your Health Information. We will charge you $1.00 per page, no limit, to duplicate your Health Information, plus postage fees, if you want us to mail your records to you. You must send us a written request for a copy of your records. We will contact you in a reasonable amount of time to inform you of the actual fee. This fee must be paid in advance before any duplication is done. We may deny your request to inspect and copy your Health Information in limited circumstances. If you are denied access to your Health Information, you may request that the denial be reviewed. 4. Request an amendment of Protected Health Information. If you feel that Health Information that we maintain about you is incomplete or incorrect, you may request that we amend it. You may request an amendment as long as we maintain your Health Information. To request an amendment you must send a written request to the Physician Practice Privacy Officer at Tower Medical Building, Suite 6, 737 Main Street, Lumberton, New Jersey, 08060. In addition, you must include a reason that supports your request. We are not required to honor your request to change your Health Information. If we deny your request to amend your Health Information, you have the right to file a statement of disagreement with the decision and we give you a rebuttal to your statement. 5. Receive an accounting of disclosure of your Protected Health Information. You have the right to receive an accounting of the disclosures we have made of health Information about you after April 14,2003 for most purposes other than disclosures made for treatment, payment, health care operations, information provided by you, directory listings, notifications, communications with family, certain government functions, and appointment reminders as described in section I of this Notice of Privacy Practices. To request an accounting you must submit your request in writing to the Physician Practice Privacy Officer at Tower Medical Building, Suite 6, 737 Main Street, Lumberton, New Jersey, 08060. Your request must specify the exact time period, but may not be longer than six years. The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time. 6. Request communications of Protected Health Information by alternative means or at alternative locations. For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box. To request confidential communication of Health Information about you, you must submit your request in writing to the Physician Practice Privacy Officer at Tower Medical Building, Suite 6, 737 Main Street, Lumberton, New Jersey 08060. Your request must state how or when you would like to be contacted. We will accommodate all reasonable requests. V. Our DutiesWe are required by law to maintain the privacy of your Health Information and to make a reasonable effort to provide you with a copy of this Notice. We are also required to abide by this Notice. We reserve the right to amend this Notice at any time in the future and to make the new Notice provisions applicable to all your Health Information- even if it was created prior to the change of this Notice. If such amendment is made, we will immediately display the revised Notice at our office and provide you with a copy of the amended Notice. We will also provide you with a copy at any time upon written request. VI. Complaints to the GovernmentYou may make complaints to the Secretary of the Department of Health and Human Services if you believe your rights have been violated. We promise not to retaliate against you for any complaint you make to the government about our Privacy Practices. VI. Contact InformationYou may contact us about our Privacy Practices by calling the Physician Practice Privacy Officer at: 609-267-9400 You may contact the U.S. Department of Health & Human Services at:
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