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Privacy Policy

ORTHOPAEDIC ASSOCIATES OF SOUTHERN DELAWARE, P.A.
NOTICE OF PRIVACY PRACTICES

EFFECTIVE DATE: MARCH 1, 2003
DATE OF LAST REVISION: APRIL 10, 2003

Welcome to Orthopaedic Associates of Southern Delaware, P.A.! The information documented in the Notice of Privacy Practices is made available to you, our patient, upon request at any time. It describes how medical information about you may be used and disclosed and how you can obtain access to this information. This Notice applies to all of your medical records pertaining to your care created by our practice or made by an associated facility. Please read the Notice of Privacy Practices carefully.

This Notice describes our Practice’s policies, which extend to:

  • Any healthcare professional authorized to enter information into your chart (including physicians, physician assistants, registered nurses, clinical assistants, etc.).
  • All areas of Practice (Front Desk, Administration, Billing and Collection, etc.).
  • All employees, staff, and other personnel that work for or with our Practice.
  • Our business associates (including billing service or facilities to which we refer patients), on-call physicians, etc.

Othopaedic Associates of Southern Delaware, P.A. provides this Notice of Privacy Practices in compliance with the Department of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

OUR THOUGHTS ABOUT YOUR PROTECTED HEALTH INFORMATION

We understand that your medical information is personal to you, and we are committed to protecting the information about you. As our patient, we create paper and electronic medical records about your health, or care for you, and the services and/or items we provide to you as our patient. We need this record to provide for your care and to comply with certain legal requirements.

We are required by law to:

  • Make sure that the Protected Health Information about you is kept private.
  • Provide you with a Notice of Privacy Practices and your legal right with respect to protected health information about you.
  • Follow the conditions of the Notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose Protected Health Information that we have and share with others. Each category of uses or disclosures  provides a general explanation and provides some examples of uses. Please note that not every use of disclosure in a category is either listed or actually in place. The explanation is provided for your general information only.

  • Medical Treatment. We use previously given medical information about you to provide you with current or prospective medical treatment or services. Therefore we may, and most likely will, disclose medical information about you to doctors, nurses, technicians, medical students, or hospital personnel who are involved in taking care of you. For example, a doctor to whom we refer you for ongoing or further care may need your medical record. Different areas of the Practice also may share medical information about you including your record(s), prescriptions, requests of lab work, and X-rays. We may also discuss your medical information with you to recommend possible treatment options or alternatives that may be of interest to you. We also may disclose medical information about you to people outside of the Practice who may be involved in your medical care after you leave the Practice; this may include your family members, or other personal representatives authorized by you in writing on your Confidentiality Questionnaire that our Practice has you fill out or by a legal mandate (a guardian or other personal representative who has been named to handle your medical decisions should you become incompetent).
  • Payment. We may use and disclose medical information about you for services and procedures so they may be billed and collected from you, an insurance company or any other third party. For example, we may need to give your healthcare information, about treatment you received at the Practice, to obtain payment or reimbursement for the care. We may also tell your health plan and/or referring physician about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment, to facilitate payment of a referring physician, or the like.

  • Healthcare Operations. We may use and disclose medical information about you so that we can run our Practice more efficiently and make sure that all of our patients receive quality care. These uses may include reviewing our treatment and services to evaluate the performance of our staff, deciding what additional services to offer and where, deciding what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other personnel for review and learning purposes. We may also combine the medical information we have with medical information from other Practices to compare how we are doing and see where we can make improvement, in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study healthcare and healthcare delivery without learning who the specific patients are.

    We may also use or disclose information about you for internal or external utilization review and/or quality assurance, to business associates for purposes of helping us to comply with our legal requirements, to auditors to verify our records, to billing companies to aid us in this process, and the like. We shall endeavor, at all times when business associates are used, to advise them of their continued obligation to maintain the privacy of your medical records.

  • Appointment and Patient Recall Reminders. We may ask that you sign in writing at the Receptionists’ Desk, a Sign-In Log on the day of your appointment with our Practice. We may use and disclose medical information to contact you as a reminder that you have an appointment for medical care with the Practice or that you are due to receive periodic care from the Practice. The Confidentiality Questionnaire that our Practice has you fill out allows you to authorize us to contact you by telephone or in writing, and may involve the leaving of a message on an answering machine or voice mail, or otherwise which could (potentially) be received or intercepted by others.

  • Emergency Situations. Unless you direct us not to notify certain family members or friends, the Confidentiality Questionnaire that our Practice has you fill out authorizes us to disclose medical information about you to an organization in an emergency situation (for example, an organization assisting in a disaster relief effort). This also allows us to disclose information about you to family members or friends that you have listed, so that they can be notified about your condition, status, and location.

  • Research. Under certain circumstances, we may use and disclose medical information about you for research purposes regarding medications, efficiency of treatment protocols, and the like. All research projects are subject to an approval process which evaluates a proposed research project and its use of medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process. We will obtain an authorization from you before using or disclosing your individually identifiable health information unless the authorization requirement has been waived. If possible, we will make the information unidentifiable to a specific patient. If the information has been made sufficiently unidentified, an authorization for the use or disclosure is not required.

  • Required by Law. We will disclose medical information about you when required to do so by federal, state, or local law.

  • To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat either to your specific health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

  • Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

  • Workers’ Compensation. We may release medical information about you for Workers’ Compensation or similar programs. These programs provide benefits for work-related injuries or illness.

  • Property and Casualty Insurance. We may release medical information about you to property and casualty insurance companies. For example, if an automobile insurance company pays to treat your injuries, we may release the information needed to obtain payment.

  • Public Health Risks. Law or public policy may require us to disclose medical information about you for public health activities. These activities generally include the following:
    • To prevent or control disease, injury, or disability.
    • To report births and deaths.
    • To report child abuse or neglect.
    • To report reactions to medications or problems with products.
    • To notify people of recalls of products they may be using.
    • To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
    • To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

  • Investigation and Government Activities. We may disclose medical information to a local, state, or federal agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the payor, the government, and other regulatory agencies to monitor the healthcare system, government programs, and compliance with civil rights laws.

  • Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. This is particularly true if you make your health an issue. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. The Practice’s physicians may be required to give oral depositions at the office and/or appear in court for testimony regarding your medical information. If the court/administrative order, subpoena, discovery request, or other lawful process we receive does not contain a carbon copy (cc) notation that lists your name indicating you have been given a copy, we shall attempt in these cases to tell you about the request so that you may obtain an order protecting the information requested if you so desire. We may also use such information to defend ourselves or any member of our Practice in any actual or threatened action.

  • Law Enforcement. We may release medical information if asked to do so by a law enforcement official.
    • In response to a court order, subpoena, warrant, summons, or similar process.
    • To identify or locate a suspect, fugitive, material witness, or missing person.
    • About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement.
    • About a death we believe may be the result of criminal conduct.
    • About criminal conduct at the Practice.
    • In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime.
  • Coroners, Medical Examiners, and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the practice to funeral directors as necessary to carry out their duties.

  • Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This would be necessary (1) for the institution to provide you with heathcare; (2) to protect your health and safety of the health and safety of others; or (3) for the safety and security of the correctional institution.


CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as any information we may receive from you in the future. We will post a copy of the current Notice in the Practice. The Notice will contain on the first page, in the top left-hand corner, the effective date and the date of last revision. In addition, each time you visit the Practice for treatment or healthcare services you may request a copy of the current Notice of Privacy Practices in effect.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services. To file a complaint with the Practice, contact our Practice Administrator, who will direct you on how to file an office complaint. All complaints must be submitted in writing, and all complaints shall be investigated without repercussion to you. You will not be penalized for filing a complaint.

You may contact our Practice Administrator at the following address and/or telephone number:

Address:

Practice Administrator
Orthopaedic Associates of Southern Delaware, P.A.
17005 Old Orchard Road
Lewes, Delaware 19958           

Telephone:
(302) 644-3311


OTHER USES OF MEDICAL INFORMATION

Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written permission, unless those uses can be reasonably inferred from the intended uses above. It you have provided us with your permission to use or disclose medical information about you, you may revoke that permission in writing at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.


PATIENT RIGHTS

This section describes your rights and the obligations of Orthopaedic Associates of Southern Delaware, P.A. regarding the use and disclosure of your medical information.

RIGHT TO INSPECT AND COPY

You have the right to inspect and copy medical information that may be used to make decisions about your care. This includes your own medical and billing records, but does not include psychotherapy notes. Upon proof of an appropriate legal relationship, your medical information may also be disclosed to the following representatives:

  • Parent, guardian, or caregiver if you are a minor.
  • Guardian or conservator if you are incompetent.
  • Beneficiary or personal representative if you are deceased.

To inspect and copy your medical record, you must submit your request in writing on our “Patient or Patient Representative Request to Inspect or Copy Protected Health Information” form to our Medical Records Clerk. Ask the Front Desk person for this form.

Our Medical Records Clerk and/or your treating physician may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request to have our HIPAA Compliance Officer review the denial and have another licensed healthcare professional at our Practice who did not partake in the initial denial decision review your request. We will comply with the outcome and recommendations from that review.

RIGHT TO AMEND

If you feel that the medical information we have about you in your record is incorrect or incomplete, then you may ask us to amend the information, following the procedure below. You have the right to request an amendment for as long as the Practice maintains your medical record.

To request an amendment:

  • Your request must be submitted in writing, along with your intended amendment and a reason that supports your request to amend.
  • The amendment must be dated and signed by you and notarized.
  • Mail your request for “Amendment” to our Medical Records Clerk at the address noted below. The Medical Records Clerk will notify your licensed treating physician at our Practice to review your request for amendment.


Address:
Medical Records Clerk
Orthopaedic Associates of Southern Delaware, P.A.
17005 Old Orchard Road
Lewes, Delaware 19958

Telephone:
(302) 644-3311

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

  • Was not created by our Practice, unless the person or entity that created the information is no longer available to make the amendment.
  • Is not part of the medical information kept by or for the Practice.
  • Is not part of the information which you would be permitted to inspect and copy.
  • Is inaccurate and incomplete.

RIGHT TO AN ACCOUNTING OF DISCLOSURES

You have the right to obtain a list of the disclosures we made of medical information about you, to others. To request this list you must do the following:

  • Submit your request for “accounting of disclosures” in writing, date it, and sign it.
  • Your request must state a time period no longer than six (6) years back and may not include dates before April 14, 2003, or the actual implementation date of the HIPAA Privacy Regulations.
  • Mail your request for “accounting of disclosures” to our Medical Records Clerk at the following address:


Address:
Medical Records Clerk
Orthopaedic Associates of Southern Delaware, P.A.
17005 Old Orchard Road
Lewes, Delaware 19958

Telephone:
(302) 644-3311

We will provide the accounting of disclosures on paper. We will notify you of the cost involved. (The fee would include the cost of paper, envelope, office supplies needed for processing, labor, and postage if applicable associated with your request.) You may choose to withdraw or modify your request at that time before any costs are incurred.


RIGHT TO REQUEST RESTRICTIONS OR LIMITATIONS

You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care (a family member or friend). For example, you could ask that we not use or disclose information about a particular treatment you received. Please note that the Confidentiality Questionnaire that our Practice has you fill out only lists those family members or friends who you have authorized to receive your medical information and also authorizes us to release medical information about you in an emergency situation.

As our patient, we want you to know that we respect the privacy of your personal medical information and will do all we can to secure and protect that privacy. Your personal medical information is critical for providing you with quality healthcare. We believe we have taken appropriate safeguards and internal restrictions to protect your personal medical information, and that additional restrictions may be harmful to your care.

We also want you to be aware that if you choose to restrict or limit medical information we use or disclose about you for the purpose of treatment, payment, or healthcare operations, and we agree to your request, your health insurance provider, Workers' Compensation carrier, Property and Casualty Insurance, etc., may refuse payment on the basis that they cannot obtain your medical information for the purpose of payment.

To request restrictions or limitations, you must make your request in writing. In your request you must indicate the following:

  • What information you want to restrict or limit.
  • Whether you want to limit our use, disclosure or both.
  • To whom you want the limits to apply. (For example, disclosures, to your children, parents, spouse, etc.)
  • Mail your request for “Right to Request Restrictions or Limitations” to our Medical Records Clerk at the following address:

Address:
Medical Records Clerk
Orthopaedic Associates of Southern Delaware, P.A.
17005 Old Orchard Road
Lewes, Delaware 19958

Telephone:
(302) 644-3311

We are not required to agree to your request and we may not be able to comply with your request. Upon receipt of your request for “Right to Restrictions or Limitations” of your medical information, we will review it and notify you whether we have accepted or denied your request.

RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or through the mail, that we not leave voice mail or a message on your telephone answering machine, or the like. The Confidentiality Questionnaire that our Practice has you fill out provides you with the opportunity to specify how you want us to communicate with you.

To request a change in your confidential communications with our Practice you must:

  • Make your request in writing, date it, and sign it.
  • Specify how or where you wish us to contact you.
  • Whom you do not or do want us to leave a message with.
  • Mail your request for “Right to Request Confidential Communications” to our Medical Records Clerk at the following address:

Address:
Medical Records Clerk
Orthopaedic Associates of Southern Delaware, P.A.
17005 Old Orchard Road
Lewes, Delaware 19958

Telephone:
(302) 644-3311

RIGHT TO A PAPER COPY OF NOTICE OF PRIVACY PRACTICES

We will provide you with a paper copy of this Notice and ask you to sign an “Acknowledgement of Receipt of Notice of Privacy Practices." You may refuse to sign this Acknowledgement, but we will document that you were given a copy. You have the right to receive a copy of the “Notice of Privacy Practices” at any time upon request, and we encourage you to do so as it may be revised in the future from time to time.

HIPAA  03/01/2003/REVISED 04/10/2003