Legal Disclaimer THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND RELEASED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
Effective April 14, 2003
While receiving care from our facility, information regarding your medical history, treatment, and payment for your health care may be originated and/or received by us. Information which can be used to identify you and which relates to your past, present or future medical condition, receipt
of health care or payment for health care is considered Protected Health Information (PHI).
Federal law imposed certain obligations and duties upon us as a covered health care provider with respect to your PHI. Specifically we are required to:
* Provide you with notice of our legal duties and our facilities' policies regarding the use and disclosure of your PHI.
* Maintain the confidentiality of your PHI in accordance with state and federal law.
* Honor your requested restrictions regarding the use and disclosure of your PHI unless under the law we are authorized to release your PHI without your authorization, in which case you will be notified within a reasonable period of time.
* Allow you to receive a copy of your PHI during our regular business hours within thirty (30) days of your request.
* Accommodate reasonable requests to communicate PHI by alternative means or methods. Omaha Orthopedic Clinic and Sports Medicine may use and/or release your PHI in the following instances:
TREATMENT: We will use your PHI to provide, coordinate and manage your care and treatment. For example, a clinic physician may share your PHI with another physician for consultation or referral.
PAYMENT: In order to receive payment for services provided, Omaha Orthopedic Clinic will provide your PHI to health insurance companies or other appropriate third party payors. We may also need to tell your insurance plans about treatment you are going to receive so that it can
determine whether or not it will cover the treatment expense.
HEALTH CARE OPERATIONS: In order for the practice to operate in accordance with applicable law, we will use your PHI for certain activities related to the functioning of the clinics. For example, we may use or disclose PHI for quality assurance activities, legal services,
underwriting and other business management and administrative activities.
Appointment Reminders: We may use your PHI to contact you as a reminder that you have an appointment for medical treatment or care at the clinic or hospital.
Additional Uses and Disclosures of your Protected Health Information
* Unless you have informed us otherwise, your PHI may be used to notify a family member or other person responsible for your care. In most cases, PHI disclosed for notification purposes will be limited to your name, location and general condition. In addition, unless you have informed us otherwise, PHI may be released to a family member who is involved in your care to the extent necessary for them to participate in your care. For example we may provide limited PHI to allow a family member to pick up a prescription, medical records or x-ray for you.
* Under emergency conditions, to government or other groups that assist in emergencies or disasters.
Your PHI may also be disclosed without your consent in the following cases:
* When required by law
* For public health activities
* Relating to victims of abuse/neglect/domestic violence
* For judicial and administrative proceedings to the extend permitted by law
* For law enforcement purposes, as permitted or required by law
* To coroners/medical examiners as permitted by law
* Research, but such use is subject to numerous governmental requirements intended to protect the privacy of your PHI
* To avert a serious threat to health or safety
* Specialized governmental functions, such as military discharge and national security and intelligence
* Workers' Compensation
Some of your PHI may be subject to other laws and regulations and afforded greater protection than what is outlined in this notice. For instance, HIV/AIDS, substance abuse and mental health information are often given more protection. In the event your PHI is afforded greater protection
under federal or state law, we will comply with the applicable law.
Sign In Log: Omaha Orthopedic Clinic maintains a sign-in log which is located in a position where staff can readily see who is seeking care in the office.
YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION
Federal law grants you certain rights with respect to your PHI. You have the right to:
* Receive a copy of this Privacy Notice
* Request that certain uses and disclosures of your PHI be restricted. We may, hover, refuse your request if release of such information without consent/authorization is permitted by law.
* Inspect and copy your PHI as provided by law. You must provide a written request to our Privacy Officer. We will charge you a fee for the cost of copying, mailing or other supplies. We will supply only records created and maintained by this office.
* Request that your PHI be amended. To request an amendment you must submit a written request to our Privacy Officer. You must provide a reason that supports your request. We may deny your request if it is not in writing, if you do not give us a reason to support the request, if the
information to be changed was not created by us, or if the information is not part of your PHI maintained by us.
* Request an "accounting of disclosures." This is a list of companies, agencies, persons who have received your health information except for treatment, payment or health care operations. To request this you must submit a written request to our Privacy officer. Your request must state a time period which may not be longer than six (6) years, and may not include dates before April 13, 2003.
* Revoke any prior authorizations or consents for use or disclosure of PHI, except to the extent that action has already been taken.
* Request communications of your PHI are done by alternative means or at alternative locations.
You have the right to file a complaint to Omaha Orthopedic Clinic or the Secretary of the Department of Health and Human Services if you believe your privacy rights have been violated. To file a complaint with Omaha Orthopedic Clinic, you must contact our Privacy Officer. All complaints must be in writing. We ill not retaliate against you or filing a complaint.
You may contact our facilities' Privacy Officer at (402) 691-0500. We reserve the right to or may be required by law to change our privacy practices, which may result in changes to this notice. We further reserve the right to make the revised or changed privacy practices notice effective for medical information we already have as well as any information we receive in the future. We will post a copy of the current notice in our office and on our website, www.omahaorthopedic.com.