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Privacy
Notice
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.
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 conducting 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.
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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.
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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 some examples 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.
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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.
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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:
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When
Required By Law. We will disclose your protected health information
when we are required to do so by federal, state, or local law.
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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:
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Collection
and reporting of adverse events, product defects or problems, or
biological product deviations
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Tracking
of FDA-regulated products
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Product
recalls, repairs, or lookback,
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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 employer’s
workforce.
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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.
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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.
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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.
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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- ordered warrant, 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.
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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.
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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.
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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.
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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.
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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.
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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 person’s 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 reliance upon
your authorization.
Your Rights Regarding Your Protected Health Information
You have the following rights regarding your protected health information:
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The Right to Request Restriction of Uses and Disclosures.
You have the right to request that we not use or disclose certain parts
of your protected health information for the purposes of treatment,
payment, or healthcare operations. You also have the right to request
that we do not disclose your protected health information to friends
or family members who may be involved in your care, or for notification
purposes as described earlier in this notice. Your request must be made
in writing and must state the specific restriction requested and the
individuals to whom the restriction applies.
We are not required to agree to a restriction you may request. We will
notify you if we do not agree to your restriction request. If we do
agree to the restriction request, we will not use or disclose your protected
health information in violation of the agreed upon restriction, unless
necessary for the provision of emergency treatment.
We may terminate our agreement to a restriction if you agree to the
termination in writing; if you agree to the termination orally and the
oral agreement is documented, or if we notify you of termination of
the agreement and the termination applies only to protected health information
created or received by us after you receive the notice of termination
of the restriction.
Request for restrictions must be made in writing to the Privacy Officer.
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The
Right to Request Confidential Communications. You have the
right to request that you receive communications of protected health
information from us by alternative means or at alternative locations.
We must accommodate reasonable request of this nature. We may condition
the provision of accommodation by requesting information from you describing
how payment will be handled, or by requesting specification of an alternative
address or alternative form of contact.
Requests for confidential communications must be made in writing to
the Privacy Officer.
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The
Right to Inspect and Copy Protected Health Information.
You have the right to inspect and obtain a copy of your protected health
information that is maintained in a designated record set for as long
as we maintain the protected health information. The designated record
set is a collection of records maintained by us, which contains medical
and billing information used in the course of your care, and any other
information used to make decisions about you.
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.
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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.
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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.
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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
For further information about this Notice, please contact:
Director of Operations
New Mexico 0rthopaedic Associates
201 Cedar SE, Ste. 6600
Albuquerque, NM 87106
(505) 724-4319
If you have privacy issues, or if you believe that your privacy rights
have been violated, please contact the above individual.
Effective
Date
This Notice is effective April 14, 2003.
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