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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:
- When Required By Law. We will disclose your protected
health information when we are required to do so by federal, state,
or local law.
- 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:
- Collection and reporting of adverse events, product defects or
problems, or biological product deviations
- Tracking of FDA-regulated products
- Product recalls, repairs, or lookback,
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
Contact Information
For further information about this Notice, please contact:
Director of Operations
New Mexico Orthopaedic 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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