NOTICE OF PRIVACY PRACTICES

The Center for Spine and Joint Wellness, PA (“CSJW”) is required by federal and state law to maintain the privacy of your protected health information.  This notice describes how we may use and disclose your protected health information, your privacy rights related to your protected health information, and our obligations concerning the use and disclosure of your protected health information. 

This notice is effective on November 1, 2008.  This Notice of Privacy Practices 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 by law.  It also describes your privacy rights and your rights to access your protected health information.   “Protected Health information” is information about you, including demographic information, which may identify you and relates to your past, present, or future physical or mental health or condition and related health care services.

We are required to abide by the terms of this Notice of Privacy Practices.  We may change the terms of our notice at any time.  The new notice will be effective for all protected health information that we maintain at that time.  Upon your request, we will provide you with any revised Notice of Privacy Practices at the time of your next appointment.

This notice is not intended to, nor does it create contractual or other rights independent of those stated in the Federal Privacy Rule.

I.          USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

This section of the Notice will describe the different ways that CSJW may use and disclose your protected health information for treatment, payment, or health care operations purposes.  Each of these descriptions includes examples, but please note that the examples contained in this notice are not all inclusive.

Treatment.  We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services.  We may consult with other health care providers regarding your treatment and coordinate your care with others.  Some examples of uses and disclosures of your protected health information for treatment include:  physicians and other staff at CSJW who are involved in your care may review your medical record and discuss your protected health information in connection with your treatment.  We may use and disclose your protected health information when you need a prescription, lab work, and x-ray or other health care services;  we may use and disclose your protected health information when referring you to another health care provider;  we may share and discuss your protected health information with an outside physician with whom we are consulting regarding you, including but not limited to sending a report about your care to such a physician so that he or she may treat you.

Payment.  The Practice may use and disclose your protected health information to obtain payment for your health care services.  This may include certain activities that your health insurance plan may require before it approves or pays for the health care services we recommend for you such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and medical record review activities.  For example, obtaining preauthorization for a procedure may require that your relevant protected health information be disclosed to the health plan to obtain approval. 

Healthcare Operations.  We may use or disclose, as needed, your protected health information in order to support the business activities of CSJW.  These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students and residents, licensing, and conducting or arranging for other business activities.  The practice may use a sign-in sheet for its patients in the waiting area of the office which is accessible to all patients.  The practice may also page patients in the waiting room when it is time for them to receive services.  The practice may contact you to provide you with appointment reminders, information about treatment alternatives, and other health-related benefits or services that may be of interest to you.

We may use or disclose your PHI as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.  We may also use and disclose your PHI for other marketing activities.  For example, your name and address may be used to send you information about products or services that we believe may be beneficial to you or to send you a newsletter about our practice and the services we offer.  You may contact our privacy officer to request that the se materials not be sent to you.

Others involved in Your Healthcare.  Unless you object, we may disclose your PHI to a member of your family, a relative, close friend, or any person you specify, as it directly relates to that person’s involvement in your health care.   If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.  We may use or disclose PHI to notify or assist in notifying a family member, personal representative, or any other person that is responsible for your care, general condition, or death.  Finally, we may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involve din your health care.

Emergencies.  We may use or disclose your PHI in an emergency treatment situation.

Required by Law.  We may use or disclosed your PHI to the extent that is required by law.  The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law.  You will be notified of any such uses or disclosures. 

Public Health.  As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.  We may also disclose your protected information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight.  We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations and inspections.   Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect.  We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect.  In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect, or domestic violence to the governmental entity or agency authorized to receive such information.  In this care, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration.  We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, and tracking of products to enable product recalls, make repairs or replacements, or to conduct post marketing surveillance as required.

Legal Proceedings.  We may disclose protected information in the course of any judicial or administrative proceeding, in response to an order of a court, subpoena, discovery request, or other lawful process.

Law Enforcement.  We may also disclose PHI, as long as applicable legal requirements are met, for law enforcement purposes.   These law enforcement purposes include legal processes required by law, limited information requests for identification and location purposes, pertaining to victims of a crime, suspicion that a death has occurred as a result of criminal conduct, in the event that a crime occurs on the premises of the practice and medical emergency (not on the practice’s premises) and it is likely that a crime has occurred.

Coroners, Funeral Directors, and Organ Donation.  We may disclose protected health information to a coroner or medical examiner for identification purposes, determining the cause of death or for the coroner or medical examiner to perform other duties authorized by law.  We may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties.   We may disclose such information in reasonable anticipation of death. PHI may be used and disclosed for cadaver organ, eye, or tissue donation purposes.

Research.  We may use or disclose your PHI for research purposes under certain limited circumstances.  The Practice must obtain a written authorization to use and disclose your PHI for research purposes except in situations specifically authorized by the Federal Privacy Rule or where a research project meets specific, detailed criteria established by the Federal Privacy Rule to ensure the privacy of protected health information.

Criminal Activity.  Consistent with applicable federal and state laws, we may disclose your protected health information, if we belief that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.  We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military activity and National Security.  When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel for activities deemed necessary by appropriate military command authorities, for the purposes of a determination by the Department of Veterans Affairs of your eligibility for benefits or to foreign military authority if you are a member of that foreign military service.  We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers’ Compensation.  Your protected health information may be disclosed as authorized to comply with workers’ compensation laws and other similar legally established programs.

Business Associates.  There are certain services provided to CSJW through arrangements with business associates, such as billing companies, transcription companies, accounting firms, and law firms.  Where permitted by federal and state privacy rules, we may disclose PHI to our business associates and allow them to create and receive your PHI on our behalf so that they can perform their duties on our behalf.  As an example, the practice may share information regarding your care with a billing company so that the billing company can submit these claims for payment and we can receive the reimbursement for your care from the insurer.  Whenever an arrangement between our office and a business associate involves the use or disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.

Inmates.  Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof, health information necessary for your health and the health and safety of other individuals.

Required Uses and Disclosures.  Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services, to investigate or determine our compliance with the requirements of Federal Law.

Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law.  You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physicians practice has already taken an action relying on the use of your previously signed authorization.

II. YOUR RIGHTS

The following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights.

You have the right to obtain a copy of your protected health information.  This means that you may obtain a copy by providing our staff with a written request for your designated record set.  A “designated record set” contains medical and billing records and any other records that your physician and the practice use for making decisions about you.

Under federal law, however, you may not inspect or copy the following records:  psychotherapy notes, information being compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and any other records that are subject to Federal or State law.  Depending on the circumstances, your request may be denied.  You have the right to have this decision reviewed.  Please contact our Privacy Officer if you have questions about access to your medical record.

You have the right to request a restriction of your protected health information.  This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations.  You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices.  Your request must state the specific restriction requested and to whom you want the restriction to apply.

Your physician is not required to agree to a restriction that you may request.  If your physician believes it is in your best interest to permit use and disclosure of your protected health information, your information will not be restricted.   If your physician does agree to the request, we may not violate that restriction unless it is needed to provide emergency treatment.  With this in mind, please discuss any restriction you may wish to request with your physician.  You may also request a restriction by providing a written request to your Privacy Officer, Leland Berkwits, MD.

You may have the right to have your physician amend your protected health information.   This means you may request an amendment of protected health information about you in a designated record set for as long as we maintain this information.  In certain cases, we may deny your request for amendment.  If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you a copy of any such rebuttal.  Please contact our Privacy Officer, Leland Berkwits, MD, if you have any questions regarding amending your medical record.

You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.  The right applies to disclosures for purposes other than treatment, payment, or healthcare operations as described in this Notice of Privacy Practices.   It excludes disclosures we may have made to you, to family members, or friends involved in your care or for notification purposes.  You have the right to receive specific information regarding these disclosures that occurred after November 1, 2008.  The right to receive this information is subject to certain exceptions, restrictions, and limitations.  The first request in a twelve (12) month period will be free, but we may charge you for all reasonable costs of providing additional lists in the same twelve (12) month period.  We will tell you about these costs at the time you make such a request, and you may choose to cancel your request at any time before incurring any costs. 

You have a right to obtain a paper copy of this notice.  You have the right to receive a paper copy of this notice at any time.  This right applies even if you have previously agreed to receive this notice electronically.  Please contact our Privacy Officer in writing to obtain a paper copy of this Notice. 

III.  COMPLAINTS

 If you believe that we have violated your privacy rights, you may submit a complaint to CSJW or to the Secretary of Health and Human Services.  To file a complaint with us, please submit the complaint in writing to our Privacy Officer at the address listed at the end of this Notice.  The Practice’s Privacy Officer will provide you with the contact information for the Secretary of Health and Human Services upon request.  Center for Spine and Joint Wellness, PA will not retaliate or take action against you for filing such a complaint.

IV.  QUESTIONS

 If you have any questions about this Notice, please contact our Privacy Officer at the address and telephone number listed below.

V.  PRIVACY OFFICER CONTACT INFORMATION

You may contact our Privacy Officer at the following address and telephone number:

Center for Spine and Joint Wellness, PA

828-333-9196

This Notice of Privacy Practices was published

and first became effective on November 1, 2008.