HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
When you need health care, you give information about yourself and your health to doctors, nurses, and other healthcare workers and staff. This information, along with the record of the care you receive, is “protected health information” (or “health information”). This information is kept in a paper form, such as your medical record, and in an electronic form on the computer.
New England Orthopaedic and Spine Surgery, LLC uses and discloses (shares) health information for many different reasons. For some of these uses and disclosures, we will need to obtain prior written authorization (permission). However, New England Orthopaedic and Spine Surgery, LLC may legally use or disclose your health information for treatment, payment, and healthcare operations. We do not need to receive prior authorization for uses and disclosures within the following categories:
For each category of use or disclosure, we will explain what we mean and try to give some examples. Not every use or disclosure is a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
For treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to other doctors and healthcare providers involved in your care. Example: a primary care physician may refer you to a specialist such as a radiologist or a surgeon. The specialist may tell you that you need to be admitted to the hospital for treatment or surgery. All of the doctors in this example will share the medical information about you. This is to coordinate care before, during and after you go into the hospital.
For payment. We may use and disclose your health information in order to bill and collect payment for the treatment and services provided to you. Example: A bill may be sent to you or a third party payer. If you have health insurance, information on or accompanying the bill may include a portion of your health information that identifies you as well as your diagnosis, procedures and supplies used for treatment. The insurance company uses the information to tell if you are eligible for benefits or if the services you received were medically needed for payment purposes. We may also provide your health information to our business associates, such as a billing company, claims processing companies and others that process our healthcare claims.
For healthcare operations. We may disclose your health information for activities that are known as healthcare operations. These activities use healthcare information for the purposes of evaluating our performance and findings better ways to provide care. We may use your health information in order to evaluate the quality of healthcare services that you received or to evaluate the performance of health care professionals who provided healthcare services to you. We may also share your health information with outside parties (“business associates”) who perform services on behalf of New England Orthopaedic and Spine Surgery, LLC. These business associates must agree to keep your health information private. Examples of activities that make up healthcare operations include legal counsel, transcription, storage, auditing, and consulting services.
Other uses of your health information. New England Orthopaedic and Spine Surgery, LLC may use your health information to contact you about:
- scheduled appointments, registration/insurance updates, pre-procedure assessments or test results.
- With information about patient care issues and treatment choices.
- with other health-related benefits and services that may be of interest to you.
We may disclose your health information to others without your consent in certain situations. Example: If you need emergency treatment or if you are unable to communicate with us (unconscious or in severe pain). In each of these situations we will try to get your consent. But if you are unable to agree or disagree to consent, and we believe you would consent if you were able to do so, we will disclose health information without consent.
SPECIFIC USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR CONSENT.
When disclosure of health information is required by federal, state or local law, administrative or legal proceedings, health oversight activities, or by law enforcement. Examples of some required reporting include health information about victims of abuse, neglect or domestic violence; patients with gunshot or other wounds. In addition, we disclose health information when ordered in a legal or administrative proceeding.
For public health activities. 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. Example: We report information about births, deaths and various diseases to the government officials in charge of collecting that data consistent with applicable law to carry out their duties.
For business associates. There are some services provided in our practice through contracts with business associates. Examples include the New England Baptist Hospital, Professional Management Associates, Total Information, Inc. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we have requested them to do and bill you or a third party for services rendered.
For purpose of organ donation. Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engages in procuring, banking or transplantation or organs, eye or tissue donation and transplants.
For research purposes. In certain circumstances this practice may provide health information in order to conduct or participate in medical research. Your health information will only be used/or disclosed to researchers when their research has been approved by an Institutional Review Board (IRB) that has reviewed the research proposal and established protocols to ensure the privacy of your health information. An example of this research would be to assess the outcomes of patients who had received specific therapy treatments.
To avoid harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide health information to law enforcement personnel or persons able to prevent or lessen such harm.
For specific government functions. We may disclose health information of military personnel and veterans in certain situations. We may disclose health information for national security purposes, such as protecting the President of the United States or conducting intelligence operations.
For Worker’s Compensation purposes. We may provide health information to the extent authorized by and to the extent necessary to comply with laws relating to Worker’s Compensation and other similar programs.
Appointment reminders and health related benefits or services. We may use health information to provide appointment reminders or give you information about, treatment alternatives, or other healthcare services or benefits we offer.
THE USE AND DISCLOSURE REQUIRING YOU TO HAVE THE OPPORTUNITY TO OBJECT
Disclosure to family, friends or others. New England Orthopaedic and Spine Surgery, LLC in using its best judgment may disclose health information to a family member, friend or other person that you indicate, unless you object in whole or in part, health information relevant to that person’s involvement in your can or payment related to your care. The opportunity to get your authorization may be obtained retroactively in emergency situations.
ALL OTHER USES AND DISCLOSURES REQUIRE YOUR PRIOR WRITTEN AUTHORIZATION.
In any other situation not described above, we will ask for your written authorization before using or disclosing any of your health information.
YOUR HEALTH INFORMATION RIGHTS
Unless otherwise required by law, your health record is the physical property of the healthcare practitioner or facility that compiled it and the information belongs to you. You have the right to:
Request limits on uses and disclosures of your health information. You have the right to ask for restrictions on the use and disclosure of your health information for treatment, payment or health care operations. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that are legally required and allowed to be made.
The right to ask that your health information be communicated to you in a confidential manner. You have the right to ask for your health information to be sent to you in different ways. You may ask for the practice to contact you by mail rather than telephone, or only call you at home rather than at work. Your request must be in writing and explain the method of contact and location where you wish to be contacted. We will try to honor your request as long as we can easily provide it in the format you request.
The right to see and get copies of your health information. In most cases, you have the right to look at or get copies of your personal health information we have, but you must make the request in writing. We will respond within thirty (30) days from the receipt of your request. If you ask for a copy of your record, you will be charged a fee. If your request is denied, we will inform you in writing regarding our reasons for the denial and explain your right to have the denial reviewed. We may offer to give you a summary or explanation of the information you requested as long as you agree in advance to this as well as to any fees incurred. If you ask for information we do not have but we know where it is, we must tell you where to direct your request.
The right to receive an accounting of disclosures (a record of when and to whom your health information was shared without your authorization). You have the right to obtain a list of the instances when we shared your health information. You must make this request in writing. You may request as far back as six years beginning January 1, 2009. The listing you receive will include the date, name and address (if known) of the person or organization receiving it. It will also include a brief description of the information given, a brief statement on why the information was shared, or a copy of the written request for the information.
The list will not include uses or disclosures that you have already consented to, such as those made for the treatment, payment or healthcare operations, directly to you or your family. The list will also not include uses or disclosures made for national security purposes, to corrections or law enforcement personnel, or before January 1, 2009.
We have 60 days to respond to your written request. If we do not act on your request within the 60 days, we will notify you that we are extending the response time by 30 days. If we do this, we will explain the delay in writing and give you a new date of when to expect a response. We will provide this list at no charge. If you make more than one request in the same year, we will charge you $20.00 for each additional request.
The right to correct or update your health information. If you believe there is a mistake in your health information or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information. You must provide the request and your reason for the request in writing.
We have 60 days to respond to your request. We may deny your request, in writing, if the health information is (a) correct and complete as it stands; (b) not created by us; (c) not allowed to be disclosed; or, (d) not part of our records. Our written denial will state the reason(s) for the denial and explain your rights to file a written statement of disagreement with the denial. If you do not file a written statement of disagreement, you have the right to request that your request and our denial be attached to all future disclosures of your health information.
The right to get this notice by e-mail. You have the right to get a copy of this Notice by e-mail. Even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of this Notice.