(a division of David A.
McGuire, M.D., A.P.C.)
Effective Date:
A.
PURPOSE OF THE
NOTICE.
Alaska Orthopaedic
Specialists
is committed to preserving the privacy and confidentiality of your health
information which is created and/or maintained at our clinic. State and federal laws and regulations
require us to implement policies and procedures to safeguard the privacy of your
health information. This Notice
will provide you with information regarding our privacy practices and applies to
all of your health information created and/or maintained at our clinic,
including any information that we receive from other health care providers or
facilities. The Notice describes
the ways in which we may use or disclose your health information and also
describes your rights and our obligations concerning such uses or
disclosures.
We will abide by the terms of
this Notice, including any future revisions that we may make to the Notice as
required or authorized by law. We
reserve the right to change this Notice and to make the revised or changed
Notice effective for health information we already have about you as well as any
information we receive in the future.
We will post a copy of the current Notice, which will identify its
effective date, in our clinic and on our website at
www.mcguiremd.com
The privacy practices
described in this Notice will be followed by:
1.
Any health care professional
authorized to enter information into your medical record created and/or
maintained at our clinic;
2.
All employees, students,
residents, and other service providers who have access to your health
information at our clinic;
3.
Providers or facilities that
we refer you to for diagnostic, surgery or rehabilitation
services.
4.
Any member of a volunteer
group which is allowed to help you while receiving services at our
clinic.
The individuals identified
above will share your health information with each other for purposes of
treatment, payment and health care operations, as further described in the
Notice.
B.
USES AND DISCLOSURES OF
HEALTH INFORMATION FOR TREATMENT, PAYMENT AND HEALTH CARE
OPERATIONS.
1. Treatment, Payment
and Health Care Operations. The following section describes
different ways that we may use and disclose your health information for purposes
of treatment, payment, and health care operations. We explain each of these purposes below
and include examples of the types of uses or disclosures that may be made for
each purpose. We have not listed
every type of use or disclosure, but the ways in which we use or disclose your
information will fall under one of these purposes.
a.
Treatment. We may use your health information to
provide you with health care treatment and services. We may disclose your health information
to doctors, nurses, nursing assistants, medication aides, technicians, medical
and nursing students, rehabilitation therapy specialists, or other personnel who
are involved in your health care.
For example, we may order
physical therapy services to improve your strength and walking abilities. We will need to talk with the physical
therapist so that we can coordinate services and develop a plan of care. We also may need to refer you to another
health care provider to receive certain services. We will share information with that
health care provider in order to coordinate your care and
services.
b.
Payment. We may use or disclose your health
information so that we may bill and receive payment from you, an insurance
company, or another third party for the health care services you receive from
us. We also may disclose health
information about you to your health plan in order to obtain prior approval for
the services we provide to you, or to determine that your health plan will pay
for the treatment.
For example, we may need to
give health information to your health plan in order to obtain prior approval to
refer you to a health care specialist, such as a neurologist or orthopedic
surgeon, or to perform a diagnostic test such as a magnetic resonance imaging
scan (“MRI”) or a CT scan.
c.
Health Care
Operations. We may use or disclose your health
information in order to perform the necessary administrative, educational,
quality assurance and business functions of our clinic.
For example, we may use your
health information to evaluate the performance of our staff in caring for
you. We also may use your health
information to evaluate whether certain treatment or services offered by our
clinic are effective. We also may
disclose your health information to other physicians, nurses, technicians, or
health profession students for teaching and learning
purposes.
We may use or disclose your
health information in certain special situations as described below. For these situations, you have the right
to limit these uses and disclosures as provided for in Section F of this Notice.
1.
Appointment
Reminders. We may use or disclose your health
information for purposes of contacting you to remind you of a health care
appointment.
2.
Family Members and
Friends. We may disclose your health information
to individuals, such as family members and friends, who are involved in your
care or who help pay for your care.
We may make such disclosures when:
(a) we have your verbal agreement to do so; (b) we make such disclosures
and you do not object; or (c) we can infer from the circumstances that you would
not object to such disclosures. For
example, if your spouse comes into the exam room with you, we will assume that
you agree to our disclosure of your information while your spouse is present in
the room.
We also may disclose your
health information to family members or friends in instances when you are unable
to agree or object to such disclosures, provided that we feel it is in your best
interests to make such disclosures and the disclosures relate to that family
member or friend’s involvement in your care. For example, if you present to our
clinic with an emergency medical condition, we may share information with the
family member or friend that comes with you to our clinic. We also may share your health
information with a family member or friend who calls us to request a
prescription refill for you.
There are certain instances
in which we may be required or permitted by law to use or disclose your health
information without your permission.
These instances are as follows:
1.
As required by
law. We may disclose your health information
when required by federal, state, or local law to do so. For example, we are required by the
Department of Health and Human Services (HHS) to disclose your health
information in order to allow HHS to evaluate whether we are in compliance with
the federal privacy regulations.
2.
Public Health
Activities. We may disclose your health
information to public health authorities that are authorized by law to receive
and collect health information for the purpose of preventing or controlling
disease, injury or disability; to report births, deaths, suspected abuse or
neglect, reactions to medications; or to facilitate product recalls.
3.
Health Oversight
Activities. We may disclose your health information
to a health oversight agency that is authorized by law to conduct health
oversight activities, including audits, investigations, inspections, or
licensure and certification surveys.
These activities are necessary for the government to monitor the persons
or organizations that provide health care to individuals and to ensure
compliance with applicable state and federal laws and regulations.
4.
Judicial or administrative
proceedings. We may disclose your health information
to courts or administrative agencies charged with the authority to hear and
resolve lawsuits or disputes. We
may disclose your health information pursuant to a court order, a subpoena, a
discovery request, or other lawful process issued by a judge or other person
involved in the dispute, but only if efforts have been made to (i) notify you of
the request for disclosure or (ii) obtain an order protecting your health
information.
5.
Worker’s
Compensation. We may disclose your health information
to worker’s compensation programs when your health condition arises out of a
work-related illness or injury.
6.
Law Enforcement
Official. We may disclose your health information
in response to a request received from a law enforcement official to report
criminal activity or to respond to a subpoena, court order, warrant, summons, or
similar process.
7.
Coroners, Medical Examiners,
or Funeral Directors. We may disclose your health information
to a coroner or medical examiner for the purpose of identifying a deceased
individual or to determine the cause of death. We also may disclose your health
information to a funeral director for the purpose of carrying out his/her
necessary activities.
8.
Organ Procurement
Organizations or Tissue Banks. If you are an organ donor, we may
disclose your health information to organizations that handle organ procurement,
transplantation, or tissue banking for the purpose of facilitating organ or
tissue donation or transplantation.
9.
Research. We may use or disclose your health
information for research purposes under certain limited circumstances. Because all research projects are
subject to a special approval process, we will not use or disclose your health
information for research purposes until the particular research project for
which your health information may be used or disclosed has been approved through
this special approval process.
However, we may use or disclose your health information to individuals
preparing to conduct the research project in order to assist them in identifying
patients with specific health care needs who may qualify to participate in the
research project. Any use or
disclosure of your health information which is done for the purpose of
identifying qualified participants will be conducted onsite at our
facility. In most instances, we
will ask for your specific permission to use or disclose your health information
if the researcher will have access to your name, address or other identifying
information.
10.
To Avert a Serious Threat to
Health or Safety. We may use or disclose your health
information when necessary to prevent a serious threat to the health or safety
of you or other individuals.
11.
Military and
Veterans. If you are a member of the armed forces,
we may use or disclose your health information as required by military command
authorities.
12.
National Security and
Intelligence Activities. We may use or disclose your
health information to authorized federal officials for purposes of intelligence,
counterintelligence, and other national security activities, as authorized by
law.
13.
Inmates. If you are an inmate of a correctional
institution or under the custody of a law enforcement official, we may use or
disclose your health information to the correctional institution or to the law
enforcement official as may be necessary (i) for the institution to provide you
with health care; (ii) to protect the health or safety of you or another person;
or (iii) for the safety and security of the correctional
institution.
E.
USES AND DISCLOSURES PURSUANT TO YOUR WRITTEN
AUTHORIZATION.
Except for the purposes
identified above in Sections B through D, we will not use or disclose your
health information for any other purposes unless we have your specific written
authorization. You have the right
to revoke a written authorization at any time as long as you do so in
writing. If you revoke your
authorization, we will no longer use or disclose your health information for the
purposes identified in the authorization, except to the extent that we have
already taken some action in reliance upon your
authorization.
You have the following rights
regarding your health information.
You may exercise each of these rights, in writing, by providing us
with a completed form that you can obtain from our office. In some instances, we may charge you for
the cost(s) associated with providing you with the requested
information.
1.
Right to Inspect and
Copy. You have the right to inspect and copy
health information that may be used to make decisions about your care. We may deny your request to inspect and
copy your health information in certain limited circumstances. If you are denied access to your health
information, you may request that the denial be reviewed.
2. Right to
Amend. You have the right to request an
amendment of your health information that is maintained by or for our clinic and
is used to make health care decisions about you. We may deny your request if it is not
properly submitted or does not include a reason to support your request. We may also deny your request if the
information sought to be amended:
(a) was not created by us, unless the person or entity that created the
information is no longer available to make the amendment; (b) is not part of the
information that is kept by or for our clinic; (c) is not part of the
information which you are permitted to inspect and copy; or (d) is accurate and
complete.
3. Right to an Accounting of
Disclosures. You have the
right to request an accounting of the disclosures of your health information
made by us. This accounting will
not include disclosures of health information that we made for purposes of
treatment, payment or health care operations or pursuant to a written
authorization that you have signed.
4. Right to Request
Restrictions. You have the right to request a
restriction or limitation on the health information we use or disclose about you
for treatment, payment, or health care operations. You also have the right to request a
limit on the health information we disclose about you to someone, such as a
family member or friend, who is involved in your care or in the payment of your
care. For example, you could ask
that we not use or disclose information regarding a particular treatment that
you received. We are not required
to agree to your request. If we do
agree, that agreement must be in writing and signed by you and
us.
5. Right to Request
Confidential Communications. You have the right to request that we
communicate with you about your health care in a certain way or at a certain
location.
6. Right to a Paper
Copy of this Notice. You have the right to receive a paper
copy of this Notice. You may ask us
to give you a copy of this Notice at any time.
If you have any questions regarding this Notice or wish to receive additional information about our privacy practices, please contact our Privacy Officer at 907-751-4100. If you believe your privacy rights have been violated, you may file a complaint with our clinic or with the Secretary of the Department of Health and Human Services (HHS). To file a complaint with our clinic, contact our Privacy Officer at 4100 Lake Otis Parkway #320, Anchorage, AK 99508. All complaints must be submitted in writing. You will not be penalized for filing a complaint.