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ORDC NOTICE
OF PRIVACY PRACTICES
THIS
NOTICE IS EFFECTIVE AS OF APRIL 13, 2003
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.
ORDC uses health information
about you for treatment, to obtain payment for treatment, for
administrative purposes, and to evaluate the quality of care
that you receive. Your health information is contained in a
medical record that is the physical property of ORDC.
How ORDC May
Use or Disclose Your Health Information
I. Permitted Use &
Disclosure of Your Health Information
a. For
Treatment. ORDC may use your health information to provide
you with medical treatment or services. For example, information
obtained by a health care provider, such as a physician, nurse,
or other person providing health services to you, will record
information in your record that is related to your treatment.
This information is necessary for health care providers to
determine what treatment you should receive. Health care
providers will also record actions take by them in the course of
your treatment and note how you respond to the actions. In
addition ORDC Health Care Provider(s) may disclose your health
information when consulting with a physician regarding your
medical condition and/or in the process of obtaining an
interpretation for a Diagnostic test.
b. For
Payment. ORDC may use and disclose your health information
to others for purposes of receiving payment for treatment and
services that you receive. For example, a bill may be sent to
you or a third-party payor, such as an insurance company or
health plan. The information on the bill may contain information
that identifies you, your diagnosis, and treatment or supplies
used in the course of treatment.
c. For
Health Care Operations. ORDC may use and disclose health
information about you for operational purposes. For example,
your health information may be disclosed to members of the
medical staff, risk or quality improvement personnel, and others
to:
-
evaluate
the performance of our staff;
-
assess
the quality of care and outcomes in your cases and similar
cases;
-
learn
how to improve our facilities and services; and
-
determine
how to continually improve the quality and effectiveness of
the health care we provide.
d. Appointments.
ORDC may use your information to provide appointment reminders
or information about treatment alternatives or other
health-related benefits and services that may be of interest to
you.
e. Fund
Raising. ORDC may use your information to contact you to
raise funds for ORDC.
f. Group
Health Plans. A group health plan, health insurance issuer,
or HMO with respect to a group health plan may disclose health
information to the sponsor of the plan.
II. Uses and Disclosures
With Patient Authorization. Under the Privacy Regulations,
we can use and disclose your health information for purposes
other than treatment, payment or health care operations with
your written authorization. For example, with your authorization
we can provide your name and medical condition to companies who
might be able to provide you useful items or services. Under the
Privacy Regulations, you may revoke your authorization; however,
such revocation will not have any effect on uses or disclosures
of your health information prior to our receipt of the
revocation.
III. Uses and Disclosures
With Patient Opportunity to Verbally Agree or Object. Under
the Privacy Regulations, we are permitted to disclose your
health information without your written consent or authorization
to a family member, a close personal friend or any other person
identified by you, if the information is directly relevant to
that person's involvement in your care or treatment. You must be
notified in advance of the use or disclosure and have the
opportunity to verbally agree or object.
IV. Uses and Disclosures
Without Patient Consent, Authorization or Opportunity to
Verbally Agree or Object. Under the Privacy Regulations, we
are permitted to use or disclose your health information without
your consent, authorization or the opportunity to verbally agree
or object with regard to the following:
a. Required
by law. ORDC may use and disclose information about you as
required by law. For example, ORDC may disclose information for
the following purposes: · for judicial and administrative
proceedings pursuant to legal authority; · to report
information related to victims of abuse, neglect or domestic
violence; and · to assist law enforcement officials in their
law enforcement duties;
b. Public
Health. Your health information may be used or disclosed for
public health activities such as assisting public health
authorities or other legal authorities to prevent or control
disease, injury, or disability, or for other health oversight
activities.
c. Decedents.
Health information may be disclosed to funeral directors or
coroners to enable them to carry out their lawful duties.
d. Organ/Tissue
Donation. Your health information may be used or disclosed
for cadaveric organ, eye or tissue donation purposes.
e. Research.
ORDC may use your health information for research purposes when
an institutional review board or privacy board that has reviewed
the research proposal and established protocols to ensure the
privacy of your health information has approved the research.
f. Health
and Safety. Your health information may be disclosed to
avert a serious threat to the health or safety of you or any
other person pursuant to applicable law.
g. Government
Functions. Your health information may be disclosed for
specialized government functions such as protection of public
officials or reporting to various branches of the armed
services.
h. Workers'
Compensation. Your health information may be used or
disclosed in order to comply with laws and regulations related
to Workers' Compensation.
i. Abuse
and Neglect. We may disclose your health information if we
have a reasonable belief of abuse, neglect or domestic violence.
j. Regulatory
Agencies. We may disclose your health information to a
health care oversight agency for activities authorized by law,
including, but not limited to, licensure, certification, audits,
investigations and inspections. These activities are necessary
for the government and certain private health oversight agencies
to monitor the health care system, government programs and
compliance with civil rights.
k. Judicial
and Administrative Proceedings. We may disclose health
information in judicial and administrative proceedings, as well
as in response to an order of a court, administrative tribunal,
or in response to a subpoena, summons, warrant, discovery
request or similar legal request.
l. Military/Veterans.
If you are a member of the armed forces, we may disclose your
health information as required by military command authorities.
m. Marketing.
We may use or disclose your health information to make a
marketing communication to you, if such communication is
conducted face-to-face, concerns products or services of nominal
value, or identifies us as the communicating party and that we
will receive remuneration for making the communication and,
where required by the Privacy Regulations, instructions
describing how you may verbally object to receiving future
communications.
n. Law
Enforcement Purposes. We may disclose your health
information to law enforcement officials when required to do so
by law
o. Other
uses. Other uses and disclosures will be made only with your
written authorization and you may revoke the authorization
except to the extent ORDC has taken action in reliance on such.
V. Uses
and Disclosures to Business Associates. With the proper
consent or authorization, we are permitted to disclose your
health information to Business Associates and to allow Business
Associates to receive your health information on our behalf. A
Business Associate is defined under the Privacy Regulations as
an individual or entity under contract with us to perform or
assist us in a function or activity which requires the use of
your health information. Examples of business associates
include, but are not limited to, consultants, accountants,
lawyers, medical transcriptionists and third party billing
companies. We require all Business Associates to protect the
confidentiality of your health information.
VI. Patient Rights.
Although your medical record is
our property, you have the following rights concerning your
medical record and health information:
a. Right
to Request Restrictions on the Use and Disclosure of Your Health
Information. You have the right to request restrictions
on the use and disclosure of your health information for
treatment, payment and health care operations. However, we are
not required to agree with such a request. If, however, we agree
to the requested restriction, it is binding on us.
b. Right
to Inspect and Copy Your Health Information. You have
the right to inspect and copy your own health information upon
request. However, we are not required to provide you access to
all the health information that we maintain. For example, this
right does not extend to psychotherapy notes, information
compiled in reasonable anticipation of, or for use in, a civil,
criminal or administrative proceeding, or subject to or exempt
from Clinical Laboratory Improvements Amendments of 1988. Access
may also be denied if disclosure would reasonably endanger you
or another person.
c. Right
to Verbally Object. You have the right to verbally
object to certain disclosures that are routinely made without
any Consent or Authorization. For example, we are required to
give you an opportunity to object to the sharing of your health
information with a person or family member accompanying you for
treatment.
d. Right
to Seek an Amendment of Your Health Information. You
have the right to request an amendment of your health
information. If we disagree with the requested amendment, we
will permit you to include a statement in the record. Moreover,
we will provide you with a written explanation of the reasons
for the denial and the procedures for filing appropriate
complaints and appeals.
e. Right
to an Accounting of Disclosure of Your Health information.
You have the right to receive an accounting of disclosures made
by us of your health information within six (6) years prior to
the date of your request. The accounting will not include
disclosures related to treatment, payment or health care
operations, disclosures to you based on your consent,
authorization or other means permitted by the Privacy
Regulations, disclosures to persons involved in your care, or
disclosures that occurred prior to our compliance deadline under
the Privacy Regulations. The accounting of disclosures shall
include the date of each disclosure, name and address of the
person or organization who received your health information, a
brief description of the information disclosed, and the purpose
for the disclosure.
f. Right
to Confidential Communications. You have the right to
receive confidential communications of your health information
by alternative means or alternative locations. For example, you
may request that we only contact you at work or by mail.
g. Right
to Revoke Your consent and/or Authorization. You have
the right to revoke your consent or authorization for the use or
disclosure of your health information. However, such revocation
will not have any effect on uses or disclosures prior to the
receipt of the revocation.
h. Right
to Receive Copy of this Notice. You have the right to
receive a copy of this Notice.
Contact Information and
How to Report a Privacy Rights Violation
If you have questions and would like additional
information regarding the uses and disclosures of your health
information, you may contact Kim Schrader at 740-687-5025.
Moreover, the Practice has established an internal complaint
process for reporting privacy rights violations. If you believe
that your privacy rights have been violated, you may file a
complaint with us or the Secretary of the Department of Health
and Human Services at 200 Independence Avenue, S.W., Washington,
D.C. 20201. To file a complaint with us, please contact Kim
Schrader at 740-687-5025. All complaints must be submitted to
the Practice in writing at 2405 North Columbus Street, Suite
140, Lancaster, Ohio 43130. There will be no retaliation for
filing a complaint.
OBLIGATIONS
OF ORDC
ORDC is required by law
to:
- maintain the privacy of
protected health information;
- provide you with this notice
of its legal duties and privacy practices with respect to
your health information;
- abide by the terms of this
notice;
- notify you if we are unable
to agree to a requested restriction on how your information
is used or disclosed;
- accommodate reasonable
requests you may make to communicate health information by
alternative means or at alternative locations; and
ORDC reserves the right to
change its information practices and to make the new provisions
effective for all protected health information it maintains.
Revised notices will be made available to you by your request.
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