Privacy
Notice
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
rights to access and control your protected
health information in some cases. Your
"protected health information" means any
written and oral health information about
you, including demographic data that can be
used to identify you. This is health
information that is created or received by
your health care provider, and that relates
to your past, present or future physical or
mental health or condition.
I. Uses
and Disclosures of Protected Health
Information
Ocean Reef
Medical Center may use your protected health
information for 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 the
practice has obtained your
authorization or the use or disclosure is
otherwise permitted by the HIPAA privacy
regulations or state law. Disclosures of
your protected health information for the
purposes described in this Privacy Notice
may be made in writing, orally, or by
facsimile.
A.
Treatment. We will use and disclose
your protected health information to
provide, coordinate, or manage your health
care and any related services. This
includes the coordination or management of
your health care with a third party for
treatment purposes. For example, we may
disclose your protected health information
to a pharmacy to fill a prescription or to a
laboratory to order a blood test. We may
also disclose protected health information
to physicians who may be treating you or
consulting with the practice with respect to
your care. In some cases, we may also
disclose your protected health information
to an outside treatment provider for
purposes of the treatment activities of the
other provider.
B.
Payment. Your protected health
information will be used, as needed, to
obtain payment for the services that we
provide. This may include certain
communications to your health insurance
company to get approval for the procedure
that we have scheduled. For example, we may
need to disclose information to your health
insurance company to get prior approval for
the surgery. We may also disclose protected
health information to your health insurance
company to determine whether you are
eligible for benefits or whether a
particular service is covered under your
health plan. In order to get payment for
the services we provide to you, we may also
need to disclose your protected health
information to your health insurance company
to demonstrate the medical necessity of the
services or, as required by your insurance
company, for utilization review. We may
also disclose patient information to another
provider involved in your care for the other
provider’s payment activities. This may
include disclosure of demographic
information to anesthesia care providers for
payment of their services.
C.
Operations. We may use or disclose
your protected health information, as
necessary, for our own health care
operations to facilitate the function of the
Ocean Reef Medical Center and to provide
quality care to all patients. Health care
operations include such activities as:
quality assessment and improvement
activities, employee review activities,
training programs including those in which
students, trainees, or practitioners in
health care learn under supervision,
accreditation, certification, licensing or
credentialing activities, review and
auditing, including compliance reviews,
medical reviews, legal services and
maintaining compliance programs, and
business management and general
administrative activities.
In certain
situations, we may also disclose patient
information to another provider or health
plan for their health care operations.
D.
Other Uses and Disclosures.
As part of treatment, payment and health
care operations, we may also use or disclose
your protected health information for the
following purposes: to remind you of your
surgery date, to inform you of potential
treatment alternatives or options, to inform
you of health-related benefits or services
that may be of interest to you, or to
contact you to raise funds for the practice
or an institutional foundation related to
the practice. If you do not wish to be
contacted regarding fundraising, please
contact our Privacy Officer.
Uses and
Disclosures Beyond
Treatment, Payment, and Health Care
Operations Permitted Without Authorization
or Opportunity to Object
Federal privacy
rules allow us to use or disclose your
protected health information without your
permission or authorization for a number of
reasons including the following:
A.
When Legally Required. We will
disclose your protected health information
when we are required to do so by any
federal, state or local law.
B.
When There Are Risks to Public Health.
We may disclose your protected health
information for the following public
activities and purposes:
To prevent,
control, or report disease, injury or
disability as permitted by law.
To report vital
events such as birth or death as permitted
or required by law.
To conduct
public health surveillance, investigations
and interventions as permitted or required
by law.
To collect or
report adverse events and product defects,
track FDA regulated
products, enable product recalls,
repairs or replacements to the FDA and to
conduct post marketing surveillance.
To notify a
person who has been exposed to a
communicable disease or who may be at risk
of contracting or spreading a disease as
authorized by law.
To report to an
employer information about an individual who
is a member of the workforce as legally
permitted or required.
C.
To Report Suspended Abuse, Neglect
Or Domestic
Violence. We may notify government
authorities if we believe that a patient is
the victim of abuse, neglect or domestic
violence. We will make this disclosure only
when specifically required or authorized by
law or when the patient agrees to the
disclosure.
D.
To Conduct Health Oversight Activities.
We may disclose your protected health
information to a health oversight agency for
activities including audits; civil,
administrative, or criminal investigations,
proceedings, or actions; inspections;
licensure or disciplinary actions; or other
activities necessary for appropriate
oversight as authorized by law. We will not
disclose your health information under this
authority if you are the subject of an
investigation and your health information is
not directly related to your receipt of
health care or public benefits.
E.
In Connection With Judicial
And
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. In
certain circumstances, we may disclose your
protected health information in response to
a subpoena to the extent authorized by state
law if we receive satisfactory assurances
that you have been notified of the request
or that an effort was made to secure a
protective order.
F.
For Law Enforcement Purposes. We
may disclose your protected health
information to a law enforcement official
for law enforcement purposes as follows:
As required by
law for reporting of certain types of wounds
or other physical injuries.
Pursuant to court order,
court-ordered warrant, subpoena, summons or
similar process.
For the purpose of
identifying or locating a suspect, fugitive,
material witness or missing person.
Under certain
limited circumstances, when you are the
victim of a crime.
To
a law enforcement
official if the practice has a suspicion
that your health condition was the result of
criminal conduct.
In an emergency to
report a crime.
G.
To Coroners, Funeral Directors, and for
Organ Donation. We may disclose
protected health information to a coroner or
medical examiner for identification
purposes, to determine cause of death or for
the coroner or medical examiner to perform
other duties authorized by law. We may also
disclose protected health information 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. Protected health information may
be used and disclosed for
cadaveric organ,
eye or tissue donation purposes.
H.
For Research Purposes. We may use
or disclose your protected health
information for research when the use or
disclosure for research has been approved by
an institutional review board that has
reviewed the research proposal and research
protocols to address the privacy of your
protected health information.
I.
In the Event of a Serious Threat to
Health or Safety. We may,
consistent with applicable law and ethical
standards of 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 or safety
or to the health and safety of the public.
J.
For Specified Government Functions.
In certain circumstances, federal
regulations authorize the practice to use or
disclose your protected health information
to facilitate specified government functions
relating to military and veterans
activities, national security and
intelligence activities, protective services
for the President and others, medical
suitability determinations, correctional
institutions, and law enforcement custodial
situations.
K.
For Worker's Compensation. The
practice may release your health information
to comply with worker's compensation laws or
similar programs.
Uses and
Disclosures Permitted without Authorization
but with Opportunity to Object
We may
disclose your protected health information
to your family member or a close personal
friend if it is directly relevant to the
person’s involvement in your surgery or
payment related to your surgery. We can
also disclose your information in connection
with trying to locate or notify family
members or others involved in your care
concerning your location, condition or
death.
You may
object to these disclosures. If you do not
object to these disclosures or we can infer
from the circumstances that you do not
object or we determine, in the exercise of
our professional judgment, that it is in
your best interests for us to make
disclosure of information that is directly
relevant to the person’s involvement with
your care, we may disclose your protected
health information as described.
IV.
Uses and Disclosures which you Authorize
Other than as
stated above, we will not disclose your
health information other than with your
written authorization. You may revoke your
authorization in writing at any time except
to the extent that we have taken action in
reliance upon the authorization.
V. Your Rights
You have the
following rights regarding your health
information:
A.
The right to inspect and copy your protected
health information. You may inspect
and obtain a copy of your protected health
information that is contained in a
designated record set for as long as we
maintain the protected health information.
A “designated record set” contains medical
and billing records and any other records
that your surgeon and the practice
uses for making
decisions about you.
Under federal
law, however, you may not inspect or copy
the following records: psychotherapy notes;
information compiled in reasonable
anticipation of, or for use in, a civil,
criminal, or administrative action or
proceeding; and protected health information
that is subject to a law that prohibits
access to protected health information.
Depending on the circumstances, 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 your life or
safety or that of another person, or that it
is likely to cause substantial harm to
another person referenced within the
information. You have the right to request
a review of this decision.
To inspect and
copy your medical information, you must
submit a written request to the Privacy
Officer whose contact information is listed
on the last page of this Privacy Notice. 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 in complying with your request.
Please contact
our Privacy Officer if you have questions
about access to your medical record.
B.
The right to request a restriction on uses
and disclosures of your protected health
information. You may ask us not to
use or disclose certain parts of your
protected health information for the
purposes of treatment, payment or health
care operations. You may also request that
we not disclose your health information to
family members or friends who may be
involved in your care or for notification
purposes as described in this Privacy
Notice. Your request must state the
specific restriction requested and to whom
you want the restriction to apply.
The practice is
not required to agree to a restriction that
you may request. We will notify you if we
deny your request to a restriction. If the
practice does agree to the requested
restriction, we may not use or disclose your
protected health information in violation of
that restriction unless it is needed to
provide emergency treatment. Under certain
circumstances, we may terminate our
agreement to a restriction. You may request
a restriction by contacting the Privacy
Officer.
C.
The right to request to receive confidential
communications from us by alternative means
or at an alternative location. You
have the right to request that we
communicate with you in certain ways. We
will accommodate reasonable requests. We
may condition this accommodation by asking
you for information as to how payment will
be handled or specification of an
alternative address or other method of
contact. We will not require you to provide
an explanation for your request. Requests
must be made in writing to our Privacy
Officer.
D.
The right to request amendments to your
protected health information. 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 an 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 with a
copy of any such rebuttal. Requests for
amendment must be in writing and must be
directed to our Privacy Officer. In this
written request, you must also provide a
reason to support the requested amendments.
E.
The right to receive an accounting.
You have the right to request an accounting
of certain disclosures of your protected
health information made by the practice.
This right applies to disclosures for
purposes other than treatment, payment or
health care operations as described in this
Privacy Notice. We are also not required to
account for disclosures that you requested,
disclosures that you agreed to by signing an
authorization form, disclosures for a
practice directory, to friends or family
members involved in your care, or certain
other disclosures we are permitted to make
without your authorization. The request for
an accounting must be made in writing to our
Privacy Officer. The request should specify
the time period sought for the accounting.
We are not required to provide an accounting
for disclosures that take place prior to
April 14, 2003. Accounting requests may not
be made for periods of time in excess of six
years. We will provide the first accounting
you request during any 12-month period
without charge. Subsequent accounting
requests may be subject to a reasonable
cost-based fee.
F.
The right to obtain a paper copy of this
notice. Upon request, we will
provide a separate paper copy of this notice
even if you have already received a copy of
the notice or have agreed to accept this
notice electronically.
VI. Our
Duties
The practice is
required by law to maintain the privacy of
your health information and to provide you
with this Privacy Notice of our duties and
privacy practices. We are required to abide
by terms of this Notice as may be amended
from time to time. We reserve the right to
change the terms of this Notice and to make
the new Notice provisions effective for all
future protected health information that we
maintain. If the practice changes its
Notice, we will provide a copy of the
revised Notice by sending a copy of the
revised Notice via regular mail or through
in-person contact.
VII.
Complaints
You have the
right to express complaints to the practice
and to the Secretary of Health and Human
Services if you believe that your privacy
rights have been violated. You may complain
to the practice by contacting the practice’s
Privacy Officer verbally or in writing,
using the contact information below. We
encourage you to express any concerns you
may have regarding the privacy of your
information. You will not be retaliated
against in any way for filing a complaint.
Contact Person
The practice’s
contact person for all issues regarding
patient privacy and your rights under the
federal privacy standards is the Privacy
Officer. Information regarding matters
covered by this Notice can be requested by
contacting the Privacy Officer. If you feel
that your privacy rights have been violated
by this practice you may submit a complaint
to our Privacy Officer by sending it to:
Ocean Reef
Medical Center
30 Ocean Reef
Drive
Key Largo, FL
33037
ATTN: Privacy
Officer
The Privacy
Officer can be contacted by telephone at
(305) 367-2600.
IX. Effective
Date
This Notice
is effective April 14, 2003.
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