ORTHOPOP INC. NOTICE OF PRIVACY PRACTICES
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION THAT DO NOT REQUIRE YOUR AUTHORIZATION
Your protected health information may be used and disclosed by OrthoPop Inc., its staff and others outside of its offices who are involved in your care and treatment for the purpose of providing healthcare services to you. he following list, by way of example rather than limitation, explains certain uses and disclosures of your protected health information that OrthoPop Inc. and its affiliates is permitted to make
TREATMENT
OrthoPop Inc. will use and disclose your protected health information to provide, coordinate or manage your healthcare and any related services. This includes the coordination or management of your healthcare with another provider. For example, OrthoPop Inc. may disclose your protected health information to physicians or other healthcare providers who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. In addition, OrthoPop Inc. may disclose your protected health information from time to time to another physician or healthcare provider (e.g., specialist) who, at the request of your physician, becomes involved in your care by providing assistance with your healthcare diagnosis or treatment. As another example, a doctor treating you for a broken bone may need to know if you have diabetes, because diabetes may slow the healing process.
HEALTH INFORMATION EXCHANGE
OrthoPop Inc. may share information that we obtain or create about you with other healthcare providers or other healthcare entities, such as your health plan or health insurer, as permitted by law, through Health Information Exchanges (HIEs). For example, information about your past care and current conditions and medications can be available to us or to your non-OrthoPop Inc. primary care physician or hospital, if they participate in the HIE as well. Your hospital or healthcare provider may also participate in HIEs, including HIEs that allow your provider to share your information directly through our electronic record system. You may choose to opt out of HIEs by contacting the Health Information Management department at OrthoPop Inc.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE
Unless you indicate otherwise, OrthoPop Inc. may disclose to a relative, a close friend or any other person you identify, the portion of your protected health information which directly relates to that person’s involvement in your healthcare or payment for your healthcare. If you are unable to agree or object to such a disclosure, OrthoPop Inc. may disclose such information as necessary for your healthcare or payment for your healthcare, if, based on our professional judgment, OrthoPop Inc. determines that it is in your best interest. OrthoPop Inc. may disclose protected health information to notify or assist in notifying a family member or personal representative (or any other person who is responsible for your care) of your location, general condition or death. Finally, OrthoPop Inc. may disclose your protected health information to an authorized public or private entity to assist in disaster-relief efforts. OrthoPop Inc. may disclose your protected health information to a sponsor of a self-funded group health plan—such as an employer or other entity—that is providing a healthcare program to you, for plan administration purposes (e.g., claims management, appeal decisions, review). Additionally, if your company’s group health plan contracts with OrthoPop Inc. to provide coverage for its employees, then we may provide your company with summary health information for premium billing purposes, modifying or terminating the plan, or to perform enrollment and disenrollment activities.
GENETIC INFORMATION
OrthoPop Inc. is prohibited from using or disclosing genetic information for health plan insurance coverage underwriting purposes and employment purposes. Underwriting involves whether a health plan gives you coverage and the price of the coverage.
TO AVERT A SERIOUS THREAT TO HEALTH OR SAFETY
OrthoPop Inc. may use and disclose protected health information about you when necessary to prevent a serious threat to your health and safety, or the health and safety of another person or the public. However, any disclosure would only be to someone who is able to help prevent the threat.
WORKERS’ COMPENSATION
OrthoPop Inc. may release protected health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
PUBLIC HEALTH RISKS AND PATIENT SAFETY ISSUES
OrthoPop Inc. may disclose protected health information about you for public health activities and purposes to a public health authority that is permitted by law to receive the information. For example, disclosures may be made for the purposes of preventing or controlling disease, injury or disability; to report deaths; to report reactions to medications or problems with products; and to notify people of recalls of products that they may be using.
COMMUNICABLE DISEASES
OrthoPop Inc. may disclose or use your protected health information to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and to comply with state-mandatory disease reporting, such as cancer registries.
ABUSE OR NEGLECT
OrthoPop Inc. may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the healthcare system, the health insurance system, government benefit programs and compliance with civil rights laws. OrthoPop Inc. may disclose your protected health information to a public health authority authorized by law to receive reports of child abuse or neglect, and to notify the appropriate government authority if OrthoPop Inc. believes a patient has been the victim of abuse, neglect or domestic violence under certain circumstances. OrthoPop Inc. will only make this disclosure when required or authorized by law.
LEGAL PROCEEDINGS
OrthoPop Inc. may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized) or, in certain conditions, in response to a subpoena, discovery request or other lawful process.
LAW ENFORCEMENT
OrthoPop Inc. may disclose protected health information for certain law-enforcement purposes as authorized or required by law, such as: in response to a court order, subpoena, warrant, summons or similar process; to identify or locate a suspect, fugitive, material witness or missing person; about the victim of a crime, if under certain limited circumstances, we are unable to obtain the person’s agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at the location of a OrthoPop Inc. entity; and, when responding to an emergency or a location other than a OrthoPop Inc. entity, to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
CORONERS, EXAMINERS AND FUNERAL DIRECTORS
OrthoPop Inc. may release protected health information to a coroner or examiner, for example, to identify a deceased person or determine the cause of death. We may also release protected health information about patients to funeral directors as necessary to carry out their duties.
MILITARY ACTIVITY AND NATIONAL SECURITY
OrthoPop Inc. may use or disclose the protected health information of individuals who are armed forces personnel for activities deemed necessary by appropriate military-command authorities when we are authorized by law to do so, including disclosures to foreign military authorities when permitted by law. We may also disclose your protected health information 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.
REQUIRED BY LAW
OrthoPop Inc. may use or disclose your protected health information to the extent that such use or disclosure is permitted or required by law and the use or disclosure complies with and is limited to the relevant requirements of such law.
RIGHT TO AN ACCOUNTING OF DISCLOSURES
You have the right to request an accounting of disclosures we have made of your protected health information. This list will not include every disclosure made, including those disclosures made for treatment, payment, healthcare operations or disclosures you authorized in writing. To request an accounting of disclosures, include the specific time period desired and submit your request in writing to the Health Information Manager at OrthoPop Inc. will not list disclosures made earlier than six years before your request. The first accounting of disclosure to you in any 12-month period is free. Additional accounting of disclosures requested by the same individual within the 12-month period may cost a fee; you will be notified in advance of any cost involved so that you may choose to withdraw or modify your request before incurring a cost.
RIGHT TO REQUEST RESTRICTIONS
You have the right to request a restriction on the ways your protected health information is used or disclosed to carry out treatment, payment or healthcare operations. To request a restriction, submit your request in writing to the Health Information Manager at OrthoPop Inc. The request should include what information you want to limit, whether you want to limit use or disclosure, or both, and to whom you want the limits to apply—for example, disclosures to your spouse. OrthoPop Inc. is not required to agree to your request. If we do agree, we will comply with your restriction unless the information is needed to provide emergency treatment. OrthoPop Inc. will agree to restrict disclosures of your health information to your health insurance plan for payment and healthcare operations purposes (not for treatment) if the disclosure pertains solely to a healthcare item or service for which you paid in full.
RIGHT TO REQUEST CONFIDENTIAL COMMUNICATION
You have the right to request that OrthoPop Inc. communicate with you about healthcare matters in a certain way or at a certain location. For example, you can request that you are only contacted at work or at a specific address. Such requests should be made in writing to the Health Information Manager at OrthoPop Inc. and should specify how or where you wish to be contacted. OrthoPop Inc. will accommodate all reasonable requests.
RIGHT TO A PAPER COPY OF THIS NOTICE
You have the right to a paper copy of this Notice of Privacy Practices, even if you have agreed to receive this Notice electronically. You may ask us to give you a copy of this Notice at any time. Copies of this Notice will be available throughout OrthoPop Inc., or by contacting the Health Information Management department at OrthoPop Inc. You may also find an electronic copy of this Notice on the OrthoPop Inc. website.
OTHER USES OF PROTECTED HEALTH INFORMATION
Other uses and disclosures of your protected health information not covered by this Notice or allowed by law will be made only with your written permission. If you provide permission to use or disclose protected health information, you may revoke that permission, in writing, at any time. If you revoke your permission, OrthoPop Inc. will no longer use or disclose protected health information about you for the reasons covered by your written authorization. OrthoPop Inc. is unable to take back any disclosures it may have already made with your permission.
USE OF UNSECURE ELECTRONIC COMMUNICATIONS
If you choose to communicate with us or any of your OrthoPop Inc. providers via unsecure electronic communication, such as regular email or text message, we may respond to you in the same manner in which the communication was received and to the same email address or account from which you sent your original communication. Before using any unsecure electronic communication to correspond with us, note that there are certain risks, such as interception by others, misaddressed/ misdirected messages, shared accounts, messages forwarded to others or messages stored on unsecured, portable electronic devices. By choosing to correspond with us via unsecure electronic communication, you are acknowledging and agreeing to accept these risks. Additionally, you should understand that use of email is not intended to be a substitute for professional advice, diagnosis or treatment. Email communications should never be used in an emergency. We recommend that you use the patient portal for secure electronic communications with myiuhealth.org. When you visit and use our websites or use certain of our online services, we may collect and share other digital data and personal information not covered by this Notice of Privacy Practices, including through the use of cookies and other similar website tracking technologies (such as, for example, your internet protocol address automatically assigned to your computer by your internet service provider, device operating system, device information, browser type and language, and referring URLs). This collection and sharing is governed by our OrthoPop Inc. website privacy policy and not this Notice. You should review the terms contained on our website privacy policy for detailed information on the type of cookies and other technologies we use, what information we collect, the reasons why we use these technologies, as well as the terms associated with using our websites and online services.
CHANGES TO THIS PRIVACY NOTICE
OrthoPop Inc. reserves the right to change this Notice and to make the revised or changed Notice effective for protected health information we already have about you, as well as any information we receive in the future. The revised Notice of Privacy Practices will be posted on the OrthoPop Inc. website or mailed to you. In addition, at any time you may request a copy of the Notice currently in effect.
QUESTIONS OR COMPLAINTS
If you believe OrthoPop Inc. has violated your privacy rights, you may file a complaint with us. Please send any complaint to the OrthoPop Inc. Privacy Office at the address, email or telephone number provided below. You may also file a complaint with the secretary of the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint. If you have questions about this Notice of Privacy Practices, contact the OrthoPop Inc. Privacy Office at 317.402.2808.
NOTICE OF NONDISCRIMINATION
OrthoPop Inc. does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status, or any other characteristic protected by federal, state or local law.