Center
for Specialty Surgery
Notice of Privacy Practices for Protected Health Information
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!
Our office is permitted by federal privacy laws to make uses and disclosures
of your health information for purposes of treatment, payment, and health
care operations. Protected health information is the information we create
and obtain in providing our services to you. Such information may include
documenting your symptoms, examination and test results, diagnoses, treatment,
and applying for future care or treatment. It also includes billing documents
for those services.
- During the course of your treatment, the physician determines he/she
will need to consult with another specialist in the area. He/she will
share the information with such specialist and obtain his/her input.
- We submit requests for payment to your health insurance company. The
health insurance company or business associate helping us obtain payment
requests information from us regarding your medical care given. We will
provide information to them about you and the care given.
We may obtain services from business associates such as quality assessment,
quality improvement, outcome evaluation, protocol and clinical guidelines
development, training programs, credentialing, medical review, legal services,
and insurance. We will share information about you with such business
associates as necessary to obtain these services.
Your Health Information Rights
The health and billing records we maintain are the physical
property of the doctor’s office. You have the following rights with
respect to your Protected Health Information
1. Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office-we are not required to grant the request but we will comply with any request granted;
2. Obtain a paper copy of the Notice of Privacy Practices for Protected Health Information ("Notice") by making a request at our office;
3. Right to inspect and copy your health record and billing record-you may exercise this right by delivering a signed written request to our office; appeal a denial of access to your protected health information except in certain circumstances;
4. Right to request that your health care record be amended to correct incomplete or incorrect information by delivering a signed written request to our office (The physician or other health care provider is not required to make such amendments); you may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information;
5. Right to receive an accounting of disclosures of your health information as required to be maintained by law by delivering a signed written request to our office. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care;
6. Right to confidential communication by requesting that communication of your health information be made by alternative means or at an alternative location by delivering a signed written request to our office and, if you want to exercise any of the above rights, please contact our medical records department at 503.214.5203, during normal hours. She will provide you with assistance on the steps to take to exercise your rights.
Our Responsibilities
The office is required to:
- Maintain the privacy of your health information as required by law;
- Provide you with a notice as to our duties and privacy practices as
to the information we collect and maintain about you;
- Abide by the terms of this Notice;
- Notify you if we cannot accommodate a requested restriction or request;
and
- Accommodate your reasonable requests regarding methods to communicate
health information with you.
- Accommodate your request for an accounting of disclosures.
We reserve the right to amend, change, or eliminate provisions in our
privacy practices and access practices and to enact new provisions regarding
the protected health information we maintain. If our information practices
change, we will amend our Notice. You are entitled to receive a revised
copy of the Notice by calling and requesting a copy of our "Notice"
or by visiting our office and picking up a copy.
To Request Information or File a Complaint
If you have questions, would like additional information, or want to report
a problem regarding the handling of your information, you may contact
Tina Caster, CSS director at 503.906.4300. Additionally, if you believe
your privacy rights have been violated, you may file a written complaint
at our office by delivering the written complaint to Tina Caster.
You may also file a complaint by mailing it or e-mailing it to the Secretary
of Health and Human Services.
We cannot, and will not, require you to waive the right to file a complaint
with the Secretary of Health and Human Services (HHS) as a condition of
receiving treatment from the office.
- We cannot, and will not, retaliate against you for filing a complaint
with the Secretary of Health and Human Services.
Following is a List of Other Uses and Disclosures Allowed
by the Privacy Rule
Patient Contact
We may contact you to provide you with appointment reminders, with information
about treatment alternatives, or with information about other health-related
benefits and services that may be of interest to you. We may contact you
as part of a fund raising effort.
Notification
– Opportunity to Agree or Object
Unless you object we may use or disclose your protected health information
to notify, or assist in notifying, a family member, personal representative,
or other person responsible for your care, about your location, and about
your general condition, or your death.
Communication with Family - Using our best judgment, we may disclose to
a family member, other relative, close personal friend, or any other person
you identify, health information relevant to that person's involvement
in your care or in payment for such care if you do not object or in an
emergency.
We may use and disclose your protected health information to assist in
disaster relief efforts.
Opportunity to Agree or Object Not Required
PUBLIC
HEALTH ACTIVITIES
Controlling Disease - As required by law, we may disclose your
protected health information to public health or legal authorities charged
with preventing or controlling disease, injury, or disability.
Child Abuse & Neglect - We may disclose protected health information
to public authorities as allowed by law to report child abuse or neglect.
Food and Drug Administration (FDA) - We may disclose to the FDA
your protected health information relating to adverse events with respect
to food, supplements, products and product defects, or post-marketing
surveillance information to enable product recalls, repairs, or replacements.
VICTIMS
OF ABUSE, NEGLECT, OR DOMESTIC
VIOLENCE
We can disclose protected health information to governmental authorities
to the extent the disclosure is authorized by statute or regulation and
in the exercise of professional judgment the doctor believes the disclosure
is necessary to prevent serious harm to the individual or other potential
victim.
OVERSIGHT
AGENCIES
Federal law allows us to release your protected health information to
appropriate health oversight agencies or for health oversight activities
to include audits, civil, administrative or criminal investigations: inspections;
licensures or disciplinary actions, and for similar reasons related to
the administration of healthcare.
JUDICIAL/ADMINISTRATIVE
PROCEEDINGS
We may disclose your protected health information in the course of any
judicial or administrative proceeding as allowed or required by law, or
as directed by a proper court order or administrative tribunal, provided
that only the protected health information released is expressly authorized
by such order, or in response to a subpoena, discovery request or other
lawful process.
LAW
ENFORCEMENT
We may disclose your protected health information for law enforcement
purposes as required by law, such as when required by court order, including
laws that require reporting of certain types of wounds or other physical
injury.CORONERS, MEDICAL EXAMINERS AND FUNERAL DIRECTORS
We may disclose your protected health information to funeral directors
or coroners consistent with applicable law to allow them to carry out
their duties.
ORGAN
PROCUREMENT ORGANIZATIONS
Consistent with applicable law, we may disclose your protected health
information to organ procurement organizations or other entities engaged
in the procurement, banking, or transplantation of organs, eyes, or tissue
for the purpose of donation and transplant.
RESEARCH
We may disclose information to researchers when their research has been
approved by an institutional review board that has reviewed the research
proposal and established protocols to ensure the privacy of your protected
health information.
THREAT TO HEALTH AND SAFETY
To avert a serious threat to health or safety, we may disclose your protected
health information consistent with applicable law to prevent or lessen
a serious, imminent threat to the health or safety of a person or the
public.
FOR SPECIALIZED GOVERNMENTAL FUNCTIONS
We may disclose your protected health information for specialized government
functions as authorized by law such as to Armed Forces personnel, for
national security purposes, or to public assistance program personnel.
CORRECTIONAL INSTITUTIONS
If you are an inmate of a correctional institution, we may disclose to
the institution or it’s agents the protected health information necessary
for your health and the health and safety of other individuals.
WORKERS COMPENSATION
If you are seeking compensation through Workers Compensation, we may disclose
your protected health information to the extent necessary to comply with
laws relating to Workers Compensation.
Other Uses and Disclosures
- Other uses and disclosures besides those identified in this Notice will
be made only as otherwise authorized by law or with your written authorization
which you may revoke except to the extent information or action has already
been taken.
Website
- Our website also our Privacy Practices posted as well. Our website address
is http://www.css-oregon.com.