ONE Policies

Privacy Policy

Ortho NorthEast
HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003, Revised Date: November 2011

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.

If you have any questions about this notice, please contact Pat Weicker at (260) 484-8551 ext. 2308.
WHO WILL FOLLOW THIS NOTICE.
This notice describes Orthopaedics Northeast’s (ONE) Policies and Procedures for HIPAA Privacy Compliance and that of:
  • Any health care professional authorized to enter information into your medical record.
  • All departments and units of the practice.
  • Any member of a volunteer group we allow to help you while you are in the practice.
  • All employees, staff and other practice personnel.
  • All ONE entities, sites and locations shall follow the terms of this notice.  In addition, these entities, sites and locations may share medical information with each other for treatment, payment or hospital operations purposes described in this notice.

OUR PLEDGE REGARDING MEDICAL INFORMATION:
ONE understands that medical information about you and your health is personal.  ONE is committed to protecting medical information about you.  ONE creates a record of the care and services you receive at the practice.  We need this record to provide you with quality care and to comply with certain legal requirements.  This notice applies to all of the records of your care generated by the practice, whether made by practice personnel or your personal doctor.  This notice will tell you about the ways in which we may use and disclose medical information about you.  We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
  • make sure that medical information that identifies you is kept private; 
  • give you this notice of our legal duties and privacy practices with respect to medical information about you; and
  • follow the terms of the notice that is currently in effect.

HOW ONE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.
The following categories describe different ways that ONE may use and disclose medical information.  For each category of uses or disclosures we will explain what we mean.  Not every use or disclosure in a category will be listed.  However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
For Treatment.  ONE may use medical information about you to provide you with medical treatment or services.  ONE may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in your care at the practice. Different departments of the practice also may share medical information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays.  We may also disclose medical information about you to people outside the practice who may be involved in your medical care after you leave the practice, such as family members, clergy or others we use to provide services that are part of your care. An example would be sending medical information to a provider outside our practice to coordinate your care for other health care needs, such as physical therapy. In the course of your treatment at ONE, verbal communications between ONE staff members and others related to your healthcare may be overheard by non-staff members in our office.  ONE will make their best efforts to keep your health information as private as possible.
For Payment.  ONE may use and disclose medical information about you so the treatment and services you receive at the practice may be billed to and payment may be collected from you, an insurance company or a third party.  For example, we may need to give your health plan (insurance company) information about treatment you received at our practice to receive payment for the treatment.  We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
For Health Care Operations.  ONE may use and disclose medical information about you for practice operations.  These uses and disclosures are necessary to run the practice and make sure that all of our patients receive quality care.  For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also disclose information to doctors, nurses, technicians, medical students, and other practice personnel for review and learning purposes.  We may also combine the medical information we have with medical information from other physicians to compare how we are doing and see where we can make improvements in the care and services we offer.  We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.  ONE may have occasion to use your name as a part of the operational process of servicing our patients.  ONE staff will make their best effort to protect any information, written or verbal, from being seen or over heard.
Business Associates.  A “business associate” is not employed by ONE but, through a contractual agreement, performs services for ONE that may involve the use, access, or disclosure of your health information.  All business associates are held by the same standard of privacy and security as ONE.  An example of a business associate would be an outside claims auditor auditing ONE’s compliance against standard guidelines for documentation and billing.
Communications. Our professionals, using their best judgment, may disclose to a family member, close personal friend, or any other person you identify as involved in your health care, information relevant to that person’s involvement in your care or payment of your care. ONE may also disclose your condition to family or friends who accompany you to our offices.  Other communications may be may be a phone message to remind you of an appointment or to call our office.  Communications may include email to verify entrance or access to our secured “Patient Information Portal,” or to send other non-protected information to you such as information on products or services ONE offer’s that may be of interest to you.
Marketing.  For marketing activities the patient’s authorization may or may not be required.  An example of when an authorization is not required would be when ONE communicating with you about a service or product we offer that might be of benefit to you.  An example of when an authorization would be required is when ONE would want to send you information about services or products offered by someone other than ONE such as from a pharmaceutics company or durable medical equipment company.
Fundraising Activities.  ONE only would release contact information, such as your name, address and phone number and the dates you received treatment or services at the practice.  If you do not want the practice to contact you for fundraising efforts, you must notify, in writing, Pat Weicker at 5050 N. Clinton, Fort Wayne, IN 46825.
Research.  Under certain circumstances, ONE may use and disclose medical information about you for research purposes.  For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process.  This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients' need for privacy of their medical information.  Before we use or disclose medical information for research, the project will have been approved through this research approval process, but we may, however, disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the medical information they review does not leave the practice.  We will almost always ask for your specific permission if the researcher will have access to your name, address or other information that reveals who you are.
To Avert a Serious Threat to Health or Safety.  ONE may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.  Any disclosure, however, would only be to someone able to help prevent the threat.
Protective Services for the President, National Security and Intelligence Activities. ONE may disclose information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state to conduct special investigations, for intelligence, counter intelligence, and any other national security activities authorized by law.


SPECIAL SITUATIONS
Organ and Tissue Donation.  If you are an organ donor, ONE may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Military and Veterans.  If you are a member of the armed forces, ONE may release medical information about you as required by military command authorities.  We may release medical information about foreign military personnel to the appropriate foreign military authority.  We may use and disclose to components of the Department of Veterans Affairs medical information about you to determine whether you are eligible for certain benefits.
Workers' Compensation.  ONE may release medical information about you for workers' compensation or similar programs.  These programs provide benefits for work-related injuries or illness. Worker’s compensation claims allow for the employer to obtain our medical records related only to the claim the employer is responsible for without your authorization.
Public Health Risks.  ONE may disclose medical information about you for public health activities.  These activities generally include the following:
  • to prevent or control disease, injury or disability;
  • to report births and deaths;
  • to report child abuse or neglect;
  • to report reactions to medications or problems with products;
  • to notify people of recalls of products they may be using;
  • 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;
  • to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence.  We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities.  ONE may disclose medical information to a health oversight agency for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections, and licensure.  These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes.  If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order.  We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement.  ONE may release medical information if asked to do so by a law enforcement official:
  • 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 practice; and
  • In emergency circumstances 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, Medical Examiners and Funeral Directors.  ONE may release medical information to a coroner or medical examiner.  This may be necessary, for example, to identify a deceased person or determine the cause of death.
Inmates.  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.  This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.


YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy.  You have the right to inspect and copy medical information that may be used to make decisions about your care.  Usually, this includes medical and billing records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to make decisions about you, you may call our office at (260) 484-8551 and select the option “Release of Information.”  If you request a paper copy of your information, ONE may charge a cost based on IC 16-39-9-4 and 760 IAC 1-71-3.  You may also request an electronic copy of your records such as on a flash drive or disk.  The cost associated with electronic copies is based on the cost of the media used.
ONE may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to medical information, you may request that the denial be reviewed.  Another licensed health care professional chosen by the practice will review your request and the denial.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome of the review.
Right to Amend.  If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.  You have the right to request an amendment for as long as the information is was created by or for the practice.
To request an amendment, your request must be made in writing and submitted to our Privacy Officer, Pat Weicker at 5050 N. Clinton, Fort Wayne, IN 46825.  In addition, you must provide a reason that supports your request.
ONE may deny your request for an amendment if it is not in writing or does not include a reason to support the request.  In addition, we may deny your request if you ask us to amend information that:
  • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
  • Is not part of the medical information kept by or for the practice;
  • Is not part of the information which you would be permitted to inspect and copy; or
  • Is accurate and complete.
Right to an Accounting of Disclosures.  You have the right to request an "accounting of disclosures."  This is a list of the disclosures we made of medical information about you that is outside of for treatment, payment, or health care operations.
To request this list or accounting of disclosures, you must submit your request in writing to our Privacy Officer, Pat Weicker at 5050 N. Clinton, Fort Wayne, IN 46825.  Your request must state a time period which may not be longer than six years and may not include dates before April 16, 2003.  Your request should indicate in what form you want the accounting (for example, on paper, electronically).  The first list you request within a 12 month period will be free.  For additional lists, we may charge you for the costs of providing the list.  We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions.  You have the right to request a restriction or limitation on the medical 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 medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.  For example, you could ask that we not use or disclose information about a surgery you had to your spouse.  You also have the right to restrict us from ONE from submitting a claim to your insurance carrier for services you paid for out-of-pocket.
We are not required to agree to your request except for services paid out-of-pocket. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to our Privacy Officer, Pat Weicker at 5050 N. Clinton, Fort Wayne, IN 46825.  Your request must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications.  You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to our Privacy Officer, Pat Weicker at 5050 N. Clinton, Fort Wayne, IN 46825.  We will not ask you the reason for your request.  We will accommodate all reasonable requests.   Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice.  You have the right to a paper copy of this notice.  You may ask us to give you a copy of this notice at any time.  Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
To obtain a paper copy of this notice, ask at any of our locations.

CHANGES TO THIS NOTICE
ONE reserves the right to change this notice.  We reserve the right to make the revised or changed notice effective for medical 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 in the practice office.  The notice will contain on the first page, in the top right-hand corner, the effective date.  In addition, each time you register for treatment or health care services as an outpatient, we will offer you a copy of the current notice in effect.


COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with the our Privacy Officer, Pat Weicker at 5050 N. Clinton, Fort Wayne, IN 46825 or with the Office of Civil Rights.  All complaints must be submitted in writing.
You will not be penalized for filing a complaint.


OTHER USES OF MEDICAL INFORMATION.
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission.  If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.   You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.