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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAYBE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Bone and Joint Clinic of Houston, P.A. (the “Health Care Provider”) provides orthopedic services and services ancillary thereto to its patients. Federal and state law require that health care providers protect the privacy of your medical information, which includes, but may not be limited to, information that identifies you and relates to your past, present or future health or condition, the provision of health care to you, or the payment for health care received by you. If state law affords greater protection for your medical information than federal law, Health Care Provider is required to follow the state law regarding the use and disclosure of that medical information. The Health Care Provider may hire other companies (“Business Associates”) to help provide healthcare services to you. These Business Associates may also receive and maintain your medical information.

THIS PROTECTION IS AUTOMATIC. YOU DO NOT NEED TO DO ANYTHING TO GET PRIVACY PROTECTION FOR YOUR MEDICAL INFORMATION.

Federal law requires that the Health Care Provider provide you with this Notice about its privacy practices and its legal duties regarding your medical information. This Notice explains how, when, and why the Health Care Provider uses and discloses your medical information. By law, the Health Care Provider must follow the privacy practices that are described in the current privacy notice.

The Health Care Provider may change its privacy practices and the terms of this Notice at any time. Changes will be effective for all of your medical information received or created by the Health Care Provider. If the Health Care Provider changes its policies regarding the protection of your medical information, the Health Care Provider will mail you a notice of privacy practices that incorporates any changes within 60 days.

HOW THE HEALTH CARE PROVIDER MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION.

Certain Uses and Disclosures Do Not Require Your Written Permission 

The Health Care Provider may use and disclose your medical information without your written permission for the following purposes:

For treatment: The Health Care Provider may disclose medical information the Health Care Provider has created or received for treatment purposes. For example, the Health Care Provider may disclose your medical information to your doctor or another doctor, at your doctor’s request, for your treatment.

To obtain payment for treatment: The Health Care Provider or one of its Business Associates may use or disclose your medical information to assist in the payment of claims for medical services provided to you or to provide eligibility information to your doctor when you receive medical treatment.

For health care operations: The Health Care Provider may provide your medical information to our accountants, attorneys, and others in other to make sure we are complying with federal and state law. For example, your medical information may be used or disclosed to access the quality of health care you receive, for activities relating to the creation, renewal, or replacement of health insurance coverage, or to assist the Health Care Provider in the management of its business and performance of administrative activities.

To you, your personal representative, or others involved in your healthcare: The Health Care Provider may provide your medical information to you and your legal representative. The Health Care provider may also provide your medical information to a person, including family members, other relatives, friends, or others identified by you and acting on your behalf, so long as you do not object and the information is directly relevant to such person’s involvement in your health care. For this purpose, a person acts on your behalf by being involved in the provision and/or payment of your healthcare.

When a disclosure is required by law: The Health Care Provider may use or disclose your medical information when required by law. For example, the Health Care Provider may disclose your medical information to comply with worker’s compensation or other similar laws.

To Business Association: The Health Care Provider has contracts with Business Associates that help the Health Care Provider in its business of providing health care. The Health Care Provider may disclose your medical information to its Business Associates so that they may perform the services that the Health Care Provider has asked them to perform. To protect your health information, however, the Health Care Provider requires that these companies follow the same rules that are set out in this Notice.

For health-related benefits: The Health Care Provider or one of its Business Associates may contact you to provide appointment reminders. They may also contact you to give you information about treatment alternatives or other health benefits or services that may be of interest to you.

For other uses and disclosures permitted by law such as:

  • To public health authorities for public health purposes (i.e., the reporting of communicable diseases);
  • To state agencies handling cases of abuse, neglect, or domestic violence;
  • To a government agency authorized to oversee the health care system or government programs (i.e., determining eligibility for public benefits);
  • To comply with legal proceedings, such as a court or administrative order or a subpoena;
  • To law enforcement officials for limited law enforcement purposes (i.e., to locate a missing person or suspect);
  • To a coroner, medical examiner, or funeral director about a deceased person (i.e., to identify a person);
  • To an organ procurement organization in limited circumstances;
  • For research purposes in limited circumstances (i.e., if identifying information is removed or a research board has approved the use of the information);
  • To avert a serious threat to your health or safety or the health or safety of others;
  • To military authorities if you are a member of the armed forces or a veteran of the armed forces;
  • To federal officials for lawful intelligence, counterintelligence, and other national security purposes;
  • To an executor or administrator of your estate; and
  • To any other persons and/or entities authorized under law to receive medical information.

All Other Uses and Disclosures Require Your Prior Written Permission 

For any other use or disclosure of your medical information, the Health Care Provider must have your written permission. You may cancel your written permission for the use and disclosure of any or all of your medical information, unless the Health Care Provider has taken action in reliance on your permission.

YOUR RIGHTS

  • Add additional limitations or restrictions on certain uses and disclosures of your medical information;
  • Choose how the health care provider sends medical information to you;
  • With a few exceptions, see and get copies of your medical information;
  • Get a list of certain uses and disclosures of your medical information by the health care provider;
  • Get a copy of this notice; and
  • File a complaint if you think the health care provider has violated your privacy rights concerning your medical information.

Although the health care provider will utilize its best efforts to comply with your request, the health care provider may legally deny your request in certain circumstances. The health care provider will notify you of the reason for the denial and you will get a chance to respond. The health care provider may not deny a request to communicate with you in confidence by a different means or location if the current means or location used by the health care provider endangers you. The health care provider may, however, request payment for any additional expenses it incurs to comply with your request. Your request to communicate by a different means or location must be in writing, include a statement that disclosure of all or part of the health information by the current means could endanger you, specifically state the different means or location by which you would like the health care provider to communicate with you, and continue to allow the health care provider to collect premiums and pay claims.

COMPLAINTS 

If you feel as if your privacy rights have been violated, you may file a written complaint to:                   

Privacy Officer
6624 Fannin St., 26th Floor
Houston, TX 77030
(713) 790-1818

You may also send a written or electronic complaint to the Secretary of the United States Department of Health and Human Services. The complaint must state the name of the entity that is the subject of the complaint and describe the act or omissions believed to be in violation of law. A complaint must be filed within 180 days of when you knew or should have known that the act or omission complained of occurred. The health care provider may not retaliate against you if you file a complaint.

MORE INFORMATION

If you would like more information about this privacy notice, please contact the privacy office at (713) 790-1818

EFFECTIVE DATE OF THIS NOTICE

This notice will go into effect on April 14, 2003.