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Notice of Privacy Practices
 
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN HAVE ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.
 
Effective Date:           April 14, 2003
 
Purpose: Federal law requires Orthopaedic Associates of Wausau, SC (OAW) to inform its patients about the ways that the clinic may use and disclose your protected health information. In addition, federal law requires Orthopaedic Associates of Wausau, SC to inform patients of your rights regarding disclosures of your health information. 
 
It is the policy of Orthopaedic Associates of Wausau, SC to keep medical information confidential and not disclose patient protected health information without your consent, authorization or as specifically allowed by the federal privacy law or other federal or state law as described in this notice. We are required to abide by the terms of our Privacy Notice that is currently in effect.
 
All Orthopaedic Associates of Wausau, SC patients have a right to read this notice. Any question about the clinic’s privacy practices or questions you may have regarding possible violations of your privacy may be directed to Orthopaedic Associates of Wausau, SC clinic Privacy Officer. To facilitate complaints, Orthopaedic Associates of Wausau, SC requests that you use our complaint form available at the clinic Reception desk. This form will be sent to "Orthopaedic Associates of Wausau, SC, Attention - Privacy Officer” who will address any concerns. No patient will be retaliated against for filing a complaint.
 
All forms and policies referred to in this document are available to you through Orthopaedic Associates of Wausau, SC Privacy Officer.
 
The Orthopaedic Associates of Wausau, SC Privacy Officer can be reached at:
Orthopaedic Associates of Wausau, SC
Attn: Privacy Officer
3200 Westhill Dr Suite 201
Wausau WI 54401-4707
715-847-2382
 
In addition to filing a complaint at Orthopaedic Associates of Wausau, SC, any patient may also contact the federal government directly, specifically the Department of Health and Human Services at the contact information below:
 
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775                
Email:
hhsmail@os.dhhs.gov
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
 
Orthopaedic Associates of Wausau, SC may use and disclose protected health care information without your consent or authorization only in certain circumstances. For purposes of treatment, payment and health care operations, the clinic may make use of or disclose your information once you have signed our Consent to Use Protected Health Information form. State and federal law allow Orthopaedic Associates of Wausau, SC to use/disclose your protected health information in other defined circumstances as well. Except in treatment circumstances, Orthopaedic Associates of Wausau, SC will make efforts to limit the information used or disclosed to that which is minimally necessary. Following are a listing of these circumstances and examples of uses and disclosures to assist your understanding of our privacy practices.
 
1.                  Treatment: Once you sign a consent, Orthopaedic Associates of Wausau, SC will use your protected health information in order to treat you in the clinic, to facilitate appropriate transfer of information to consulting specialists or referral center of health care (e.g., the hospital or surgical centers), and to ensure continuity of care and coordinate your health care through case management.
 
Examples could be:
Orthopaedic Associates of Wausau, SC doctors and nursing staff will need to access your health information regarding medications and ongoing medical problems to best manage your care at Orthopaedic Associates of Wausau, SC.
 
We may need to send selective information to specialists. For example, we might send EKG results to a cardiologist to consult with him or her before surgery.
 
To ensure optimal continuity of care, Orthopaedic Associates of Wausau, SC will send pertinent copies of X-rays and labs to a hospital or a doctor we refer you to so as to avoid repeating tests and to prepare the health care providers at the hospital for your arrival.
 
2.                  Payment: Orthopaedic Associates of Wausau, SC will use and disclose your health information to send bills and to collect payment from you, your insurance company and other third-parties for services you have received at Orthopaedic Associates of Wausau, SC.
 
Examples include sending health information about dates of service and type of service/procedures performed to your health insurance company in order to receive reimbursement. In addition, some health insurance companies require pre- certification for some procedures. Orthopaedic Associates of Wausau, SC may have to disclose the type of procedure to be performed and the diagnosis justifying the procedure.
 
3.                  Health Care Operations: In order to ensure quality care for our patients, Orthopaedic Associates of Wausau, SC engages in numerous health care operations. These health care operations include, but are not limited to:
·         Care management and case coordination
·         Guideline and protocol development
·         Administrative and business management activities
·         Business planning and development
·         Training, accreditation, certification, licensing or credentialing
·         Health care improvement and quality management programs
·         Health care cost-reduction programs
·         Staff competence and provider reviews
·         Legal and accounting services
·         Medical review and auditing
·         Investigating and resolving internal grievances
 
Some specific examples of how Orthopaedic Associates of Wausau, SC would use your protected health information in its health care operations include the following:
 
·         Removal of personal identifying information from your record so that it can be used to help evaluate guideline use for chronic health problems like back pain, depression, asthma or arthritis.
·         Evaluation of medications you have been issued from a pharmacy to decide which medications are most cost effective.
·         Conducting patient satisfaction surveys. Orthopaedic Associates of Wausau, SC may reference your chart if you comment in the survey that you were not satisfied with the care you received if your survey indicated your name for identification.
·         Presenting patient cases to national review and certification boards as part of ongoing training. If your information is used in a case presentation it would be de-identified (patient name and any identifiers eliminated).
·         Using and disclosing your medical information to recommend treatment options that may be of interest to you.
 
4.                  Federal, State or Local Law: Orthopaedic Associates of Wausau, SC will disclose your protected health information when required to do so by state, federal or local law.
 
For example: Orthopaedic Associates of Wausau, SC will report gunshot wound information and information about suspicious burns to the local police or sheriff.
 
5.                  Public Health Policy: Orthopaedic Associates of Wausau, SC will disclose your health information to public health departments and agencies if required to do so by law.
 
For example: diseases such as hepatitis, TB and certain sexually transmitted diseases are reported to public health departments. Additionally, some adverse side effects are reported to the FDA.
 
6.                  Organ and tissue donation: If needed, Orthopaedic Associates of Wausau, SC may disclose protected health information to relevant organization to facilitate organ and tissue donation and transplantation.
 
7.                  Research: Orthopaedic Associates of Wausau, SC may, at times participates in research studies for new treatments and would share protected health information with the research organization. In these circumstances, any Orthopaedic Associates of Wausau, SC patients participating in the research study would sign a separate consent to be in the study and to share specific health information. If a patient did not want to participate in the study, their wishes will be respected. 
 
8.                  Circumstances of Serious and Imminent Threat to Health or Safety: If there is a serious and imminent threat to your health or safety or the health or safety of the public or another person, Orthopaedic Associates of Wausau, SC may disclose your protected health information.
 
9.                  Victims of Abuse or Neglect: Orthopaedic Associates of Wausau, SC will notify the appropriate government authority if Orthopaedic Associates of Wausau, SC believes a patient has been the victim of abuse or neglect.
 
For example: Orthopaedic Associates of Wausau, SC will contact Child Protective Services in cases of suspected or alleged child abuse.
 
10.              Coroners and Medical Examiners: Orthopaedic Associates of Wausau, SC may disclose information to a coroner or medical examiner to assist with determining the cause of a death.
 
For example: if a patient dies and their death is investigated by the medical examiner, the medical examiner may contact Orthopaedic Associates of Wausau, SC to determine what health problems the patient may have had and what medications the patient was taking prior to his/her death.
 
11.              Health Oversight Activities: Orthopaedic Associates of Wausau, SC may disclose protected health information to certain health oversight activities authorized by law including audits, investigations, accreditations, licensure or disciplinary activities. 
 
For example, the Department of Health and Human Services is authorized to access protected health information to investigate violations of the HIPAA Privacy Rule.
 
12.              Worker’s Compensation: Orthopaedic Associates of Wausau, SC may disclose your medical records to worker’s compensation departments for the benefit of treatment and case management of work-related injuries.
 
For example: If you injure your knee at work, Orthopaedic Associates of Wausau, SC may release recommendations on your diagnosis, treatment, work modification/time off and expected length of illness to the worker’s compensation department of your employer or your Workers Comp insurance carrier.      
 
13.              Government Functions: In some circumstances, Orthopaedic Associates of Wausau, SC can disclose your protected health information for specific government activities. Examples of these include:
 
·         Inmates and Law Enforcement Custody: If you are an inmate, Orthopaedic Associates of Wausau, SC may disclose medical information to the correctional institute or law enforcement as necessary.
·         Medical Suitability Determinations: Orthopaedic Associates of Wausau, SC may disclose your protected health information to the Department of State for use in making medical suitability determinations.
·         Military and Veterans: If you are a member of the armed forces, Orthopaedic Associates of Wausau, SC may disclose your protected health information to the government to facilitate military missions.
·         National Security and Intelligence: If authorized by law, Orthopaedic Associates of Wausau, SC may disclose your protected health information for intelligence, counter-terrorism and national security activities.
·         Protective Services for the President and Others: In order to provide protection to the president or foreign heads of state, Orthopaedic Associates of Wausau, SC may need to disclose your protected health information, only if authorized by law.
 
14.              Judicial Proceedings: Orthopaedic Associates of Wausau, SC may release protected health information in response to a court order.
 
Examples include:
·         In response to a subpoena, court order, warrant or summons.
·         Identification or location procedures of suspects, fugitives, material witnesses or missing persons.
·         Release of information concerning the victim of a crime (only in circumstances where efforts have been made to inform you about the request or efforts have been made to protect the information requested).
·         Information about a death Orthopaedic Associates of Wausau, SC believes may be the result of criminal activity.
·         Information about criminal activities that occur at Orthopaedic Associates of Wausau, SC.
·         In emergency circumstances to report a crime, the location of a crime or victims, or the identity, description or location of the person who committed the crime.
 
15.              Disclosures for purposes of quality, safety and effectiveness about FDA regulated products.
Examples include:
·         Reports of adverse drug effects
·         To enable product recalls
DISCLOSURES THAT YOU MAY OBJECT TO:
Unless you object, Orthopaedic Associates of Wausau, SC may also use or disclose limited medical information in the following situations:
 
1.                  Orthopaedic Associates of Wausau, SC may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.
2.                  Orthopaedic Associates of Wausau, SC currently does not use your health information for fundraising purposes. If Orthopaedic Associates of Wausau, SC chooses to use your information for fundraising, Orthopaedic Associates of Wausau, SC would need to get your approval for this disclosure prior to any release of information.
3.                  Orthopaedic Associates of Wausau, SC currently does not use your information for external marketing purposes and will not use any health information for marketing unless you have given specific consent for this disclosure. Please see the Marketing Policy for full details.
4.                  Orthopaedic Associates of Wausau, SC will release medical information to a family member or friend regarding your condition only as you specifically designate and have consented to by completing the required disclosure forms. This is fully detailed in the Facility Directory Policy.
 
Any other uses or disclosures will be made only with your written authorization and you may revoke this authorization in writing at any time. Orthopaedic Associates of Wausau, SC requests that you use our Authorization for Release of Medical Information and our Revocation of Authorization to Release Medical Information forms for these purposes.
 
Patient Rights Regarding Protected Health Information
 
As a patient, you have numerous rights regarding how your protected health information is used. Your rights include the following:
1.                  You have a right to request that we restrict our uses and disclosures of protected health information.
For example: Orthopaedic Associates of Wausau, SCwill permit a patient to
request that it restrict uses or disclosures of protected health information about the
patient to carry out treatment, payment or health care operations; disclosures of
protected health information directly relevant to the involvement of a family
member, personal representative or another person responsible for the care of the
patient; or to entities involved in disaster relief purposes. The circumstances in
which you can request restrictions are detailed in the Policy for Requesting
Restrictions of Protected Health Care Information. It is important to understand
that Orthopaedic Associates of Wausau, SCis not required to agree to requests for
restrictions.
 
2.                  You have a right to receive communications that contain protected health information at alternative locations or by alternative means.
For example: patients may request that Orthopaedic Associates of Wausau, SC
contact them at work for appointment reminders rather than at home provided that
the patient provides Orthopaedic Associates of Wausau, SC with his or her work
contact number. However, Orthopaedic Associates of Wausau, SC will not honor
a request for alternative contact methods unless the patient provides sufficient
alternative address or contact information. These are detailed in the Policy for
Requesting Restrictions of Protected Health Care Information.
 
3.                  You have the right to inspect and copy your protected health information. Orthopaedic Associates of Wausau, SC requests that you use the Authorization for Release of Medical Information form when exercising this right. Orthopaedic Associates of Wausau, SC may charge a reasonable fee for the costs of copying, mailing or preparing summary information that responds to your request. You should know that in certain limited circumstances, the law allows Orthopaedic Associates of Wausau, SC to deny your request to inspect and copy your records. The full policy and procedures regarding this are detailed in the Policy on Individual Access to Protected Health Information.
 
4.                  You have the right to have changes made to your protected health information if you feel it is inaccurate. Orthopaedic Associates of Wausau, SC requests that you use our Request for Amendment of Health Informationform to request these changes. The clinic will review your request and make the changes if we believe they are appropriate. Orthopaedic Associates of Wausau, SC will also distribute these changes to health care providers that you ask be made aware of the change or to others we believe should know of the change. Under some circumstances, Orthopaedic Associates of Wausau, SC may deny your request for an amendment to your protected health information. Orthopaedic Associates of Wausau, SC will provide a written response to your request for an amendment and in this response will provide detailed information on how you may review the changes or appeal the denial. Your right to amend health care information is fully detailed in the Patient Request to Amend Medical Records Policy.
 
5.                  You have a right to receive an accounting of our disclosures of your protected health information by Orthopaedic Associates of Wausau, SC. This accounting will not include disclosures of your health information made for treatment, payment or health care operations. Orthopaedic Associates of Wausau, SC requests that you use the Request for Accounting of Protected Health Informationform to receive this log. Your request must specify a time period for the accounting, which may be no longer than six years. Orthopaedic Associates of Wausau, SC will provide the first accounting to you in any 12-month period free-of-charge. After this, Orthopaedic Associates of Wausau, SC may charge a fee but we will notify you of the fee before we process the request. You have the right to withdraw your request once you have learned that your request will require you to pay a fee. The full details of our policy and procedures for receiving a log of disclosures of your protected health information and the circumstances in which disclosures will not be provided in the accounting is described in the Policy on Accounting of Disclosures of Protected Health Information.
6.                  You have a right to receive a paper copy of this Privacy Notice at any time. If you have received an electronic version of this Privacy Notice you may also request a paper copy. Paper copies are available through written request made to:
 
Orthopaedic Associates of Wausau, SC
Attn.: Privacy Officer
3200 Westhill Drive Suite 201
Wausau WI 54401-4707
 
Distribution and Revision of the Privacy Notice
 
Orthopaedic Associates of Wausau, SC is required by federal law to maintain the privacy of protected health information and to provide patients with notice of its legal duties and to abide by the terms of this Privacy Notice. Orthopaedic Associates of Wausau, SC will distribute this privacy notice to all clinic patients who will be seen on or after the effective date. The clinic will post the notice in a clear and prominent location in all of its clinics and on its web site. Orthopaedic Associates of Wausau, SC will provide the Privacy Notice via e-mail to any requesting patient who agrees to an electronic notice. Orthopaedic Associates of Wausau, SC patients may, at any point, withdraw their agreement to an electronic Privacy Notice. Any patient who receives an electronic Privacy Notice may also obtain a paper copy if requested.
 
Orthopaedic Associates of Wausau, SC will also make efforts to obtain written acknowledgement that patients have received and reviewed the Privacy Notice.
 
Orthopaedic Associates of Wausau, SC is allowed to make revisions to the Privacy Notice. If revisions are made, the notice of these revisions will be distributed to current patients of Orthopaedic Associates of Wausau, SC within 60 days of a revision as well as information on how to obtain a copy of the revised Privacy Notice.
 
Other:
All forms and policies referred to in this Privacy Notice are available for you through the Orthopaedic Associates of Wausau, SC Privacy Officer.