of Our Privacy Practices
January 8, 2007
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
GET ACCESS TO THIS INFORMATION
Please review the full Notice of Privacy
Practices (NPP), which is attached. If you have any questions about this notice, please contact our
offices at (478) 971-2282
WHO WILL FOLLOW THIS NOTICE
Kinnebrew Orthopedics & Sports Medicine
notice describes our privacy practices. All these entities, sites, and locations follow the terms
of this notice. In addition, these entities, sites, and locations may share health information with
each other for treatment, payment, or health care operations purposes described in this notice.
OUR PLEDGE REGARDING HEALTH INFORMATION:
We understand that health
information about and your health care is personal. We are committed to protecting health
information about you. We create a record of the care and services you receive from us. 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 this health care practice, whether
made by your personal doctor or others working in this office. This notice will tell you about the
ways in which we may use and disclose health information about you. We also describe your rights to
the health information we keep about you, and describe certain obligations we have regarding the
use of disclosure of your health information.
We are required by law to:
- Make sure that health information that identifies you is kept private;
- Give you this notice of your legal duties and privacy practices with respect to health
information about you; and
- Follow the terms of the notice that is currently in effect
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.
The following categories describe different ways that we use and disclose health information. By
coming for care, you give us the right to use your information for treatment, to get reimbursed for
your care, and to operate our organization.
There are also various other ways in which we may use or disclose your information:
- Appointment Reminders
- Health-Related Services and Treatment Alternatives
- To Allow Oversight of the Quality of the Healthcare We Provide
- To Allow Worker's Compensation Claims
- As Required by Subpoena in Lawsuits and Disputes
- Various Uses as Required by Law or to Avert a Serious Threat to Health or Safety
- The Full details for all these uses are contained in the full NPP.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU.
You have the following rights regarding health information we maintain about you:
- Right to Inspect and Copy
- Right to Amend
- Right to an Accounting of Disclosures
- Right to Request Restrictions
- Right to Request Confidential Communications
- Right to a Paper Copy of this Notice
Information on how to exercise these rights can be seen in the NPP or can be obtained from the
Privacy Officer at (478) 971-1153
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We
reserve the right to make the revised or changed notice effective for health 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 our facility. The notice will contain on the first page, in the right hand
corner, the effective date. In addition, each time you register for treatment or health care
services; we will offer you a copy of the current notice in effect.
If you believe your privacy rights have been violated, you may
file a complaint with is or with the Secretary of the Department of Health and Human Services. To
file a complaint with us, contact the Privacy Officer. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.
OTHER USES OF HEALTH INFORMATION.
Other uses and disclosures of health
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 with permission to use or disclose health 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 health 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