Privacy Notice

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Privacy Policy

HIPAA (Healthcare Information Portability & Accountability Act) states that medical information that is confidential must be protected from inappropriate dissemination.  This policy defines our Practice policy on when it is appropriate to share your PHI (Personal Health Information).

We require you to fill out forms that specifically designate who may receive your health information.

Practice Disclosure

The practice may use and disclose your PHI for specific reasons.  The following are examples of the reasons for this:

  • For Health Care Quality- To make sure that we are providing appropriate care your information may be used to evaluate our process or our providers
  • For Payment- We will send your PHI to your designated third party payor
  • For Care- We release your healthcare information to any provider that is directly involved in your care

When Authorization Is Not Required To Disclose

The Practice may be required to disclose your information without your authorization.  Some examples are:

  • De-identified information- your medical information is stripped of any identifiers that can be traced to you
  • Business Associates- the Practice contracts with someone (i.e. Billing services, On-call provider)
  • Public Health Activities- Government
  • Food & Drug Administration- Government
  • Health Oversight- Government
  • Law Enforcement- Government
  • Coroner or Medical Examiner- in case of your death for identification purposes
  • Organ, eye or Tissue donation- if you are a donor
  • National Security & Intelligence activities – Government
  • Workers Compensation
  • Judicial Enforcement- Government

Appointment Reminder

You will be contacted by phone or mail to remind you of an upcoming appointment 48 hours prior.

On-Call Coverage

In order to provide on-call coverage for you, it is necessary that the Practice establish relationships with other physicians who will take your call if a physician from the Practice is not available.  Those on-call physicians will provide the Practice with whatever PHI they create and will keep your PHI confidential.

Family & Friends Involved In Your Care

The Practice may disclose to your family member, other relative or a close personal friend or any other person identified by you or your PHI directly relevant to such person’s involvement with your care.  The Practice may also use or disclose your PHI to notify or assist in the notification of a family member, a personal representative or a person responsible for your care, of your location, general condition or death.

Your Rights

You have the right to:

  • Revoke any authorizations, in writing, at any time.  This must be submitted to the Practice’s Privacy Officer.
  • Request restrictions for use and disclosure of your PHI (as long as this is legal and does not prevent the office from providing information for your emergency care)
  • Contact the Privacy Officer in order to find out about your rights.
  • Complain to the Privacy Officer, by submitting your complaints in writing.  Or submit your complaints in writing to the Secretary of Health and Human Services.
  • Receive an accounting of the disclosures of your PHI.  Your first request is free.  Subsequent requests for the same time period will have a fee assessed.
  • Receive a paper copy of this policy, by submitting a request in writing to the Privacy Officer.
  • Request an amendment to your PHI.  This must include the reasons for your request.  It is up to the Practice to decide if the amendment will be done.  If you disagree with the decision you may file a letter of disagreement with the Privacy Officer.

Practice Obligations

Required by law to maintain the privacy of your PHI and to provide you with this Privacy Notice
Reserves the right to change the terms of this Privacy Notice.
Must make a good faith effort to provide you with this notice.
Will post this privacy notice on the Website for Pinnacle Orthopedic & Spine Specialists

Effective date 6/30/2008