Privacy Policy
Foundation Surgery Affiliates
is committed to ensuring the privacy and security of protected health
information. Federal laws and regulations pertaining to the Health Insurance
Portability and Accountability Act (HIPAA) have established standards with
which health care organizations must comply to maintain the security and
confidentiality of protected health information (PHI). To support our
commitment to security of patient health information, all employees of
Foundation Surgery Affiliates will receive appropriate training as
required under 45 CFR 164.308.
The HIPAA Privacy Rule
regulates the use and disclosure of PHI by HIPAA covered entities. The Privacy
Rule defines PHI as all individually identifiable health information
transmitted or maintained in any format, including paper and electronic
records. The term "individually identifiable health information" means
information, including demographic information, collected from an individual
that: (1) is created or received by a health care provider, health plan,
employer, or health care clearinghouse; (2) relates to either the past,
present, or future physical or mental health or condition of an individual; the
provision of health care to an individual; or the past, present, or future
payment for the provision of health care to an individual; and (3) either
identifies the individual, or there is a reasonable basis to believe the
information can be used to identify the individual.
THIS NOTICE DESCRIBES HOW
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Introduction
At FOUNDATION SURGERY, we are
committed to treating and using protected health information about you
responsibly. This Notice of Health Information Practices describes the personal
information we collect, and how and when we use or disclose that information.
It also describes your rights as they relate to your protected health
information. This Notice is effective April 14, 2003 and applies to all
protected health information as defined by federal regulations.
Understanding Your Health Record/Information
Each time you visit FOUNDATION
SURGERY, a record of your visit is made. Typically, this record contains your
symptoms, examination and test results, diagnoses, treatment, and a plan for
future care or treatment. This information, often referred to as your health or
medical records, serves as a:
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Basis for planning your care and treatment,
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Means of communication among the many health professional who contribute to
your care,
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Legal document describing the care you received,
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Means by which you or a third-party payer can verify that services billed were
actually provided,
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A tool in educating health professionals,
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A source of data for medical research,
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A source of information for public health officials charged with improving the
health of this state and the nation,
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A source of data for our planning and marketing, and
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A tool with which we can assess and continually work to improve the care we
render and the outcome we achieve.
Understanding what is in your
record and how your health information is used helps you to: ensure its
accuracy, better understand who, what, when, where and why others may access
your health information, and make informed decisions when authorizing
disclosure to others.
Your Health Information Rights
Although your health record is
the physical property of FOUNDATION SURGERY, the information belongs to you.
You have the right to:
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Obtain a paper copy of this notice of information practices upon request,
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Inspect and copy your health record as provided for in 45 CFR 164.524,
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Amend your health record as provided in 45 CFR 164.528
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Obtain an accounting of disclosures of your health information as provided in
45 CFR 164.528
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Request communications of your health information by alternative means or at
alternative locations,
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Request a restriction on certain uses and disclosures of your information as
provided by 45 CFR 164.522, and
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Revoke your authorization to use or disclose health information except to the
extent that action has already been taken.
Our Responsibilities
FOUNDATION SURGERY is required
to:
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Maintain the privacy of your health information,
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Provide you with this notice as to our legal duties and privacy practices with
respect to information we collect and maintain about you,
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Abide by the terms of this notice,
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Notify you if we are unable to agree to a requested restriction, and
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Accommodate reasonable requests you may have to communicate health information
by alternative means or at alternative locations.
We reserve the right to change
our practices and to make the new provisions effective for all protected health
information we maintain. Should our information practices change, we will
provide at the time of your next visit to the facility a revised notice.
We will not use or disclose
your health information without your authorization, except as described in this
notice. We will also discontinue to use or disclose your health information
after we have received a written revocation of the authorization according to
the procedures included in the authorization.
For More Information or to Report a Problem
If you have questions and would
like additional information, you may contact the facility?s Privacy Officer at
the number shown on the "Contact Us"
page of this web site. Should you wish to file an anonymous complaint, contact
the Compliance Hotline at 1-877-874-8415.
If you believe your privacy
rights have been violated, you can file a complaint with the practice?s Privacy
Officer or with the Office for Civil Rights, U.S. Department of Health and
Human Services. There will be no retaliation for filing a complaint with either
the Privacy Officer or the Office for Civil Rights.
The address for the OCR is:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
Examples of Disclosures for Treatment, Payment and Health Operations
We will use your health information for treatment.
Example: Information obtained by a nurse, physician, or other member of
your health care team will be recorded in your record and used to determine the
course of treatment that should work best for you. Your physician will document
in your record his or her expectations of the members of your health care team.
Members of your health care team will then record the actions they took and
their observations. In that way, the physician will know how you are responding
to treatment.
We will also provide your physician or subsequent health care provider with
copies of various reports that should assist him or her in treating you once
you?re discharged from this facility.
We will use your health information for payment
Example: A bill may be sent to you or a third-party payer. The
information on or accompanying the bill may include information that identifies
you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health operations
Example: Members of the medical staff, the risk or quality improvement
manager, or members of the quality improvement team may use information in your
health record to assess the care and outcomes in your case and others like it.
This information will then be used in an effort to continually improve the
quality and effectiveness of the healthcare and service we provide.
Business associates
There are some services
provided in our organization through contacts with business associates.
Examples include physician services in the emergency department and radiology,
certain laboratory tests, and a copy service we use when making copies of your
health record. When these services are contracted, we may disclose your health
information to our business associate so that they can perform the job we?ve
asked them to do and bill you or your third-party payer for services rendered.
To protect your health information, however, we require the business associate
to appropriately safeguard your information.
Directory
Unless you notify us that you
object, we will use your name, location in the facility, general condition, and
religious affiliation for directory purposes. This information may be provided
to members of the clergy and, except for religious affiliation, to other people
who ask for you by name.
Notification
We may use or disclose
information to notify or assist in notifying a family member, personal
representative, or another person responsible for your care, your location, and
general condition.
Communication with family
Health professionals, using
their best judgment, may disclose to a family member, other relatives, close
personal friend or any other person you identify, health information relevant
to that person?s involvement in your care or payment related to your care.
Research
We may disclose information to
researchers when an institutional review board that has reviewed the research
proposal and established protocols to ensure the privacy of your health
information, has approved their research.
Marketing
We may contact you to provide
appointment reminders or information about treatment alternatives of other
health-related benefits and services that may be of interest to you.
Fundraising
We may contact you as part of a
fundraising effort.
Food and Drug Administration (FDA)
We may disclose to the FDA
health information relative to adverse events with respect to food,
supplements, product and product defects, or post marketing surveillance
information to enable product recalls, repairs, or replacement.
Workers compensation
We may disclose health
information to the extent authorized by and to the extent necessary to comply
with laws relating to workers compensation or other similar programs
established by law.
Public health
As required by law, we may
disclose your health information to public health or legal authorities charged
with preventing or controlling disease, injury, or disability.
Law enforcement
We may disclose health
information for law enforcement purposes as required by law or in response to a
valid subpoena.
Federal law makes provisions
for your health information to be released to an appropriate health oversight
agency, public health authority or attorney, provided that a work force member
or business associate believes in good faith that we have engaged in unlawful
conduct or have otherwise violated professional or clinical standards and are
potentially endangering one or more patients, workers or the public.
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