TWIN CITIES ORTHOPEDICS, P.A. NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
During your treatment at Twin Cities Orthopedics (TCO), doctors, nurses, and other caregivers may gather information about your medical history and your current health. This Notice explains how that information may be used and shared with others. It also explains your privacy rights regarding this kind of information. The terms of this Notice apply to health information created or received by TCO. We are required by law to: make sure that medical information that identifies you is kept private; give you this Notice of our legal duties and privacy practices with respect to medical information about you; follow the terms of the Notice that is currently in effect; and notify you in the event there is a breach of any unsecured protected health information about you.
Your medical information may be used and disclosed for the following purposes:
Your medical information may be released in the following special situations:
We may also release information to law enforcement that is not a part of the health record (in other words, non-medical information) for the following reasons:
You have the following rights regarding medical information we maintain about you:
If you wish to inspect and copy medical information, you must submit your request in writing to TCO. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request, to the extent permitted by state and federal law. If we maintain your health information electronically as part of a designated record set, you have the right to receive a copy of your health information in electronic format upon your request. You may also direct us to transmit your health information (whether in hard copy or electronic form) directly to an entity or person clearly and specifically designated by you in writing.
We may deny your request to inspect and copy your information in certain very limited circumstances. For example, we may deny access if your physician believes it will be harmful to your health, or could cause a threat to others. In these cases, we may supply the information to a third party who may release the information to you. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by TCO will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
To request a change to your information, your request must be made in writing and submitted to TCO. In addition, you must provide a reason that supports your request.TCO may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
To request this list of disclosures, you must submit your request in writing to TCO. Your request must state a time period for which you would like the accounting. The accounting period may not go back further than six years from the date of the request, and it may not include dates before April 14, 2003. You may receive one free accounting in any 12-month period. We will charge you for additional requests.
To request restrictions, you must make your request in writing to TCO. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply, for example, if you want to prohibit disclosures to your spouse.
To request confidential communications, you must make your request in writing to TCO. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted, and we may require you to provide information about how payment will be handled.
Changes to This Notice
The effective date of this notice is April 14, 2003, and it has been updated effective September 23, 2013. We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you, as well as any information we receive in the future. If the terms of this notice are changed, TCO will provide you with a revised notice upon request, and we will post the revised notice on our website and in designated locations at TCO.
Complaints or Questions
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with TCO, or to ask a question about this Notice, contact TCO Customer Service Department at 952-512-5625 and ask to be connected with the Clinic Manager for your physician and/or TCO clinic site. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Other Uses and Disclosures of Protected Health Information
We are required to obtain a written authorization from you for most uses and disclosures of psychotherapy notes, uses and disclosures of protected health information for marketing purposes and disclosures that constitute a sale of protected health information. Except as described in this Notice, TCO will not use or disclose your protected health information without a specific written authorization from you. If you provide us with this written authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent we have already relied on your authorization. We are unable to take back any disclosures we have already made with your permission, and we are required to retain our records of the care that we provided to you.