This notice describes how medical information about you may be used and disclosed. It also describes how you can get access to this information.
This Notice of Privacy was originally published March 24, 2003
It was last revised February 2011


The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires all health care providers to protect medical records and other individually identifiable health information used or disclosed by us in any manner, whether electronically, on paper, or orally for all patients. This Act gives you the patient new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information. We are required by law to give you this notice.

We must also abide by the terms of this Notice. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. You may obtain any revised Notice of Privacy Practices by accessing our website (www.c-osa.com); calling our office and requesting that a revised copy be sent to you in the mail; or asking for one at any of our office locations.

If you have any questions about this notice or would like to file a complaint, please contact our Privacy Officer

Mary Elkins, Privacy Officer
Carolina Orthopaedic Surgery Associates, P.A.
134 Professional Park Drive
Rock Hill, SC 29732
(803) 329-3130


Each time you visit a physician, hospital or other health care provider a record of your visit is made. This record contains information you provided during the visit as well as information from your physician regarding your treatment. We understand this information is personal and are committed to ensuring it is protected.

WHO WILL FOLLOW THESE PRACTICES?

All employees, physicians, volunteers and Business Associates of Carolina Orthopaedic Surgery Associates and The Center for Orthopaedic Surgery will follow these practices.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION (PHI)

During your registration process you will be asked to sign various consent forms for billing, treatment, and to authorize those you choose to have access to some or all of your PHI released when necessary. However, your information may also be used without your consent to obtain payment, support the operation of the physician's practice and other instances as allowed by law.

The following are examples of your PHI that physician's offices are permitted to make without your consent. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within at least one of these categories.

Treatment: We may use health information about you to provide, coordinate or manage your medical treatment or related services. We may disclose health information about you to doctors, nurses, technicians, office staff or other personnel who are involved in taking care of you and your health care. For example we may disclose information to another physician or other provider, such as a physical therapist who referred you or to whom you have been referred, to ensure they have the necessary information to diagnosis and treat you.

Payment: We may use and disclose health information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company or a third party. An example would be if we needed to provide your health insurance company with information to receive authorization for treatment or payment for services, testing or surgical procedures. Another example may be if your account is not paid in a timely manner resulting in your account being released to a credit agency for collection purposes.

HealthCare Operations: We may use and disclose health information about you in order to support the office and make sure you and our other patients receive quality care. An example may be if we use your health information to evaluate the performance of our staff in caring for you, including quality assessment, cost management and efficiency of our practice. In addition we may use a sign-in sheet at the registration desk where you may be asked to sign your name and other information. We may also use this information to evaluate new services or treatments which would be beneficial to our patients.

Appointment Reminders/Changes: We may contact you as a reminder that you have an appointment for treatment or other medical care or that your appointment may need to be rescheduled. An example would be by calling in person or via an automated system which may include leaving a message on your answering machine at home or work. Another example may be by sending a letter as an appointment reminder.

Our Ambulatory Surgical Center Directory: We may include certain limited information about you in our daily directory for our ambulatory surgery center while you are a patient at the center. This information may include your name and your location in the center. The directory information may be released to people who ask for you by name including your family, friends and clergy members.

Business Associates: There are some services in our offices that may be contracted with other providers with whom we have Business Associate contracts. We may share your information with these third party associates who perform various services. An example would be billing, transcription services, bracing companies, physical therapist or peer review agencies. Effective January 1, 2011 our Business Associate Agreements have been amended to provide that all of the HIPAA security administrative safeguards, physical safeguards, technical safeguards and security policies, procedures and documentation requirements apply to the business associate.

Individuals Involved in Your Care or Payment for Your Care: We may release your health information to a family member, other relative, close personal friend, or any other person who is involved in your care, or payments related to your care.

Other Uses and Disclosures of your PHI will be made only with your written authorization unless otherwise permitted by law as described below. You may revoke this authorization, at any time, in writing, except to the extent that your physician or the practice has taken action in on the use or disclosure indicated on the authorization.

USE AND DISCLOSURES WITHOUT YOUR CONSENT

We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations.

To avert a serious health or safety threat: We may use and disclose health information about you when necessary to prevent a serious threat to your health or to the health of others or to prevent or control disease, injury or disability.

Blood Testing: While you are receiving care, a health care worker may accidentally be exposed to blood or other body fluids. If this occurs, your blood will be tested for the presence of certain diseases (for example, HIV, Hepatitis B & C). These tests are necessary to help protect health care workers. The results of these tests will be a part of your medical record but will not be released except with your prior written consent or as required by law.

Disaster Relief: We may release your health information to an organization assisting in a disaster relief effort so that your family can be notified about your location, condition and status.

Required by law: We will disclose health information about you when required to do so by federal, state or local law.

Public Health Risk: We may disclose information regarding births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products. To notify people of recalls of products they may have been using.

Workers Compensation: We may release health information about you for workers compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Research: We may use and disclose health information about you for research projects that are subject to a special approval process. We will ask you for permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at the office.

Organ Tissue Donation: If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation, organ donation bank, as necessary to facilitate such donation and transplantation.

Military, Veterans, National Security & Intelligence: If you are or were a member of the armed forces, a part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military.

Health Oversight Activities: We may disclose health information to a health oversight agency for audits, investigations, inspections or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the healthcare system, government programs and compliance with civil rights laws.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. All releases will be subject to applicable legal requirements; we may also disclose health information about you in response to a subpoena.

Law Enforcement: We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements. To identify or locate a suspect, fugitive, material witness, or missing person. About a death we believe may be the result of criminal conduct or criminal conduct that occurred at any of our facilities.

Coroners, Medical Examiners and Funeral Directors: We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release information to funeral directors as necessary for them to carry out their duties.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your health information to the institution or law enforcement officer. This release is necessary: 1) for the institution to provide you with healthcare; 2) to protect your health and safety and the health and safety of other inmates; 3) for the safety and security of the correctional institution.

Information not personally Identifiable: We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Family and Friends: We may disclose health information about you to your family members or friends if we obtain your verbal agreement to do so or if we give you the opportunity to object to such a disclosure and you do not raise an objection. We may also disclose health information to your family or friends if we can infer from circumstances, based on our professional judgement that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse or family member when you bring them with you into an exam room during treatment or while treatment is being discussed.

In situations where you are not capable of giving consent (because you are not present or due to your incapacity of medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person's involvement in your care. For an example, we may inform the person who accompanied you to the emergency room that you have suffered a fractured leg and provide updates on your progress and prognosis.

OTHER USES AND DISCLOSURES OF HEALTH INFORMATION

We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific written Authorization. We must obtain your authorization separate from any consent we may have obtained from you. If you give us authorization to use or disclose health information about you, you may elect to revoke it in writing at any time. If you revoke your authorization, we will no longer use or disclose information about you for the reasons covered by the written authorization, but we cannot take back any uses or disclosures already made with your permission.

SPECIFIC TREATMENTS AND RELEASES

Treatment for Drugs and Alcohol, Mental Health Issues: If you receive treatment, including counseling or other medical treatment, for drug or alcohol use or mental health issues, we will not release any of this treatment information to anyone unless you authorize us to do so or a court of law gives us an order to do so.

HIV & AIDS Treatment: If you are tested or receive treatment for HIV or AIDS, we will not release any information about your test results or treatment, except in the following circumstances:

- You give us permission to do so
- We are required or permitted by law
- We receive a court order or subpoena requiring us to do so

Unemancipated Minors - Treatment for Pregnancy; Drug & Alcohol Abuse; Venereal Disease; Emotional Disturbance: If you are under the age of 16 and are not married, and have not been emancipated by a court of law, we will not reveal any information about treatment for pregnancy, drug/alcohol abuse, venereal disease or emotional disturbances, except in the following situations:

- Your doctor determines the information needs to be shared with your parents because there is a serious threat to your health or life
- If your parent or guardian contacts your doctor and specifically asks about your treatment for one of the 4 conditions listed above.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights regarding health information we maintain about you:

Right to inspect and copy: You have the right to inspect and have a copy of your health information, such as medical and billing records, that we use to make decisions regarding your care.

You must submit a written request in order to inspect your records which must be done in the presence of a designated staff member. You may not remove any item from your medical record, change any part of the record, or deface the record in any manner.

You may request a copy of your medical records for your personal use. A charge in accordance with the South Carolina fee allowance shall be charged and payable prior to records release. We will respond to your request within 30-days of receiving your written request.

In certain limited instances we may deny your request to inspect and/or copy your records. If you are denied access to your health information, you may ask that the denial be reviewed. If the law requires such a review, we will seek a licensed healthcare professional to review your request and our denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Request an Amendment to Your Record: If you feel that the information in your record is incorrect or incomplete, you may request us to make an amendment. You have the right to request for as long as the information is kept by us. To request an amendment, your request must be in writing to the Chief Privacy Officer, 134 Professional Park Dr, Rock Hill, SC 29732. You must provide a specific reason that supports your request. We will respond within 60 days of receiving your written request. We may deny your request if it is not in writing does not include supporting reasons or information, the record was not created by us, is not part of the health information kept by us, is not part of the record you would be allowed to inspect and copy or we feel the information we have is accurate or complete.

ADDITIONAL RIGHTS

Right to an Accounting Disclosure: You have a right to request in writing an "an accounting disclosure." This is a list of the disclosures we have made of your medical information about you for purposes other than treatment, payment and healthcare operations.

To obtain this list you must submit your request in writing. It must state a specific time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list, as an example on paper or electronically. We may charge you for the cost of providing this list and will notify you of the cost at which time you may elect to withdraw your request at anytime prior to the cost being incurred.

Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for it, like a family member or friend. For example, you may request that we not use or disclose the information regarding surgery you had or accident details. In some cases this may result in you becoming financially responsible for all charges.

We are NOT Required to Agree to your Request: If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions you must do so in writing using the Request for Restrictions on Use/Disclosure of Medical Information.

Right to Request Confidential Communications: You have the right to request we communicate with you about medical matters in a certain way or at a certain location. For example you may request that we contact you only by mail or while at work. To request confidential communications, you must complete and submit the Request for Restrictions on Use/Disclosure of Medical Information. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of this Notice: You have the right to a paper copy of this notice. One will be provided at the time of your initial appointment for review prior to signing your consent form. You may ask us to give you a copy at any time. Even if you have agreed to receive it electronically, you are still entitled to a paper copy. To obtain such a copy, contact our Receptionist during your appointment time or in writing at the address listed below.

CHANGES TO THIS NOTICE

We reserve the right to change this notice, and to the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a summary of the current notice in the office with its effective date in the top right hand corner. You are entitled to a copy of the notice currently in effect.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services.

To file a complaint with our office, contact:

Carolina Orthopaedic Surgery Associates, P.A.
Mary F. Elkins, Privacy Officer
134 Professional Park Drive
Rock Hill, SC 29732


You will not be penalized for filing a complaint.