Abilene Sports Medicine & Orthopedics
Dale A. Funk, MD

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 carefully.

 The Health Insurance Portability & Accountability Act (HIPAA) of 1996 is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form are kept confidential.  This Act gives you significant rights to understand and control how your health information is used.  HIPAA provides penalties for covered entities that misuse personal health information.  As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may disclose it.

 Each time you visit Abilene Sports Medicine & Orthopedics, a record of your visit is made in order to manage the care you receive.  This office understands that the medical information that is recorded about you and your health is personal.  The confidentiality of your health information is also protected under both state and federal law.

 This notice of Privacy Practices describes how Abilene Sports Medicine & Orthopedics office may use and disclose your information and the rights that you have regarding your health information.

 Although, your health information is the physical property of the facility or practitioner that compiled it, the information belongs to you, and you have certain rights over that information.  You have the right to:

q       Request, in writing, a restriction on certain uses and disclosures of your health information.  However, agreement with the request is not required by law, such as when it is determined that compliance with the restriction cannot be guaranteed.

q       Inspect or obtain a copy of your health record as provided by law.

q       Request, in writing, that your health record be amended as provided by law, if you feel the health information we have about you is incorrect or incomplete.  You will be notified if the request cannot be granted.

q       Request that we communicate with you about your health information in a specific way or at a specific location.  Reasonable requests will be accommodated.

q       Obtain an accounting of disclosures of your health information as provided by law.

q       Obtain a paper copy of the Notice of Privacy Practices on request.

 You may exercise these rights by directing a request to the Privacy Contact listed on this Notice.

 Abilene Sports Medicine & Orthopedics has certain responsibilities regarding your health information, including the requirement to:

q       Maintain the privacy of your health information.

q       Provide you with this Notice that describes Abilene Sports Medicine & Orthopedics legal duties and privacy practices regarding the information that we maintain about you.

q       Abide by the terms of this Notice currently in effect.

 Abilene Sports Medicine & Orthopedics reserves the right to change these information privacy policies and practices and to make the changes applicable to any health information that we maintain.  If changes are made, the revised Notice of Privacy Practices will be made available to our office and will be supplied when requested.

 When you obtain services from Abilene Sports Medicine & Orthopedics, certain uses and disclosures of your health information are necessary and permitted by law in order to treat you, to process payment for your treatment and to support the operations of the entity and other involved providers.  The following categories describe ways that Abilene Sports Medicine & Orthopedics uses or discloses your information, and some representative examples are provided in each category.  All of the ways your health information is used or disclosed should fall within one of these categories.

For example:  Disclosures of medical information about you may be made to doctors, nurses, technicians, or others who are involved in taking care of you.  This information may be disclosed to other physicians who are treating you or other healthcare facilities involved in your care.  Information may be shared with pharmacies, labs, or radiology centers for the coordination of different testing and treatments.

For example:  Health information about you may be disclosed so that services provided you may be billed to an insurance company or a third party.  Information may be provided to your health plan about treatment you are going to receive in order to obtain prior approval or to determine if your health plan will cover the treatment.

For Example:  The information in your health record may be used to evaluate and improve the quality of care and services we provide.

For example:  There are some services that we may provide through contracts with third party business associates.  Examples include external laboratories and transcription services.  To protect your health information, Abilene Sports Medicine & Orthopedics requires these business associates to appropriately protect your information.

 Continuity of Care:  In order to proved for the continuity of your care, your information may be shared with other healthcare providers such as home health agencies.  Information about you may be disclosed to community services agencies in order to obtain their services on you behalf.

 Unless you give notice of an objection, medical information may be released to a family member or other person who is involved in your care or who helps you pay for your care.  Information about you may be disclosed to notify a family member, legally authorized representative or other person responsible for your care, your location, and general condition.  You will be given an opportunity to agree or object to these disclosures except as due to your incapacity or in emergency circumstances.

 The following disclosures of health information may be made according to state and federal law without your written authorization or verbal agreement.

q       When a disclosure is required by federal, state or local law, judicial or administrative proceedings, or for law enforcement.  Examples would be reporting gunshot wounds or child abuse, or responding to court orders.

q       For public health purposes, such as reporting information about various diseases, or deaths, or disclosures to the FDA regarding adverse events related to food, medication, or devices.

q       For health oversight activities, such as audits, inspections, or licensure investigations.

q       For workers’ compensation purposes.

q       To avoid a serious threat to the health or safety of a person or the public.

 Other uses or disclosures of your health information that may be made include:

q       Contacting you to provide appointment reminders for treatment or medical care, as well as recommend treatment alternatives.

q       Notifying you of health-related benefits and services that may be of interest to you.

Under the law we must make disclosures when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with federal privacy law.

 Any other uses or disclosures of your health information not addressed in this notice or otherwise required by law may be addressed to the privacy contact listed in this notice, or to the Secretary of the Department of Health and Human Services.  There will be no retaliation for registering a complaint.

 Address any questions about this notice or how to exercise your privacy rights to the Privacy Contact listed below.