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.
At Alex Orthopaedics, patient privacy is important to all of us
You are entitled to protection and privacy of your health information. We are committed to providing an understandable statement of your entitlement to patient privacy and safeguarding your privacy with the same level of care we would use for our own privacy.
You can ask questions about our privacy practices. We will give you answers. If you think you health information isn’t being protected, you may file a complaint with Alex Orthopaedics, (773) 777-9100.
Privacy is important to all of us
Other privacy rights
You may have other health information rights under your state’s laws, when these laws affect your health, when this information can be used or shared, that should be made clear in the notice you receive.
This is a brief summary of your rights and protections under the federal health information privacy law. You can ask your provider or health insurer questions about how your health information is used or shared and about your rights.
Alex Orthopaedics will make and take every reasonable effort to protect the privacy of your healthcare information. We will safeguard your medical record, both written and electronic.
You May Ask To See And Get A Copy Of Your Health Records
You can ask to see and get a copy of your medical record and other health information. You may not be able to get all of your information in a few special cases. For example, if your doctor decides something in your file might endanger you or someone else, the doctor may not have to give this information to you. In most cases, your copies must be given to you within 30 days, but this can be extended for another 30 days if you are given a reason. You may have to pay for the cost of copying and mailing if you request copies and mailing.
You May Request Corrections Be Added To Your Health Information
You can ask to change any wrong information in your file or add information to your incomplete file. For example, if you and a hospital agree that your file has the wrong result for a test, the hospital must change it. Even if the hospital believes the test result is correct, you still have the right to have your disagreement noted in your file. In most cases the file should be changed within 60 days, but the hospital can take an extra 30 days if you are given a reason.
How Alex Orthopaedics Uses And Shares Your Health Information
Alex Orthopaedics uses your health information to make diagnoses and treatment decisions, to inform other members of the healthcare and or quality assurance team and for your other healthcare providers. Information about you, your diagnosis, procedures, supplies and medications may appear on a bill sent to you or a third-party payer. We may contact you for appointment reminders unless you tell us otherwise. We may use or disclose information to notify a family member, personal representative or other person responsible for your care or general condition. In our best judgment, when appropriate, we may disclose health information to a family member, relative or other person involved in your care or payment related to your care. We will make any disclosures required by law.
You May Decide Whether To Give Your Permission
In general, Alex Orthopaedics cannot provide your health information to your employer, use or share it for things like sales calls or advertising or similar purposes unless you give your permission by signing an authorization form. The authorization form will tell you who will get your information and for what purpose your information will be used.
You May Get A Report On When And Why Your Health Information Was Shared
Under the law, your health information may be used and shared for particular reasons, like making sure doctors give good care, making sure nursing homes are clean and safe, reporting when flu is in your area, or making required reports to the police, such as reporting gunshot wounds. In many cases, you can ask for a list of with whom your health information has been shared. You can get this report for free once a year. In most cases you should get the report within 60 days, but it can take an extra 30 days if you are given a reason.
You May Ask To Be Contacted Somewhere Other Than Home
You can make reasonable requests to be contacted at different places or in a different way. For example, you can have the nurse call you at your office instead of your home, or send mail to you in an envelope instead of on a postcard. If sending information to you at home might put you in danger, your health insurer must talk, call, or write to you where you ask and in the way you ask, if the request is reasonable.
You May Ask That Your Information Not Be Shared
You can ask your provider or health insurer not to share your health information with certain people, groups, or companies. For example, if you go to a clinic, you could ask the doctor not to share your medical record with other doctors or nurses in the clinic. However, they do not have to agree to do what you ask.
You Have the Right to Ask for an Accounting
You have the right to request an accounting of our disclosures of your PHI excluding disclosure (1) to perform the treatment, payment and health care operations specified in section II (A-C) above; (2) to you or any of the other family, friends and other persons involved in your treatment or payment, (3) to a third party pursuant to your written authorization; or (4) that are otherwise required or permitted to make by law. As before, your request must be made in writing to our Privacy Officer. The request should specify the time period, but please note that we are not required to provide an accounting for disclosures that take place prior to April 14, 2003. Accounting requests may not be made for periods of time in excess of six years. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
You Have the Right to File Complaints
You have the right to contact our Privacy Officer at any time if you have questions, comments or complaints about our privacy practices or if you believe we have violated your privacy rights. You also have the right to contact the Department of Health and Human Services regarding these privacy matters, particularly if you do not believe that we have been responsive to your concerns. We urge you to contact our Privacy Officer if you have any questions, comments or complaints, either in writing or by telephone. The contact information for our Privacy Officer is:
Attn: Privacy Officer
4801 W Peterson Ave, Ste 606
Chicago, IL 60646
The contact information for the Department of Health and Human Services is as follows:
U.S Department of Health and Human Services Office for Civil Rights
Attn: Privacy Officer
200 Independence Avenue S.W.
Washington, D.C. 20201
Effective as of January 2014