Health Insurance Portability and Accountability Act (HIPAA)
- Understanding Your Health Information
- Our Responsibilities
- Examples of Disclosures for Treatment, Payment and Health Options
- Questions and Complaints
SouthWest Ortho Group has developed this Privacy Notice to comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the privacy regulations of Texas. HIPAA was enacted by Congress to establish standards for protecting the confidentiality and security of your health information.
A Privacy Notice is a document that identifies the general ways your protected health information can be used to carry out treatment, payment, and health care operations. Protected health information means your personal health information created or received by a health care provider, insurance company, or employer's health benefit plan and relates to your past, present, or future physical or mental health conditions.
A medical record is made during each visit to a hospital, physician, or other healthcare provider. Typically, the record is paper or electronic and contains your health information such as: symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This health information is used for the purposes listed below:
- Basis for planning your care and treatment
- Means of communication among the many health professionals who contribute to your care
- Legal document describing the care your received
- A tool in educating health professionals
- A source of data for medical research
- A source of information for public health officials charged with improving the health of the nation
- A source of data for facility planning and marketing
- A tool that we can use to continually improve the care we give and the outcomes 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
- Make more informed decisions when authorizing disclosure to others.
Your Health Information Rights
You have the right to:
- Request a restriction on certain uses and disclosures of your information. However, SouthWest Ortho Group is not required to agree to a requested restriction.
- Receive confidential communications of protected health information. Obtain a paper copy of the Privacy Notice upon request, regardless if you have agreed to receive the Notice by email.
- Inspect and obtain a copy of your health record. We may provide a summary of your health record. Baylor College of Medicine may charge a reasonable fee to cover costs
- Request changes to your health record. Requests for changes must be in writing.
- Obtain an accounting of disclosures of your health information, except for disclosures for treatment, payment and health care operations, disclosures for public health purposes or as required by law, and disclosures authorized by you. If you make more than one request in a 12-month period, SouthWest Ortho Group may charge a reasonable fee to cover costs.
- Request communications of your health information by alternative means or at alternative locations. For example, only send appointment messages by mail. No phone messages.
- Revoke your authorization to use or disclose health information except to the extent that action has already been taken. Revocations must be in writing
SouthWest Ortho Group is required to:
- Maintain the privacy of your health information.
- Provide you with a Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
- Abide by the terms of this Notice.
- Notify you if we are unable to agree to a requested restriction.
- 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 mail a revised Notice to the address you have supplied us and post a revised Privacy Notice. The Notice can be found in each physician's office.
We will not use or disclose your health information without your authorization, except as described in this notice.
Treatment: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record along with orders, actions, observations, and your response to treatment.
We will provide your physician or an alternate healthcare provider with copies of various reports that should assist him or her in treating you once you are discharged from the hospital. We share your health information outside of the Baylor System to assist in providing medical care.
Payment: A bill may be sent to you or your insurance company. The information on or accompanying the bill may include information about your diagnosis, procedures and supplies used. We may share such information outside of the Baylor system for payment purposes.
Routine Health Operations: Members of the medical staff, risk management, quality improvement, credentialing, or compliance programs, among others, may use information in your health record to examine the care and outcomes in your case and others like it. Your information will then be used to improve the quality of care and services provided. We may share your information outside of the Baylor system for health care operations.
Appointments and Alternatives: We may contact you to provide appointment reminders of information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Business Associates: There are some services provided in our organization through contracts with business associates. Examples include transcription services and copy services we use when making copies of your health record. When these services are used, we may give your health information to our business associated so that they can perform the job we've asked them to do and bill your or your insurance company for services provided. To protect you health information, however, we require the business associate to keep your information confidential.
Communication with Family: Health professionals, using their best judgment, may disclose to a family member, other relative, 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.
Correctional Institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
Directory: Unless instructed otherwise, hospitals 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.
Education and Development: We may contact you as part of education and development efforts such as College publications, education forums, tours, College events, and opportunities for volunteerism and philanthropic support. You may decline future contacts.
Food and Drug Administration (FDA): We may disclose to the FDA health information concerning harmful events with food, supplements, product and product defects, or post marketing information to enable product recalls, repairs, or replacement.
Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Group Health Plans: A group health plan, or a health insurance issuer or HMO on behalf of a group health plan, may disclose protected health information to the sponsor of the plan.
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 provision 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.
Marketing: We must obtain your authorization for all marketing purposes except for face-to-face conversations about services and treatment alternatives. If you do not want to be contacted for future marketing purposes, please indicate this in writing, by completing a marketing opt out form, which we will provide.
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 or your location and general condition.
Organ Donation Organizations: Consistent with applicable law, we may disclose health information to organ donation organizations or other entities that collect, store and transplant organs for the purpose of tissue donation and transplantation.
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.
Registration and Scheduling: To improve our scheduling and registration operations, Texas Children's Hospital, The Methodist Hospital, Baylor College of Medicine and their participating organization have developed a centralized database that allows us to share your demographic (i.e., name, address, etc.) and insurance eligibility information among our institutions. We believe this use of information will reduce the time you spend registering at any of our facilities.
Research: We may use or disclose your personal health information for research that has been approved according to established standards for individual safety, scientific merit, and the protection of your health information privacy. Researchers may view your health information, in accordance with federal privacy regulations, to develop new scientific studies. Additionally, we may use your information to contact you about research opportunities.
School Information: We may provide information to schools to complete health medical forms or physicals.
Worker 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.
Written Authorization: Other uses and disclosures will be made only with the individual's written authorization. You may revoke such authorization.
We may seek authorization for additional purposes relating to specified health care practices such as research, marketing, and development.
Questions: If you have questions and would like additional information, you may contact SouthWest Ortho Group at (713) 610-4260.
Complaints: If you believe your privacy rights have been violated, you can file a complaint with the SouthWest Ortho Group Office through the Compliance Help line at (713) 610-4260, or with the Secretary of Health and Human Services. There will be no action taken against you for filing a complaint.
Effective date: 04/14/03