Notice of Health Information/Privacy Practices Pittsburgh Foot and Hand Center

effective January 1, 2004
updated January 15, 2010

This notice describes how medical information about you may be used and how to get access to this information.  Please review it carefully.

Understanding Your Personal Health Information/Health Record

When you initially visit Pittsburgh Foot and Hand Center, your Health Record is created.  This includes personal and demographic information, including insurance information.  Also included is a history of your current and previous medical problems, as well as current and previous treatments. Also included is medical information from your other current or previous health care providers that you provide to us or that we obtain on your behalf. At each visit a history and physical examination will be recorded as well as our discussion of our findings and plan for future care or treatment with you. Laboratory and test results are added to your record when received.  Billing records and insurance information are usually included in your personal health information.

This information serves as a basis to:

  • Collect and compare your health information to plan for your care and treatment
  • Communicate among the many health professionals who contribute to your care
  • Legally document the care you received
  • Allow you or a third party payor to verify that services billed were actually provided
  • Educate healthcare professionals
  • Collect data for medical research
  • Allow us to assess our care for quality assurance purposes
  • Collect data for our planning and marketing

Understanding what is in your health 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, and make more informed decisions when authorizing disclosure to others.
 

Uses and Disclosures of Your Personal Health Information

The following section describes situations where the law allows us to use or share your health information. We have included examples.  Not every possible use or disclosure can or will be listed.

  1. Treatment: Our employees will use your personal health information to provide your medical care. We are permitted to use and disclose your medical information to those involved in your treatment.  For example we may request that your primary care physician share medical information with us and we may share information about your particular condition so that he or she can appropriately treat you for other medical conditions, if any, and/or assist us in obtaining insurance referrals as may be required by your health plan.  Your care may also require the involvement of other specialists, therapists or orthotists, as well as pharmacists and providers of medical equipment. When we refer you to a specialist, we will share some or all of your medical information with that physician in order to facilitate delivery of your care.  We will also share some or all of your medical information with hospitals, surgical centers, imaging centers, outside laboratories or long-term care facilities in order to facilitate your care. We will also share some or all of your medical information in order to allow processing or secure payment for prescriptions provided to you, in accordance with requirements of your insurance. We will also provide your medical information to your subsequent healthcare providers, subject to verification of their identity.
  2. Payment: We will use and disclose medical information about you to obtain payment for the services we provide. For example we may give your health plan/insurance company the medical information it requires to document your treatment and before they will pay us. Disclosure of demographic and medical information about you may be required to your health insurance, third party vendors and medical equipment suppliers in order to properly prescribe tests or supplies and assist you in obtaining payment for such prescribed items. We may notify or bill you or a person designated as “responsible” for payment for services rendered to you. Information on or accompanying the notification or Bill may include your medical information. We also may provide information to a collection agency/attorney for purposes of securing payment of a delinquent amount.

  3. Healthcare Operations: We may use and disclose medical information about you to properly operate and manage our medical practice. For example we may use information in your healthcare record to assess your care and outcome, along with others like it, in order to improve quality assurance and further define and enhance our clinical treatment protocols.  We continually attempt to improve the quality and effectiveness of the healthcare and service we provide.

    Your medical information may be among that required by state or federal agencies for healthcare fraud/abuse detection and compliance programs; accreditation, certification, licensing and credentialing activities; insurance or healthcare auditing functions; compliance with the federal privacy rule or state and local regulations.

  4. Appointment Reminders: We may contact you or your designated responsible person by telephone, mail or e-mail to confirm appointments or request a return call.  We may leave a message on a home answering service, business or mobile voicemail or leave a message with an individual answering your home telephone to remind you of your appointment.  You may indicate your preferred method at communication. We will try that method first.  We may also contact you by your secure e-mail Patient Portal, if you choose to create one, to communicate with you and share updates and your medical information with you.

  5. Business Associates: Pittsburgh Foot and Hand Center May disclose some or all of your medical information to third party business associates to perform crucial and daily functions for our practice. Examples include billing services, electronic medical record services, the answering service, transcription services, collection agencies, accounting firms or law firms. To protect your health information, we require the business associate to appropriately safeguard your information.

  6. Incidental Disclosures:

    We dictate office notes at each office visit and discuss medical information among the staff in order to respond to your phone calls and requests.  During dictation or this discussion, it may be possible for other patients and staff, not directly involved in your care, to incidentally hear the discussion.

    X-rays or images: We may hang your x-rays or images in areas that may be incidentally seen by individuals other than you.

    Directory: We may use your name on sign in sheets which may be visible by other patients.  These sheets are only utilized on the day of your visit to ensure that you receive the best care possible.  If you are uncomfortable with your name on such a sheet, please let staff know of your concern and we will address your concern. 

    We will call patient's names in our waiting areas. Other individuals may incidentally hear your name.

    A single chart rack outside your examination room may contain your patient encounter form and a folder with some of your medical information. This may be seen incidentally by individuals other than you.
     

Uses and Disclosures for Other Purposes

We may use and disclose your Personal Health Information for other purposes.  This section generally describes these purposes by category.  Each category includes one or more examples.  Not every use or disclosure in a category will be listed.

Disclosures Requiring an Opportunity to Agree or Object

  1. Family and Notification: We realize the important role that families spouses, friends and other loved ones play in supporting your health care and treatment.  At the same time we are committed to protecting your patient privacy as well as complying with both state and federal law. Accordingly disclosures to other people, even family, are a decision that rests with you.

    If you bring a family member or other person to an appointment at Pittsburgh Foot and Hand Center, they may be exposed to your personal health information.  It is our policy to allow these individuals to accompany you to your appointment unless you otherwise object. Should you wish to visit the doctor alone, your visitor will be asked to wait in the waiting room.

    We may disclose your personal health information to someone involved in your care or payment for your care, such as a spouse, a family member or close friend, unless you directly notify us otherwise in writing. You may revoke this authorization at any time in writing. We may use and disclose your personal health information to notify, or assist in the notification of, a family member, a personal representative, or other person responsible for your care regarding your location, general condition or death.

  2. Marketing/business planning: We may use your personal health information and demographic data to assist internally in our marketing efforts and business planning.  We may contact you to give you information about products and services related to your treatment or to inform you about other treatment or health related benefits and services that may be of benefit to you. This contact may be by phone, mail or e-mail. An example would be our patient newsletter. You may contact us in writing if you do not wish to receive this information.

  3. Research: Under certain circumstances we may use and disclose medical information about you for research purposes.  Active clinical research trials may require your approval to participate. Special protocols for protection of patient anonymity apply. Certain simple data reviews of patients with similar problems/treatments may not require your approval.  Your identity will be protected in such reviews.

  4. Fund raising: We may provide medical information to an affiliated fundraising foundation to contact you for fundraising purposes.  We will limit this use and sharing to information that describes you in general terms only and the date of your health care. You may choose not to receive any such communication by notifying us in writing.
     

Disclosures That May be Required by Law

We may be required to use and disclose your personal health information as required by federal, state or local law.

  1. Funeral Directors, Coroners and Medical Examiners: We may disclose your personal health information to funeral directors, coroners and medical examiners, consistent with applicable laws to carry out their duties.
  2. Organ Procurement Organizations: We may release your medical information to organ procurement organizations if you are a donor.

  3. Correctional Institution/Inmates: Should you be an inmate of a correctional institution, we may disclose to the institution, or agents thereof, some or all of your personal health information necessary for your health and the health and safety of other individuals.

  4. Food and Drug Administration (FDA): We may disclose to the FDA, personal health insurance relative to adverse effects with respect to food, supplements, product and chronic defects, or post marketing surveillance information to enable product recalls, repairs or replacement.

  5. Worker's compensation: We may disclose your personal health information to the extent authorized by and to the extent necessary to comply with laws relating to worker's compensation or other similar programs established by law.

  6. Public health: As required by law we may disclose your personal health information to public health or legal authorities charged with preventing or controlling disease, injury or disability. 

  7. Law enforcement: We may disclose your personal health information for law enforcement purposes or any 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 workforce 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 patient, workers or the public.

  8. Abuse or neglect: We may also use or disclose your medical information to a public agency authorized to receive reports of domestic violence, child abuse or neglect.  Regulations also may permit the disclosure of information to report abuse or neglect of elders or the disabled.

  9. Military, National Security and Intelligence Activities: We may disclose your medical information for specialized Government functions, such as requests as necessary by appropriate military command officers, authorized national security and intelligence agencies.
     

Your Personal Health Information Rights

Your Health Record is the physical property of Pittsburgh Foot and Hand Center and we are required by law to maintain it.  However, the information belongs to you.

You have the right to:

  • Obtain a paper copy of this Notice of Health Information/Privacy Practices.  Notify our office and we will provide one for you. You may also click on Patient Privacy Form.
  • Inspect and obtain a copy of your health record as provided for in 45 CFR164. 524. This right is subject to certain limitations and we may charge for the labor and supplies involved in providing copies. You may request that we provide copies in a format other than photocopies. We will use the format you request unless it is not practical for us to do so. You may submit a written request by obtaining a medical records release of information form or submit a request by clicking Medical Record Request
  • Request amendment of your health record as provided in 45 CFR 164.526. This right is subject to limitations. To request an amendment, you must submit a written request to our privacy officer. The request must describe the information you wish to change and the reason for each change.
  • Obtain an accounting of disclosures of your personal health information as provided in 45 CFR 164.528. This list may include the times we shared your medical information for purposes other than treatment, payment, and healthcare operations    and other specified exceptions. You must submit a written request, including the applicable time, to our privacy officer. This right is limited to disclosures within 6 years of the request and other limitations.
  • Request reasonable communications of your personal health information by alternative means or at alternative locations. You must submit a written request for such communication to our privacy officer.  We will comply with your request if possible and reasonable.
  • Request a restriction on certain uses and disclosures of your personal health information as provided by 45 CFR164.522. We are not required to agree to these additional restrictions, but will do so, if we agree, except in emergencies.  You must submit a written request, detailing what information you want restricted, to whom and how you want the information restricted.
  • Revoke your authorization to use or disclose personal information except to the extent that action has already been taken. You must submit a written request to our privacy officer, detailing the changes in authorization that you are requesting.
     

Our Responsibilities

Pittsburgh Foot and Hand Center respects the privacy of your personal health information and pledges to abide by the terms of this notice.  We are required by law and regulation to protect the privacy of your personal health information and to provide you with a copy of this notice if requested. We will notify you if we are unable to agree to a requested restriction and will accommodate a reasonable request you may have to communicate health information by alternative means or locations.
 

Changes to This Notice

We reserve the right to change our practices and make the new provisions effective for all protected health information we maintain.  We will not use or disclosure health information without your authorization, except as described in this notice.  We will also discontinue the use or disclosure health information after we have received a written revocation of the authorization according to the procedures included in the authorization. Our Notice of Health Information/Privacy Practices is posted on our website.
 

Questions or Complaints

If you have questions about this notice or our privacy policy, please contact our privacy officer at (724)933-3300. If you think that we may have violated your privacy rights, you may speak to our privacy officer and submit a written complaint. No action will be taken against you and you will not be penalized in any way for filing a complaint with us.  You may also file a complaint with the Office for Civil Rights, U. S. Department of Health and Human Services.

 

The address is as follows:

Office for Civil Rights
U. S. Department of Health and Human Services
200 Independent Ave, S.W.
Room 509F, HHH Building
Washington, DC 20201

 

Medical Records Release of Information Form

Patient Privacy Form