Orthopaedic & Spine Center
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Notice of Privacy Practices

Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed, and how to get access to this information. Please review it carefully.
At the Orthopaedic & Spine Center, we believe your health information is personal. We keep records of the care and services that you receive at our practice. We are committed to keeping your health information private, and we are required by law to respect your confidentiality.  This Notice describes the privacy practices of the Orthopaedic & Spine Center. This Notice applies to all of the health information that identifies you and the care you receive at the Orthopaedic & Spine Center. This information may consist of paper, digital or electronic records but could also include photographs, videos and other electronic transmissions or recordings that are created during your care and treatment. We are legally required to keep your health information private, to notify you of our legal responsibilities and privacy practices that relate to your health information, and to notify you if there is a breach of your unsecured health information. We are also legally required to give you this Notice and to follow the terms of the Notice currently in effect.    All of our employees follow the terms of this Notice. Our Doctor and Nurse Practitioners, and other staff, may share your health information with each other for reasons of treatment, payment, and health care operations as described below. Your health information may be shared with physicians outside of our practice who are not employed by the Orthopaedic & Spine Center for the purpose of continuation of care and treatments purposes. 
How the Orthopaedic & Spine Center may use and disclose your information   When you become a patient of the Orthopaedic & Spine Center, we will use your health information within our practice and disclose your health information outside of the Orthopaedic & Spine for the reasons described in this Notice. The following categories describe some of the ways that we will use and disclose your health information.    Treatment We use your health information to provide you with health care services. We may disclose your health information to doctors, nurses, technicians, medical or nursing students, or other persons not affiliated with the Orthopaedic & Spine Center who need the information to take care of you. For example, a doctor treating you for a fractured arm or leg may need to ask another doctor if you have diabetes because diabetes may slow the healing process. This may involve talking to doctors and others not employed by us. We also may disclose your health information to people outside of the Orthopaedic & Spine Center who may be involved in your health care, such as treating doctors, home care providers, pharmacies, drug or medical device experts.    Payment We may use and disclose your health information so that the health care you receive can be billed and paid for by you, your insurance company, or another third party. For example, we may give information about treatment you had here to your health plan so it will pay us for the treatment provided to you by our Doctor or Nurse Practitioners. We may also tell your health plan about a treatment you are going to receive so we can get prior authorization or a pre-determination so we may determine if your plan will pay for the treatment.
Contacting You We may use and disclose health information to reach you about appointments and other matters. We may contact you by mail, telephone or email. For example, we may leave voice messages at the telephone number you provide us with, and we may respond to your email address.    Health Information Exchanges We may participate in certain health information exchanges whereby we may disclose your health information, as permitted by law, to other health care providers or entities for treatment, payment, or health care operations purposes.
Health-Related Services We may use and disclose health information about you to send you mailings about health-related products and services available at the Orthopaedic & Spine Center.
Legal Matters  We will disclose health information about you outside the Orthopaedic & Spine Center when required to do so by federal, state, or local law, or by the court process. We may disclose health information about you for public health reasons, like reporting abuse or neglect, reactions to medications or problems with medical products. We may release health information in an effort to notify authorities when your health or safety may be threatened. We may disclose health information to a health oversight agency for activities authorized by law, such as for audits, investigations, inspections, and licensure.   Authorizations for other uses and disclosures  s described above, the Orthopaedic & Spine Center will use your health information and disclose it outside of the Orthopaedic & Spine Center for treatment, payment, health care operations, and when required or permitted by law. We will not use or disclose your health information for other reasons without your written authorization. For example, most uses and disclosures of psychotherapy notes, uses and disclosures of health information for certain marketing purposes, and disclosures that constitute a sale of health information require your written authorization. These kinds of uses and disclosures of your health information will be made only with your written authorization. You may revoke the authorization in writing at any time, but we cannot take back any uses or disclosures of your health information already made with your authorization. 
Ohio law requires that we obtain your consent for certain disclosures of health information about the following: the performance or results of an HIV test or diagnoses of AIDS or an AIDS-related condition, drug or alcohol treatment that you have received as part of a drug or alcohol treatment program, or mental health services that you have received.
Right to Accounting  You may request an accounting, which is a listing of the entities or persons (other than yourself) to whom the Orthopaedic & Spine Center has disclosed your health information without your written authorization. The accounting would not include disclosures for treatment, payment, health care operations, and certain other disclosures exempted by law. Your request for an accounting of disclosures must be in writing, signed, and dated. It must identify the time period of the disclosures. We will not list disclosures made earlier than six (6) years before your request. Your request should indicate the form in which you want the list (for example, on paper or electronically). You must submit your written request to the medical records department of the Orthopaedic & Spine Center, located at 6810 Perimeter Drive, Suite 200-A, Dublin, Ohio 43016. We will respond to you within 60 days. We will give you the first listing within any 12-month period free of charge, but we will charge you for all other accountings requested within the same 12 months.  Right to Amend  If you feel that health information we have about you is incorrect or incomplete, you have the right to ask us to amend your medical records. Your request for an amendment must be in writing, signed, and dated. It must specify the records you wish to amend, and give the reason for your request. You must address your request to the Orthopaedic & Spine Center, Attn: Medical Records Department, located at 6810 Perimeter Drive, Suite 200-A, Dublin, Ohio 43016. The Orthopaedic & Spine Center will respond to you within 60 days. We may deny your request; if we do, we will tell you why and explain your options.
Right to Inspect and Obtain Copy  You have the right to inspect and obtain a copy of your completed health records unless your doctor believes that disclosure of that information to you could harm you. You may not see or get a copy of information gathered for a legal proceeding. Your request to inspect or obtain a copy of the records must be submitted in writing, signed and dated, to the medical records department of the Orthopaedic & Spine Center. (Requests for billing records should be sent to the billing departments.) We may charge a fee for processing your request. Please mail your request to Orthopaedic & Spine Center, Attn: Medical Records Requests, 6810 Perimeter Drive, Suite 200-A, Dublin, Ohio 43016.
Right to Request Restrictions  You have the right to ask us to restrict the uses or disclosures we make of your health information for treatment, payment, or health care operations, but we do not have to agree. You also may ask us to limit the health information that we use or disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend.  Right to Request Confidential Communications  You have the right to request that we communicate with you about your health in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. Your request for confidential communications must be in writing, signed, and dated. It must specify how or where you wish to be contacted. You need not tell us the reason for your request, and we will not ask. You must send your written request to the medical records department of the Orthopaedic & Spine Center located at 6810 Perimeter Drive, Suite 200-A, Dublin, Ohio 43016. We will accommodate all reasonable requests.  Right to a Paper Copy of This Notice   You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You also can view this Notice at our website, www.oscpain.com under Notice of Privacy Practices.  Complaints  If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the U.S. Department of Health and Human Services.  You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
To file a complaint with the Orthopaedic & Spine Center, you must submit your complaint in writing to the Orthopaedic & Spine Center, Attn: Patient Complaints, 6810 Perimeter Drive, Suite 200-A, Dublin, Ohio 43016. You will not be penalized for filing a complaint.

Changes to this Notice
The Orthopaedic & Spine Center may change this Notice at any time. Any change in the Notice could apply to medical information we already have about you, as well as any information we receive in the future. We will post a copy of the current Notice at our medical practice and on our website, www.oscpain.com 
The effective date of the Notice is on the first page in the top right corner.

Non-Discrimination Notice 
The Orthopaedic & Spine Center complies with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. The Orthopaedic & Spine Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Language assistance services, free of charge, are available to you. Please call (614) 956-1189 and notify the receptionist that you require an interpreter for your office visit. Please provide us with a 48-hour notice, prior to your appointment so we may have an interpreter available to assist you.