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.
We understand that information about you and your health is very personal. We strive to protect our patients’ privacy. We are required by law to maintain the privacy of our patients’ protected health information (“PHI”). We are also required to provide notice of our legal duties and privacy practices with respect to PHI and to abide by the terms of the Notice of Privacy Practices currently in effect.
We reserve the right to change the terms of this Notice and to make a new Notice effective for all PHI we maintain at any time without notice. We are committed to excellence in providing state-ofthe-art health care services through the practice of patient care, education, and research. Below is a description of how your health information will be used and disclosed to advance this mission.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
THAT DO NOT REQUIRE AN AUTHORIZATION
Treatment. For example, doctors, nurses, and other staff members involved in your care will use and disclose your PHI to coordinate your care or to plan a course of treatment for you.
Payment. For example, we may disclose information regarding your medical procedures and treatment to your insurance company to arrange payment for the services provided to you.
Health Care Operations. For example, we may disclose your PHI for billing or interpreter support. We may use your PHI to conduct an evaluation of the treatment and services provided or to review staff performance. We may disclose your PHI for education and training purposes to doctors, nurses, technicians, medical students, residents, fellows, and others.
Health Information Exchanges. We participate in initiatives to facilitate electronic sharing of patient information, including but not limited to Health Information Exchanges (HIEs). HIEs involve coordinated information sharing among HIE members for the purposes of treatment, payment, and health care operations. You may opt out of ARBDA/TRABECULAR’s information sharing through its HIE activities. If you wish to opt out, please contact the ARBDA/TRABECULAR Privacy Officer at firstname.lastname@example.org
Communicating with You. We will use your PHI to communicate with you about a number of important topics, including information about appointments, your care, treatment options and other health-related services, payment for your care, and opportunities to participate in research, provided this research outreach is approved by an Institutional Review Board (IRB), see Research section below.
We urge you to sign up for our patient portal to send and receive communications conveniently and securely and to share your preferences for how we contact you. The patient portal is accessible through the primary ARBDA website at https://www.arthritissj.com
We may also contact you at the email, phone number, address, or other means (including via text messages) for these communications. If your contact information changes, it is important that you let us know. Texting and email are not 100% secure. Regarding text messages, please note that message and data rates may apply, and you have an opportunity to opt out. If you wish to opt-out, please submit a written request to the Privacy Officer noted at the end of this Notice.
Research. We may use and disclose your PHI as permitted by applicable law for research. This is subject to oversight by ARBDA/TRABECULAR or the designated IRB, committees charged with protecting the privacy rights and safety of human subject research.
As an organization committed to furthering the understanding of medical knowledge,
ARBDA/TRABECULAR supports research and may contact you to invite you to participate in certain research activities. If you do not wish to be contacted for research purposes, please tell your patient care associate at the time of checking in or by contacting the ARBDA/TRABECULAR Privacy Officer at email@example.com In such case, we will use reasonable efforts to prevent research-related outreach. Note that ARBDA/TRABECULAR may continue to use your PHI for research purposes as described above and your care providers may discuss research with you.
Business Associates. At times, we need to disclose your PHI to persons or organizations outside
ARBDA/TRABECULAR who assist us with our payment/billing activities and health care operations.
We require these business associates and their subcontractors to appropriately safeguard your PHI.
Other Uses and Disclosures. We may be permitted or required by law to make certain other uses and disclosures of your PHI without your authorization. Subject to conditions specified by law, we may release your PHI:
- for any purpose required by law.
- for public health activities, including required reporting of disease, injury, birth and death, for required public health investigations, and/or to report adverse events or enable product recalls. to government agencies if we suspect child/elder adult abuse or neglect. We may also release your PHI to government agencies if we believe you are a victim of abuse, neglect, or domestic violence.
- to your employer when we have provided screenings and health care at their request for occupational health and safety, to government oversight agency conducting audits, investigations, inspections, and related oversight functions.
- in emergencies, such as to prevent a serious and imminent threat to a person or the public. if required by law, a court order, subpoena, or discovery request. for law enforcement purposes, including to law enforcement officials to identify or locate suspects, fugitives or witnesses, or victims of crime. to coroners, medical examiners, and funeral directors. if necessary to arrange organ or tissue donation or transplant. for national security, intelligence, or protective services activities. for purposes related to your workers’ compensation benefits.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION BASED ON A SIGNED AUTHORIZATION
Except as outlined above, we will not use or disclose your PHI for any other purpose unless you have signed a form authorizing the use or disclosure. You may revoke an authorization in writing, except to the extent we have already relied upon it. In some situations, a signed authorization form is required for uses and disclosures of your PHI, including:
- most uses and disclosures of psychotherapy notes or other treatment records uses; and
- disclosures for marketing purposes disclosures that constitute the sale of PHI uses; and
- disclosures for certain research protocols as required by privacy law.
- The confidentiality of substance use disorder and mental health treatment records as well as HIV-related information maintained by us is specifically protected by state and/or federal law and regulations.
- Generally, we may not disclose such information unless you consent in writing, the disclosure is allowed by a court order, or in other limited, regulated circumstances.
Access to Your PHI. Generally, you can access and inspect paper or electronic copies of certain PHI that we maintain about you. Except as noted previously, you may readily access all of your health information without charge using the patient portal. Additionally, you may also access your information through the ARBDA Privacy Officer, which you can contact at firstname.lastname@example.org
NOTE – In line with set fees under federal and state law, ARBDA/TRABECULAR will assess fees for resources necessarily to comply with your medical records requests.
Amendments to Your PHI. You can request an amendment or change to certain PHI that we maintain about you that you believe may be incorrect and/or incomplete. All such requests for changes must be in writing, signed by you or your representative, and state the reasons for the request. ARBDA/TRABECULAR is under no obligation to acknowledge receipt, accept, or apply any such request to your medical records. If your change/amendment request is accepted, we may also notify others who have copies of the information about the change. Note that even if we accept your request, we are unable to delete any information already documented in your medical record as this would be a violation of applicable law.
Accounting for Disclosures of Your PHI. In accordance with applicable law, you can ask for an accounting of certain disclosures made by us of your PHI. This request must be in writing and signed by you or your representative. This does not include disclosures made for purposes of treatment, payment, or health care operations or for certain other limited exceptions. An accounting will include disclosures made in the six years prior to the date of a request.
Restrictions on Use and Disclosure of Your PHI. You can request restrictions on certain of our uses and disclosures of your PHI for treatment, payment, or health care operations. We are not required to agree but will attempt to accommodate reasonable requests when appropriate.
Restrictions on Disclosures to Health Plans. You can request a restriction on certain disclosures of your PHI to your health plan. We are only required to honor such requests when services subject to the request are paid in full. Such requests must be made in writing and identify the services to which the restriction will apply.
Confidential Communications. You can request that we communicate with you through alternative means or at alternative locations, and we will accommodate reasonable requests. You must request such confidential communication in writing to each department you would like to accommodate the request.
Breach Notification. We are required to notify you in writing of any breach of your unsecured PHI without unreasonable delay and no later than 60 days after we discover the breach.
Paper Copy of Notice. You can obtain a paper copy of this Notice, even if you agreed to receive an electronic copy. Also, this Notice is available on our website at https://www.arthritissj.com/privacy
Complaints. If you believe your privacy rights have been violated, you can file a formal, written complaint with the ARBDA/TRABECULAR PRIVACY OFFICER by sending a signed written notice to:
ARBDA/TRABECULAR MEDICAL GROUP, LLC
ATTN: Christopher Gaffney, Ph.D.
740 Marne Highway, Suite 100
Moorestown, New Jersey 08057
You can also file a complaint with the Secretary of the U.S. Department of Health and Human Services in Washington D.C. A complaint must be made in writing and will not in any way affect the quality of care we provide you.
For further information. If you have questions about this Notice, or requests regarding privacy, please contact the ARBDA/TRABECULAR Privacy Officer at 856-424-5005 Ext. 195 or via email at email@example.com
Effective Date. This Notice of Privacy Practices is effective October 17, 2022.
Approved by: Christopher Gaffney, Ph.D.
ARBDA/TRABECULAR Privacy Officer