NOTICE OF PRIVACY PRACTICES

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.
Protecting Your Personal and Health Information

Cornerstone Prosthetics & Orthotics, Inc. is committed to protecting the privacy of your personal information. We are required by applicable federal and state laws to maintain the privacy of your personal and health information. This notice explains our privacy practices, our legal duties, and our rights concerning your personal and health information. Personal and health information (referred to in this notice as “personal information”) means any information that is identifiable to you as your personal information, including information regarding your health care and treatment; identifiable factors including your name, age, address, income, or other financial information. We will follow the privacy practices that are described in this notice while in effect.

How do we protect your personal information?

We protect your personal information by:

Treating all of your personal information that we collect as confidential;
Stating confidentiality policies and practices in our employee handbooks as well and disciplinary measures for privacy violations;
Restricting access to your personal information only to those employees who need to know your personal information in order to provide our services to you.
Only disclosing your personal information that is necessary for a service company to perform its function on our behalf, and the company agrees to protect and maintain the confidentiality of your personal information; and
Maintaining physical, electronic, and procedural safeguards that comply with federal and state regulations to guard your personal information.

How do we use and disclose your personal information?

We won’t disclose your personal information unless we are allowed or required by law to make the disclosure, or if you (or an authorized representative) give us permission. Uses and disclosures, other than those listed below require your authorization. If there are other legal requirements under applicable state laws that further restrict our use or disclosure of your personal information, we’ll comply with those legal requirements as well. Following are the types of disclosures we may make as allowed or required by law.

Treatment: We may use and disclose your personal information for our treatment activities or for the treatment activities of a health care provider. Treatment activities include disclosing your personal information to a provider to treat you.
Payment: We may use and disclose your personal information for our payment activities. We may tell you a health plan about an orthotic or prosthetic device you are going to receive to obtain prior approval or to determine whether your plan will cover the device.
Health Care Operations: We may use and disclose your personal information for our internal operations, including our customer service activities. We may share your protected health information with third-party “business associates” that perform various activities (e.g., billing, transcription services) for the facility.
Business Associates: We may also share your personal information with third-party “business associates” who perform certain activities for us. We require these business associates to afford your personal information the same protections afforded by us.
Treatment Alternatives: We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Appointment Reminders: We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment. We may contact you to schedule an appointment when we are ready to deliver the product and or service.
Sign In Sheets: We may use a sign-in sheet at the registration desk where you will be asked to sign your name. We also call you by name in the waiting room when we are ready to see you.
Marketing: We may use your personal information to contact you with information about health-related products and services or about treatment alternatives that may be of interest to you.
Sale Of Practice: If we decide to sell this practice or combine it with another practice, we may share your protected health information with new owners.
Research; Death; Organ Donation: We may disclose your personal information for research purposes in limited circumstances. We may disclose the personal information of the deceased person to a coroner, medical examiner, funeral director, or organ procurement organization for certain purposes.
Public Health and Safety: We may disclose your personal information if we believe disclosure is necessary to avert a serious and imminent threat to your health or safety or the health or safety of others. We may disclose your information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, domestic violence, or other crimes.
Required by Law: We must disclose your personal information when we are required to do so by law.
Process and Proceedings: We may disclose your personal information in response to a court or administrative order, subpoena, discovery request, or another lawful process.
Law Enforcement: We may disclose limited information to law enforcement officials.
Military and National Security: We may disclose to military authorities the personal information of Armed Forces personnel under certain circumstances. We may disclose to authorize federal officials personal information required for lawful intelligence, counterintelligence, and other national security activities.

What rights do you have as an individual regarding our use and disclosure of your personal information?

You have the right to request all of the following:

Access to Your Personal Information: You have the right to review and receive a copy of your personal information. We may charge you a nominal fee for providing you with copies of your personal information. This right doesn’t include the right to obtain copies of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to other state or federal laws that prohibit us to release such information. We may also limit your access to your personal information if we determine that providing the information could possibly harm you or another person. If we limit access based upon the belief that it could harm you or another person, you have the right to request a review of that decision.
Amendment: You have the right to request that we amend your personal information. Your request must be in writing, and it must identify the information that you think is incorrect and explain why the information should be amended. We may decline your request for certain reasons, including if you ask us to change information that we didn’t create. If we decline your request to amend your records, we’ll provide you a written explanation. You may respond with a statement of disagreement to be appended to the information you wanted to be amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you have authorized, of the amendment and to include the changes in any future disclosures of that information.
Accounting of Disclosures: You have the right to receive a report of instances in which we our business associates disclosed your personal information for purposes other than for treatment, payment, health care operations, and certain other activities. You are entitled to such an accounting for the 6 years prior to your request, though not for disclosures made prior to April 14, 2003. We’ll provide you with the date on which we made a disclosure, the name of the person or entity to which we disclosed your personal disclosure, and other applicable information. If you request this list more than once in a 12-month period, we may charge you a reasonable fee for creating and sending these additional reports.
Restriction Request: You have the right to request that we place additional restrictions on our use or disclosure of your personal information for treatment, payment, health care operations or to persons you identify. We may be unable to agree to your requested restrictions. If we do, we’ll abide by our agreement (except in an emergency).
Confidential Communication: You have the right to request that we communicate with you in confidence about your personal information by alternative means or to an alternative location. If you advise us that disclosures of all or any part of your personal information could endanger you, we will comply with any reasonable request provided you specify an alternative means of communication.
Electronic Notice: If you receive this notice by electronic mail, you are entitled to receive this notice in written form.

When is this notice effective?

This notice takes effect April 1, 2003, and will remain in effect until we revise it.

You may contact our Privacy Contact, Kelly Gies at (425) 339-2559.

Complaints

You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you in any way for filing a complaint, either with us or with the Administrative Staff.

Changes To This Notice

We reserve the right to change the privacy practices that are described in this Notice of Privacy Practices. We also reserve the right to apply these changes retroactively to Protected Health Information received before the change in privacy practices. You may obtain a revised Notice of Privacy Practices by calling and requesting a revised copy to be sent in the mail, asking for one at the time of your next appointment.