POLICIES

HIPAA Policy and Privacy

In order to comply with state and federal regulations concerning how sensitive information about your medical care is being handled, Surgery Center at Corporate Way, LLC is adopting the following HIPAA Policy and Privacy practice. This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights  as  they  relate  to  your  protected  health  information. This Notice is effective January 1st, 2016, and applies to all protected health information as defined by federal regulations.  The patient's rights and responsibilities form, as posted in our waiting room can be found here: pt_rts_resp.pdf

Understanding your
Health Record/Information

Each time you visit Surgery Center at Corporate Way, LLC a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and plan for future care or treatment. This information, often referred to as your health or medical record, serves as a basis for planning your care and treatment, a means of communication among the many health professionals who contribute to your care, a legal document describing the care you received, a means by which you or a third-party payer can verify that services billed were actually provided, 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 this state and the nation, a source of data for our planning and public relations, and a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

Understanding what is in your record and how your health information may be 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.

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example:
Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment. We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you once you have been referred for treatment.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health operations.

For example:
Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Business associates:
There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

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, your location, and general condition.

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.

Research:
We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral directors:
We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Public Relations:
We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

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

Workers 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.

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.

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.


***This notice has been provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA) of 1996***

Your Rights:
​Surprise Billing and Health Information

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s co-payments, coinsurance and/or deductible

Your Rights and Protections Against Surprise Medical Bills

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a co-payment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency Services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as co-payments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you, and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.
Your right to request a good faith estimate for non-emergency health care services the law.
A patient may ask for an estimate of the amount the patient will be charged for a non-emergency medical service provided. Federal law requires that we provide a good faith estimate within 3 business days of your request, or within 1 or 3 business days of scheduling depending on the date services are to be provided.


When balance billing isn’t allowed, you also have these protections:
You’re only responsible for paying your share of the cost (like the co-payments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
Generally, your health plan must:
Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits
Count any amount you pay for emergency services or out-of-network services toward your in network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, you may contact:  https://www.cms.gov/nosurprises/consumers or dial 1 (800) 985-3059 for more information about your rights under federal law.

You have the right to file a complaint with the Ohio Department of Insurance (ODI) if you have a problem getting the services you need, including quality and affordable health care. To file a complaint you must first complete your health plan’s appeal process.

Your Health Information

Although your health record is the physical property of Surgery Center at Corporate Way, LLC, the information belongs to you. You have the right to obtain a paper copy of this notice of information practices upon request, to inspect and copy your health record as provided for in 45 CFR 164.524 (at a reasonable fee), to request amendments to your health record that you believe to be inaccurate as provided in 45 CFR 164.528, to obtain an accounting of our uses and disclosures of your health information subject to certain exceptions as provided in 45 CFR 164.528, to request communications of your health information by alternative means or at alternative locations, to request restrictions on certain uses and disclosures of your information, although we are not obligated to honor this request, as provided by 45 CFR 164.522, to revoke your authorization to use or disclose health  information except to the extent that action has already been taken.

For More Information or to Report a Problem
If you believe your privacy rights have been violated, you can file a complaint with the practice’s Privacy Officer or with the Office for Civil Rights (OCR), U.S. Department of Health and Human Services. If you have questions and would like additional information, you may contact the practice’s Practice Manager at (937) 434-4111. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights.  The address for the OCR is listed below:

Office for Civil Rights
U.S. Department of Health and Human Services 200 Independence Avenue, S.W., Room 509F, HHS Building Washington, D.C. 20201
[email protected]

In addition, there is a pre-recorded message with useful information about OCR:
Toll free: (800) 368-1019
TDD toll free: (800) 537-7697

Our Responsibilities

Surgery Center at Corporate Way, LLC is required to maintain the privacy of your health information, to provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you, to abide by the terms of this notice, to notify you if we are unable to agree to a requested restriction, and to 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 have you read and ask questions about the agreement and its changes before proceeding with medical care. We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.