NOTICE OF PRIVACY PRACTICES
Effective Date: Febuary 6, 2015
We are committed to respecting and protecting your privacy as a visitor to our Online Patient Bill Pay. We take the issue of privacy very seriously and value the trust you place in us each time you use our services and access this web site.
This Privacy Statement describes the practices and policies we have put into place to safeguard personal information that may be gathered and used as you visit our web site.
you have any questions about this notice, please refer to our website, floridasportsinjury.com or you may contact us by telephone at 352 404 8956, email firstname.lastname@example.org or mail to Florida Sports Injury and Orthopedic Institute 1925 Don Wickham Drive, Cermont Florida 34711.
Who Is Collecting the Information?
We are collecting information on this web site as outlined in this privacy statement.
What Information Do We Collect?
Automatic Collection of Information:
If you do nothing during your visit but browse through the web site or download information, our system will automatically gather and store certain information about your visit. This information does not identify you personally and is used in an aggregate way to help us improve our web site and tell us how many people visit our site over a period of time.
Our Web server automatically collects and records the following information:
The visitor's IP address.
Aggregate information on what pages are accessed.
The name and release number of web browser software used.
The operating system used.
Date and time of access.
The address of the web site that linked to us (referrer URL).
How Do We Use the Information We Collect?
The information we gather automatically and with your permission during your visit to our web site is used to:
Monitor, review, measure, and analyze web site utilization.
Modify and enhance the web site.
Improve the content and design of our web site.
Monitor and improve our customer service efforts.
Distribute news and other health information requested by web visitors.
Notify visitors about updates to our web site.
With Whom Will the Information Be Shared?
We will not share your personally identifiable information without your permission. We do not rent, sell, exchange or in any way provide personally identifiable information to any third-party organization unless we are authorized to do so.
Registration for Access
In order to restrict access to any sections of this site displaying personal health information, we require each registrant to provide personal information that is only available to the responsible party. This personal information includes the account number obtained from the physical document printed and mailed to the responsible individual.
Security of Communications
We recognize that many people are concerned about the privacy and protection of information as it is transmitted over the Internet. You should keep in mind that the possibility exists for unauthorized individuals to intercept any e-mail message you send over the Internet. In some cases, information can be encrypted (scrambled or encoded) to make it very difficult to read if it is intercepted during communication. Certain technology and practices allow web sites to provide an increased level of security for your personal and health-related information when appropriate.
We use the following practices on our web site to enhance the level of security for communication and the transmission of personal information:
We always use industry-standard encryption technologies when transferring and receiving consumer data exchanged with our site.
We have taken reasonable steps to ensure the integrity and confidentiality of personally identifiable information that you may provide.
We use a confidential form to allow our customers to ask questions about our services and programs. These are hosted on a secure server to ensure the secure transmission of your information.
We have appropriate security measures in place in our physical facilities to protect against the loss, misuse, or alteration of information that we have collected from you at this site.
E-Commerce / Online Payment
Paying for services over the Internet requires you to provide your personal identifying information and credit card information to the web site. Many people have become accustomed to online commerce as a time-saving and useful convenience. There are a number of practices that make providing sensitive credit card information more secure and therefore make you feel more comfortable about doing so.
We accept credit card payments for services performed by our facilities on our web site. We use the following e-commerce practices to insure the security of your personal financial information:
When processing your credit card payment, we will ask for the card type, account number, expiration date, and your card's billing address.
All credit card information will be transmitted to us in an encrypted format using industry-standard, SSL (secure socket layer) encryption.
When a credit card transaction is completed, we will not maintain your credit card number on our web servers.
We will keep this information in the strictest confidence and will make every effort to maintain the privacy and security of the information at all times.
Links to Other Sites
From time to time, we may identify opportunities to use customer information for new, unanticipated uses not previously disclosed in our privacy notice. If our information practices change at some time in the future, we will post the policy changes to our web site and allow you to opt out of these new uses. If you are concerned about how your information is used, you should check back at our web site periodically.
Web Site Contact Information
WHO WILL FOLLOW THIS NOTICE
This notice describes Florida Sports Injury and Orthopedic Institute practices regarding the use and disclosure of your medical information, including use and disclosure by (a) any healthcare professional authorized to enter information into your medical record, (b) all departments and units of the system, (c) volunteers we allow to help you while you are in the facility, (d) all contracted services, and (e) all members of Florida Sports Injury and Orthopedic Institute workforce.
OUR PLEDGE REGARDING MEDICAL INFORMATION
We understand that information about you and your health is personal. We are committed to protecting that medical information. We create a record of the care and services you receive to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Florida Sports Injury and Orthopedic Institute, whether made by our employees or your personal physician. This notice tells you about the ways in which we may use and disclose information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to: make sure that health-related information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; follow the terms of the notice that is currently in effect and notify you following a breach of unsecured protected health information.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe the ways that we use and disclose health-related information. For each category of use or disclosure, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
We may use and disclose your information to provide you with medical treatment and to coordinate or manage your health care and related services. For example, we may use and disclose information about you to physicians, nurses, technicians, medical students, family members, clergy, or others who are involved in your care. We may use and disclose medical information about you when you need prescription, lab work X-rays or other healthcare services, or when referring you to another healthcare provider.
We may use and disclose information about you so the treatment and services you receive can be billed to and payment may be collected from you, an insurance company or a third party. (For example, we may need to give your health plan information about surgery you received so your health plan will pay us or reimburse you for the surgery.) We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
We may use and disclose information to contact you as a reminder that you have an appointment for treatment.
Treatment Alternatives and Health-Related Benefits and Services
We may use and disclose information to recommend or tell you about treatment alternatives and health-related benefits or services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care
Unless you object, we may release information about you to a friend or family member who is involved in or helps pay for your medical care. We may also tell your family or friends your general condition and that you are in the hospital. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Under certain circumstances, we may use and disclose information about you for research purposes. (For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another for the same condition.) All research projects are subject to a special approval process that evaluates a proposed research project and its use of medical information, trying to balance the research needs with the patient’s need for privacy of their medical information. Before we use or disclose information for research, the project will have been approved through this research approval process; however, we may disclose information about you to people preparing to conduct a research project to help them look for patients with specific medical needs, so long as the information they review does not leave Florida Sports Injury and Orthopedic Institute.. When our staff conducts a research project in which they look back at old medical records, your personal information will not be disclosed outside the clinic nor will you be identified in any reports. If a research project is conducted where your information cannot be held confidential, a separate process is in place for you to consent for this type of research.
We may follow-up your visit with us by sending to the address listed in your records a brief written survey about your satisfaction with the level of service provided to you. In some cases, the survey may be conducted by telephone or e-mail using the contact information listed in your medical record. In some instances, your name may be passed on to members of the service excellence team to investigate a complaint or corroborate an incident.
We may use certain information (name, address, telephone number, dates of service, age, gender, treating physician, department where you received service, health insurance status, and outcome) to contact you in the future. We may also provide this information to an institutionally-related foundation for the same purpose. The money raised will be used to expand and improve the services and programs we provide the community. You have the right to opt out of receiving such communications.
As Required By Law
We will disclose information about you when required to do so by federal, state or local law.
To Prevent a Serious Threat to Health or Safety
We may use and disclose information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures would only be to someone able to help prevent the threat.
Organ and Tissue Donation
If you are an organ donor, we may release information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank to facilitate organ or tissue donation and transplantation.
Military and Veterans
If you are a member of the armed forces, we may release information about you as required by military authorities. We may also release information about foreign military personnel to the appropriate foreign military authority.
We may release information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks
We will disclose information about you for public health activities as required by law. These activities generally include the following: (a) to prevent or control disease, injury or disability; (b) to report births and deaths; (c) to report child abuse or neglect; (d) to report reactions to medications or problems with products; (e) to notify people of recalls of products they may be using; (f) to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and (g) to notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence.
Health Oversight Activities
We will disclose information to a health oversight agency for activities authorized by law. These oversight activities include: audits, investigations, inspections, and licensure that are necessary for the government to monitor the healthcare system, government programs, and compliance with applicable laws.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose information about you in response to a court or administrative order. We may also disclose information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if we are assured that reasonable efforts have been made to tell you about the request or to obtain an order protecting the information requested.
We may release information if asked to do so by a law enforcement official: (a) in response to a court order, subpoena, warrant, summons or similar process; (b) to identify or locate a suspect, fugitive, material witness, or missing person; (c) about the victim of a crime if, under certain limited circumstances, we are unable to obtain the patient agreement; (d) about a death we believe may be the result of criminal conduct; (e) about criminal conduct at the hospital; and (f) in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors
We will release information to a coroner or medical examiner to identify a deceased person or determine the cause of death. We will also release information to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities
We may release information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.
Protective Services for the President of the United States and Others
We may disclose information about you to authorized Federal officials so they may conduct special investigations and provide protection to the President or other officials and dignitaries.
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release information about you to the correctional institution or law enforcement official to provide you with healthcare, to protect your and other’s health and safety, or for the safety and security of the correctional institution.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding the medical information we maintain about you:
Right to Inspect and Copy
You have the right to inspect and obtain copies of medical information that may be used to make decisions about your care. (Usually, this includes medical and billing records.) To inspect and obtain a copy of medical information that may be used to make decisions about you, you must appear in person or submit your request in writing to: Florida Sports Injury and Orthopedic Institute,, Release of Information, 1925 Don Wickham Drive., Clermont Florida 34711. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, labor, electronic media or other supplies associated with your request. We may deny your request to inspect and obtain a copy of your medical information in certain limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed.
Right to Amend
If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for Florida Sports Injury and Orthopedic Institute.. To request an amendment, your request must be made in writing and submitted to Florida Sports Injury and Orthopedic Institute – 1925 Don Wickham Drive, Clermont Florida 34711. . In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: (a) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (b) is not part of the medical information kept by or for the hospital; (c) is not part of the information which you would be permitted to inspect and copy; or (d) is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request an accounting (list) of certain types of disclosures we have made of medical information about you. We are not required to account for certain disclosures such as: (a) disclosures you authorize; (b) disclosures to carry out treatment, payment and healthcare operations; and (c) disclosures to persons involved in your care. To request an accounting of disclosures, you must submit your request in writing to to Florida Sports Injury and Orthopedic Institute – 1925 Don Wickham Drive, Clermont Florida 34711. Your request must state a time period, which may not be longer than six years, and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. There may be a charge for additional requests. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Confidential Communications
You have the right to request that we communicate with you in a certain way or at a certain location. (For example, you can ask that we only contact you at work or by mail.) If you want to request confidential communication, contact a Registration or Billing Office representative, Monday through Friday during regular business hours and/or during the registration process. We will not ask the reason for your request. We will accommodate all reasonable requests. Your request must include the address and/or telephone number where you want to be contacted.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice any time. You may obtain a copy of this notice at our website, orlandohealth.com, or at any admission/registration center.
CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time. We reserve the right to make the revised or changed notice effective for 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 in various locations indicating the effective date. Revised copies of this notice will be provided upon request.
If you believe your privacy rights have been violated, you may file a complaint with the facility or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with the facility, contact Florida Sports Injury and Orthopedic Institute, 1925 Don Wickham Drive, Clermont Florida 34711. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of information not covered by this notice or the laws that apply to us will be made only with your written permission. These include most uses and disclosures of psychotherapy notes, most uses and disclosures for marketing purposes and disclosures for which we receive remuneration in exchange for your information. If you provide us permission to use or disclose information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.