OTNGROUP: STATEMENT OF PRIVACY
You are hereby
instructed to review this Statement of Privacy carefully as you will be
required to acknowledge your review of and agreement to its statements.
This notice states
the privacy practices of OTNGROUP.COM(“OTNGROUP”) and its owners. This
statement supplies to all of these primary care physicians and specialists,
nurses, residents, researchers and Physician Assistants of OTNGROUP including
OTNGROUP is required by federal HIPPA regulations to
maintain the privacy of your health information (“protected Health Information”
or “PHI”) and to provide you with this notice.
We will take precautions to protect information necessary to
your care. We will use your health
information for treatment, to run our healthcare network and to obtain payment.
We may use and disclose (give out) your PHI in connection
with your treatment and/or other services provided to you – for example, to
diagnose and treat you. In addition, we
may contact you to provide appointment reminders or information about treatment
alternatives or other health-related benefits and services. We may record your information at the nurse’s
stations, provide it in bedside charts and collect it in sign-in sheets in
order to coordinate your care.
We may disclose your PHI to obtain payment for services that
we provide to you.
We may use and disclose your PHI for healthcare
operations. These include internal
administration and planning and various activities that improve the quality and
cost effectiveness of healthcare services.
We may use your PHI to evaluate our physicians, nurses and other
healthcare workers – or to support training of these professionals. We may also use PHI to address patient
concerns, to provide patient education and to assess patient satisfaction. We may provide licensing and accrediting
organizations with your PHI to maintain the approvals we need to continue our
We may also disclose PHI to healthcare providers when such
PHI is required for them to treat you (e.g., specialists, pharmacists), receive
payment for services they provide to you, or conduct certain healthcare
operations. For example, emergency
ambulance companies use PHI to request payment for services in bringing you to
We may disclose your PHI to a family member, other relative,
friend or any other person if we: 1)
obtain your agreement; 2) provide you with the opportunity to object to the
disclosure, and you do not object; 3) we reasonably assume that you do not
object. If we provide information on any
individual(s) listed above we will release only information that we believe is
directly relevant to that person’s involvement with your healthcare or payment
related to your healthcare. We may also
disclose your PHI in the event of an emergency or to notify (or assist in
notifying) such persons of your location, general condition or death.
We may use PHI to communicate with you about products or
services relating to your treatment, case management or care coordination, or
alternative treatments, therapies, providers or care settings without your
written authorization. We offer you help
in finding a physician and look at how this referral service is used. We may send you newsletters or informational
mailers regarding our services, programs and community events. If you have taken part in one of our health
screenings or other community events, we may follow up with you by telephone or
mail about services that may benefit you.
We may disclose your PHI for the following public health
activities: 1) reporting births or
deaths; 2) preventing or controlling disease; 3) reporting child abuse and
neglect to public health or other government authorities authorized by law to
receive such reports; 4) reporting information about products and services
under the jurisdiction of the United States Food and Drug Administration, such
as reactions to medications and problems with products; 5) alerting a person
who may have been exposed to an infectious disease or may be at risk of
contracting or spreading disease or condition; 6) notifying people of recalls
of products they may be using; and 7) reporting information to your employer as
required by law addressing work-related illnesses and injuries or workplace medical
If we reasonably believe you are a victim of abuse, neglect
or domestic violence, we may disclose your PHI to a governmental authority,
including a social service protective agency, authorized by law to receive
reports of such abuse, neglect or domestic violence.
We may disclose your PHI to a health oversight agency that
is responsible for ensuring compliance with rules of government health programs
such as Medicare or Medicaid.
We may disclose your PHI in response to a court order, subpoena,
or other lawful process.
We may disclose PHI of deceased individuals to a coroner or
medical examiner authorized by law to receive such information.
We may disclose your PHI to organizations that obtain organs
or tissue for banking and/or transplantations.
We may use or disclose your PHI to prevent or lessen a
serious and imminent threat to personal or public safety.
We may disclose your PHI as authorized by state law relating
to worker’s compensation or other similar government programs.
If you are or become a correctional institution inmate or
you are in custody of a law enforcement official, we may release your PHI to
the institution or official if required to provide you with healthcare or to
protect the health and safety of others.
We may use and disclose your PHI when required to do so by
any other laws not already referenced above.
If a business associate assists OTNGROUP operations, OTNGROUP
will disclose PHI as needed, but only if the business associate has signed a
privacy addendum agreeing to maintain the privacy of PHI.
For any purpose other than the ones described above, we may
use or disclose your PHI only when you give OTNGROUP your specific written
authorization. For instance, you will
need to sign an authorization form before we can send your PHI to a life
You may request to see and obtain copies of your medical and
billing records and to have copies sent to others. To do so, please submit a written request to OTNGROUP. We will charge you for copies. Under limited circumstances defined by law,
we may deny you access to a portion of your records.
You may request additional restrictions on OTNGROUP’s use
and disclosure of your PHI 1) for treatment, payment and healthcare operations;
2) to individuals (such as family members, or other relatives, close friends or
any other person identified by you) involved with your care or with payment
related to your care; and 3) to notify or assist in the notification of such
individuals regarding your location in the hospital and your general
condition. Although we will consider all
requests for restrictions carefully, we are not required to agree to a request.
You may request to receive your PHI by alternate means of
communication or at alternate locations.
For example, you may instruct us not to contact you by telephone at
home, or you may give us a mailing address other than your home for test
You may revoke your authorization by delivering a written
form requesting us to stop using your authorization. The request will be effective once agreed to
by as set forth above. A revocation form
is available upon request from OTNGROUP.
You have the right to request that we amend the PHI
maintained in your medical or billing records.
To do so, you must submit a written request to the OTNGROUP. We may deny your request if OTNGROUP
reasonably believes that the information is not accurate and complete, if the
PHI was not created by OTNGROUP, or other special circumstances apply.
If you wish further information about your privacy rights,
are concerned that your privacy rights were violated, or disagree with a
decision that we made about access to your PHI, you may contact OTNGROUP by
clicking on “Contact”.
Additionally, you may file a written complaint with the
Director, Office for Civil Rights of the U.S. Department of Health and Human
Services. Upon request, SVS will provide
you with contact information.
We may change the terms of this notice at any time. If we change this notice, we will post the
revised list online at OTNgroup.com.
You may obtain any revised notice by contacting us.