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This notice describes how medical information about you may be used and disclosed and how you may gain access to this information. Please review it carefully. We are required by Federal Law to provide you with the information detailed below, according to specified format and content. If you have any questions about this notice, please contact our Confidentiality Coordinator at the address/phone number listed below.

Shady Grove Orthopaedics
9601 Blackwell Road, Suite 100
Rockville, MD 20850

Phone: (301) 340-9200

Fax: (301) 340-7235

For your convenience, you may download and print a PDF of all of the information contained on this page by clicking here.

Each time you visit Shady Grove Orthopaedics ("The Practice"), your medical record is updated to record your symptoms, exam and test results, diagnosis, treatment, and recommendations for future treatment. We are required by law to ensure that your medical information is kept private, give you this Notice of Privacy Practices, and follow the terms of the notice that are currently in effect. We may change the terms of our notice at any time. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of our current Notice in our offices in a visible location at all times. 

How Shady Grove Orthopaedics May Use And Disclose Medical Information About You

The following examples provide different ways that The Practice may use and disclose medical information about you without your authorization. Your protected health information may be used and disclosed by your physician, The Practice's staff, and others outside of The Practice involved in providing healthcare services to you. Each category below gives examples as to how The Practice may use and disclose your protected health information.

  • Treatment: The Practice may use medical information about you to provide, coordinator, or manage your medical treatment or services. For example, information obtained by your nurse or physician will be recorded and used to determine the best course of treatment for you. This information may be shared with other healthcare providers involved in your healthcare diagnosis and treatment. 
  • Payment: The Practice may use and disclose medical information about you to receive payment for your healthcare services. For example, we may send a bill to you, an insurance company, or a third party such as family members. The information on the bill may include information that identifies you and the healthcare services you received. We may also communicate with your health insurance carrier to get prior approval for a treatment or to determine if a treatment is covered under your plan.
  • Healthcare Operations: The Practice may use and disclose medical information about you in order to support the business activities, which we call "healthcare operations" of the practice. For example, members of the medical staff and/or members of a quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it as a means to continually improve the quality of the healthcare and services we provide.
  • Business Associates: The Practice may use a third party to perform various functions necessary to the practice (e.g., billing and transcription). The Practice requires that third parties sign contracts stating they will protect your information.
  • Appointment Reminders: We may use and disclose medical information when we contact you by phone or mail to remind you of an appointment.
  • As Required By Law: The Practice will disclose medical information when required to do so by federal, state, or local law, in response to a court order, valid subpoena, warrant, summons, or similar process.
  • Military and Veterans: The Practice may release medical information of patients in the armed forces as required by military command authorities. 
  • Workers' Compensation: The Practice may release medical information about you to comply with workers' compensation laws.
  • Health Oversight: The Practice may disclose your health information to a state or federal health oversight agency, which is authorized by law to oversee our operations. 
  • Public Health: The Practice may disclose medical information about you for public health reasons. Some common reasons for disclosure are to prevent or control disease, injury, or disability and to report births and deaths. 
  • Law Enforcement: When legal requirements are met, The Practice may release medical information about you if asked to do so by a law enforcement official. For example, for legal processes that are required by law or concerning victim(s) of a crime.
  • National Security: The Practice may disclose your medical information to federal officials for intelligence and national security activities authorized by law.
  • Coroners, Medical Examiners, and Funeral Directors: Medical information may be released to a coroner or medical examiner, as authorized by law, for identification purposes or to determine the cause of death. 
  • Inmates: If you are an inmate of a correctional institution or in the custody of a law enforcement official, The Practice may release medical information about you to the correctional institution or law enforcement official.

Special Situations

  • Emergencies/Communication Barriers: The Practice may disclose health information in the event of an emergency health situation or if significant communication barriers exist and the physician determines, using professional judgment, that you intent to consent to use or disclose under the circumstances.
  • Family and Others Involved in your Care or Payment for you Care: Using our best judgment, The Practice may disclose health information about you to a family member, relative, or friend involved in your medical care or the payment of your care.
  • Research: The Practice may disclose medical information to researchers if an institutional review board has approved the research proposal and protocols are in place to ensure the privacy of your medical information.

Your Medical Information and Your Rights

Your health record is the physical property of your healthcare provider. The information, however, belongs to you. We are required by law to inform you of our legal rights, which are detailed below.

  • Right to Confidential Communications: You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. We will accommodate reasonable requests. You must make a written request to our Confidentiality Coordinator. 
  • Right to Inspect and Copy: You have the right to inspect and obtain a copy of your medical record. This typically includes medical and billing records. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. If you would like to inspect your medical information, you must submit your written request to our Confidentiality Coordinator. You will be contacted and an appointment arranged for review of the records in the presence of an Office Representative. If you would like to request a copy of your medical information, you must submit your written request to our Confidentiality Coordinator. You will be charged a fee for the cost of copying, mailing, and other costs associated with your request.
  • Right to Obtain an Accounting of Disclosures: You have the right to request an accounting of certain disclosures we have made (if any) of your health information, which do not fall under the routine disclosures stipulated for payment, treatment, and/or healthcare operations or for which you have not additional authorized in writing. To request an accounting of such disclosures, please submit your written request to our Confidentiality Coordinator. 
  • Right to Have Your Physician Amend Your Protected Health Information: This means you may request an amendment of protected health information about you in a designated record set if you believe it is incorrect or incomplete for as long as we maintain this information. In certain cases, we may deny your request for an amendment. If we do so, you have the right to file a statement or disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. 
  • Right to Obtain a Paper Copy of This Notice: Upon request, and at any time, The Practice will provide you with a paper copy of this Notice.
  • Right to Provide an Authorization for Other Uses and Disclosures: The Practice will obtain your written authorization for uses and disclosures that are not identified by this Notice or permitted by applicable law.

Practice Obligations Regarding Your Medical Information and Your Rights

Pursuant to your written request(s) regarding your medical information and rights, please be advises that the law requires that The Practice respond to your request(s) within thirty (30) days.

Complaints

If you believe your privacy rights have been violated, you may contact our Confidentiality Coordinator at the address/phone number listed above without fear of retribution. All complaints must be submitted in writing and will be handled confidentially. The Confidentiality Coordinator will contact you within 10 business days of receipt of your complaint.

Should you feel further assistance is warranted, you may contact the Office for Civil Rights/U.S. Department of Health and Human Services at 200 Independence Avenue, S.W., Rm 509F HHH Building, Washington, D.C. 20201 of call the Office of Civil Rights (OCR) Hotline at (866) 627-7748.