Notice of Privacy Practices

This notice will explain and detail the policies and procedures followed by Performance Orthopedics with regards to the handling of your protected health information (PHI). These policies are in accordance with guidelines set forth by the Health Information Portability and Accountability Act of 1996 (HIPAA).

If you have any questions, concerns or complaints regarding the policies or practices of Performance Orthopedics as they relate to your PHI, please contact us at 248-988-8085. Effective date of this notice is March 15, 2003.

We, at Performance Orthopedics, are required by law to do the following:

  • Advise you of our privacy practices regarding your PHI
  • Maintain your medical records and other protected health information in a manner that conforms with the requirements of the law

We may use your protected health information in the following ways without your permission:

  • Treatment – Performance Orthopedics may use or disclose your PHI in any way that is necessary to provide proper medical care. We may share information with any other doctors, nurses or other health care worker, therapists, labs, pharmacies etc. that may require this information to participate in your care. We may use your medical information for teaching or presentations after it has been de-identified (remove your name, social security # and/or date of birth so that it does not personally identify you).
  • Payment. Performance Orthopedics may use and disclose your PHI to any organization for the purposes of obtaining reimbursement for our services.
  • Health Care Operations. Performance Orthopedics may use or discloseyour PHI in any way necessary for the performance of our health care operations. This may include review of policies, treatments such as medications or injections.
  • Appointment reminders. We may contact you by phone, mail or e-mail to remind you of an upcoming appointment or in order to cancel or reschedule appointments.
  • Health related benefits and services. We may contact you and use or disclose your PHI to inform you of new treatments or services available.
  • Public safety or other Legal matters. We may use and disclose your PHI for the purposes of public safety, any criminal or judicial matters, or as the local, state or federal laws require.

Your Health Information Rights

  • You have the right to request a restriction on certain and specific uses or disclosures of your protected health information. Performance Orthopedics is not required to agree with that requested restriction.
  • You have the right to request an accounting of the uses and disclosures of your PHI.
  • You have a right to inspect, copy or amend your health information. We have the right to charge reasonable fees as compensation for the preparation, copying and mailing of your medical records.
  • You have a right to a paper copy of this notice. Performance Orthopedics reserves the right to change or modify this policy from time to time. A current copy of the notice of privacy policies will be posted in our office and will be made available by request or at the time of next service.

Any complaints, request for copies of your records or request for restrictions of the disclosure of your protected health information must be made in writing. The request must be signed and dated. Requests for restrictions must be specific as to what information will be limited and to whom the limits apply. Send privacy issue requests to:

Performance Orthopedics
24255 Thirteen Mile Road
Suite 100
Bingham Farms, MI 48025.

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