Privacy Policy

We are committed to the right to privacy for our patients and website visitors. When a person visits our website we may collect and track data from our site’s server. This information helps us to improve upon the content provided on our site. Information collected may include how long you spend on our site, the pages you visit, your browser and operating system types and the name of your Internet service provider.

Our website provides the capability to request information online. To process your request, we may require that you provide us with personal identifying information. All information collected is held in complete confidence. It is our policy not to share the information with third parties unless legally required to do so or as necessary to process your requests.

If you have any questions about our privacy policy or our use of information gathered through our website, please contact Mid State Orthopaedics & Sports Medicine, 3444 Masonic Drive, Alexandria, Louisiana 71301, (318) 473-9556.

Accessibility

Many photographs on this website are stock photography models (Models) and are not actual patients of, nor are they affiliated with, the Practice nor direct and indirect parent companies, subsidiaries, nor subsidiaries of its parent companies (“Affiliates”). The Practice has obtained the rights to use the photographs via license agreements with certain third-party stock photography companies, and the use of the photographs is in compliance with the terms of those license agreements. If individual patient photographs do appear it is with proper consent and full compliance with privacy regulations.

The photographs showing the Models are used on this website for illustrative purposes only. Models do not personally endorse the Practice, nor any products, services, causes, nor endeavors associated with, nor provided by, the Practice nor any Practice Affiliates. The context in which the photographs are used on this website is not intended to reflect personally on any of the Models shown in the photographs. The Practice nor Affiliates, their respective officers, directors, employees, agents and/or independent contractors assume no liability for any consequence relating directly or indirectly to the use of the photographs showing the Models on this website.

The Practice may update this Privacy policy occasionally to reflect changes in our practices, applicable laws and regulations. We encourage you to periodically review this policy to stay informed on how we are protecting your health information.

Site Disclaimer

Any use of this website or the information contained on the website is at your own risk. We will not be responsible for the consequences of your decision to utilize the information contained in this website.

The medical information provided in this site is for educational purposes only, it is not intended nor implied to be a substitute for professional medical advice. Always consult your physician or healthcare provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

To view the forms listed below, you will need to download Adobe Reader. Please bring your completed forms with you to our office at the time of your visit.

Stock Photography Models

Patient Privacy Statement

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this notice, please contact Scott Coleman, CEO, at (318) 473-9556.

OUR OBLIGATIONS:

We are required by law to:

Maintain the privacy of protected health information.
Give you this notice of our legal duties and privacy practices regarding health information about you
Follow the terms of our notice that is current in effect.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:

Described as follows are ways we may use and disclose health information that identifies you (“Health information”). Except for the following purposes, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to our practice Privacy Officer.

Treatment: We may use and disclose Health Information for your treatment and provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.
Payment: We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company, or a third party for the treatment and services you received. For example, we may give your health plan information so that they will pay for your treatment.
Health Care Operations: We may use and disclose Health Information for health care operation purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and manage our office. For example, we may use and disclose information to make sure services you receive are of the highest quality. We also may share information with other entities that have a relationship with you (for example, your health plan for their health care operation activities.
Appointment Reminders: Treatment Alternatives and Health Related Benefits and Services. We may use and disclose Health information to contact you and to remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care: When appropriate, we may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.
Research: Under certain circumstances, we may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. Before we use or disclose Health Information for research, the project will go through a special approval process. Even without special approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.

SPECIAL SITUATION:

As Required By Law: We will disclose Health Information when required to do so by international, federal, state or local law.
To Avert a Serious Threat to Health or Safety: We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.
Business Associates: In the course of providing you with services, we may share your information with business associates (3rd party vendors) e.g. billing services providers. All such 3rd parties are required to sign a business associate agreement (BAA) and comply with HIPAA rules and regulations to ensure that your Health Information remains secure.
Organ and Tissue Donation: If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement; banking or transportation of organs, eyes, or tissues to facilitate organ, eye or tissue donation; and transplantation.
Military and Veterans: If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.
Workers’ Compensation: We may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risk: We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim or abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities: We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement: We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain the persons agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identify, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors: We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.
National Security and Intelligence Activities: We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.
Protective Services for the President and Others: We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.
Inmates or Individuals in Custody: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary; (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.

YOUR RIGHTS:

You have the following rights regarding Health Information we have about you:

Right to Inspect and Copy: You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to Scott Coleman, CEO. If you request a copy of the information, we may charge a fee for the cost of printing, copying, mailing or other supplies associated with your request.
Right to Amend: If you feel that the Health Information we have is incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must be made in writing and submitted to Scott Coleman, CEO. In addition, you must provide a reason that supports your request. We may deny your request for 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:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
- Is not part of the health information kept by or for us Is not part of the information which you would be permitted to inspect and copy.
- Is accurate and complete.
Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to Scott Coleman, CEO. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a twelve-month period will be free. For additional lists, during such twelve month period, we may charge you for the costs of providing the list. We will notify you of cost involved and you may choose to withdraw or modify your request at that time, before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing, to Scott Coleman, CEO. We are not required to agree to your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
Right to Request Confidential Communication. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communication, you must make your request, in writing, to Scott Coleman, CEO. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.nabjc.com. To obtain a paper copy of this notice, please notify in writing, Scott Coleman, CEO. Mid State Orthopaedics & Sports Medicine, 3444 Masonic Drive, Alexandria, Louisiana 71301.

CHANGES TO THIS NOTICE:

We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office. The notice will contain the effective date on the first page, in the top right-hand corner.

COMPLAINTS:

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact Scott Coleman, CEO. All complaints must be made in writing to Mid State Orthopaedics & Sports Medicine, 3444 Masonic Drive, Alexandria, Louisiana 71301. You will not be penalized for filing a complaint.

Treatment Overview