The practice is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment and health care operations. Protected health information is the information we create and obtain in providing our services to you.
Your Health Information Rights
The health record we maintain and billing records are the physical property of the practice. The information in it, however, belongs to you. You have a right to:
* Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office.
* Obtain a copy of this Notice of Privacy Practices for Protected Health Information (“Notice”) by making a request at our office.
* Request that you are allowed to copy your health record and billing record – you may exercise this right by delivering the request in writing to our office. There is a fee for duplication of records as allowed by Pennsylvania law. More information is available upon request.
* Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office.
* File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information.
The practice is required to:
* Maintain the privacy of your health information as required by law and abide by the terms of this notice.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our “Notice” or by visiting our office and picking up a copy.
To request Information or File A Complaint
If you should have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact:
Kerri Long (Office Manager): 724-483-5080
Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our office by delivering the written complaint to Kerri. You may also file a complaint by mailing it to the Secretary of Health and Human Services whose street address is:
The US Department of Health & Human Services Office of Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
* We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the practice.
* We cannot, and will not, retaliate against you for filing a complaint with the Secretary.
Other Disclosures and Uses
To Your Family and Friends: We may disclose your health information to a family member, friend, or other person to the extent necessary to help with your healthcare or with payment for your healthcare.
Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location or your general condition. If you are present, then prior to use or disclosures of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgement disclosing only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgement and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays or other similar forms of health information.
Appointment Reminders: We may use or disclose your health information to provide you with appointment reminders (such as messages on answering machines, voicemail messages, postcards, or letters).
If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.
As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Abuse & Neglect
We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect.
If you are an inmate of a correctional institution, we may disclose to the institution, or its agents, your protected health information necessary for your health and the health and safety of other individuals.
We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecutions, or to the extent an individual is in the custody of law enforcement.
Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities.
We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order.
Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization and you may revoke the authorization as previously provided.
For Specialized Government Functions
* We may disclose your protected health information for specialized government functions as authorized by law, such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.
Effective Date: April 14, 2003