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Surgical Specialists,
P. C.
Notice of Privacy
Policies
THIS NOTICE DESCRIBES HOW INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET
ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
Introduction
At Surgical Specialists, we are
committed to treating and using protected health
information about you responsibly.
This Notice of Health Information Practices
describes the personal information we collect, and how
and when we use or disclose that information.
It also describes your rights as they relate to
your protected health information.
This Notice is effective April 14, 2003, and
applies to all protected health information as defined
by federal regulations.
Understanding
Your Health Record/Information
Each time you visit Surgical
Specialists, P. C. a record of your visit is made.
Typically, this record contains your symptoms,
examination and test results, diagnoses, treatment, and
a plan for future care or treatment. This information,
often referred to as your health or medical record,
serves as a:
• Basis for planning your care and treatment;
• Means of communication among the many health
professionals who contribute to your care;
• Legal document describing the care you received;
• Means by which you or a third-party payer can
verify that services billed were actually provided;
• A tool in educating heath professionals;
• A source of data for medical research;
• A source of information for public health
officials charged with improving the health of this
state and the nation;
• A source of data for our planning and marketing;
• A tool with which we can assess and continually
work to improve the care we render and the outcomes we
achieve.
Your Health
Information Rights
Although your health record is the
physical property of Surgical Specialists P. C., the
information belongs to you. You have the right to:
• Obtain a paper copy of this notice of information
practices upon request;
• Inspect and copy your health record as provided
for in 45 CFR 164.524;
• Amend your health record as provided in 45 CFR
164.528;
• Obtain an accounting of disclosures of your
health information as provided in 45 CFR 164.528;
• Request communications of your health information
by alternative means or at alternative locations;
•
Request a restriction on certain uses and
disclosures of your information as provided by 45 CFR
164.522, and
• Revoke your authorization to use or disclose
health information except to the extent that action has
already been taken.
Our
Responsibilities
Surgical Specialists, P. C. is
required to:
• Maintain the privacy of your health information;
• Provide you with this notice as to our legal
duties and privacy practices with respect to information
we collect and maintain about you;
• Abide by the terms of this notice;
• Notify you if we are unable to agree to a
requested restriction, and
• Accommodate reasonable requests you may have to
communicate health information by alternative means or
at alternative locations.
We reserve the right to change our
practices and to make the new provisions effective for
all protected health information we maintain.
Should our privacy notice change, we will mail a
revised notice to the address you’ve supplied us, or if
you agree, we will email the revised notice to you.
We will not use or disclose your
health information without your authorization, except as
described in this notice.
We will also discontinue to use or disclose your
health information after we have received a written
revocation of the authorization according to the
procedures included in the authorization.
For More
Information or to Report a Problem
If you have questions and would like
additional information, you may contact the practice’s
Privacy Officer, who is the Director of Operations at
(610) 527-8757, or the office manager at the site you
were seen: at the Bryn Mawr office - (610) 527- 1185; at the Paoli
and Collegeville offices - (610) 647-3077, and (610) 436-6696 or
(610) 436-6529 at our West Chester and West Grove locations.
If you believe your privacy rights
have been violated, you can file a complaint with the
practice’s Privacy Officer, or with the Office for Civil
Rights, U.S. Department of Health and Human Services.
There will be no retaliation for filing a complaint with
either the Privacy Officer or the Office for Civil
Rights. The
address for the OCR is: Office for
Civil Rights ,U.S. Department of Health and Human
Services, 200 Independence Avenue, S.W. , Room 509F,
HHH Building, Washington, D.C. 20201.
Examples of
Disclosures for Treatment, Payment and Health Operations
We will use your
health information for treatment.
For example:
Information obtained by a nurse, physician, or other
member of your health care team will be recorded in your
record and used to determine the course of treatment
that should work best for you. Your physician will
document in your record his or her expectations of the
members of your health care team. Members of your health
care team will then record the actions they took and
their observations. In that way, the physician will know
how you are responding to treatment. We will also
provide your physician or a subsequent health care
provider with copies of various reports that should
assist him or her in treating you once you are
discharged from our care.
We will use your
health information for payment.
For example:
A bill may be sent to you or a third-party payer. The
information on or accompanying the bill may include
information that identifies you, as well as your
diagnosis and procedures performed.
We will use your
health information for regular health operations.
For example:
Members of the risk or quality improvement team may
access your health record to assess the care and
outcomes in your case and others like it. This
information will then be used in an effort to
continually improve the quality and effectiveness of the
healthcare and service we provide.
Business
associates: There are some services provided in our
organization through contacts with business associates.
Examples include radiological technicians,
transcriptionists, records’ management services, etc.
When these services are contracted, we may disclose your
health information to our business associate so that
they can perform the job we’ve asked them to do and bill
you or your third-party payer for services rendered. To
protect your health information, however, we require the
business associate to appropriately safeguard your
information.
Communication with
family: Health professionals, using their best
judgment, may disclose to a family member, other
relative, close personal friend or any other person you
identify, health information relevant to that person’s
involvement in your care or payment related to your
care.
Research: We
may disclose information to researchers when their
research has been approved by an institutional review
board that has reviewed the research proposal and
established protocols to ensure the privacy of your
health information.
Marketing: We
may contact you to provide appointment reminders or
information about treatment alternatives or other
health-related benefits and services that may be of
interest to you.
Workers
compensation: We may disclose health information to
the extent authorized by and to the extent necessary to
comply with laws relating to workers compensation or
other similar programs established by law.
Public health:
As required by law, we may disclose your health
information to public health or legal authorities
charged with preventing or controlling disease, injury,
or disability.
Law enforcement:
We may disclose health information for law enforcement
purposes as required by law or in response to a valid
subpoena.
Notice of Privacy Policies:
Effective April 14, 2003, Revised January 15,
2005, Revised January 15, 2007, Revised October 1, 2009,
Revised January 26, 2010,Revised February 18, 2011.
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