|
Click here to
Print
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 office and Collegeville offices
- (610) 647-3077, and (610) 436-6696 or (610) 436-6529
at our West Chester, Kennett Square and Lionville
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 |
