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, please contact our Privacy office at the address or phone number at the bottom of this notice.
This Notice of Privacy describes how we may use and disclose your protected health information to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
Pediatric Healthcare Associates provides health care to our patients in partnership with physicians and other professionals and organizations. The information privacy practices in this notice will be followed by:
We understand that medical information about you is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive to provide quality care and to comply with legal requirements. This notice applies to all of the records of your care that we maintain, whether created by facility staff or your personal doctor. We are required by law to:
We may use and disclose medical information about you for treatment. Such as:
We may use and disclose medical information about you to support our health care operations. Such as:
We may use and disclose medical information about you to contact you as a reminder that you have an appointment for medical services. We may use and disclose medical information to you to tell you about possible treatment options or alternatives that may be of interest to you. We may use and disclose medical information to you to mail you a letter telling you of normal laboratory testing results. We may use or disclose medical information about you without your prior authorization for several other reasons. Subject to certain requirements, we may give out medical information about you without prior authorization for public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements, workers’ compensation purposes, required by military command authorities and emergencies. We also disclose medical information when required by law, such as in response to a request from law enforcement in specific circumstances, or in response to valid judicial or administrative orders.
We may disclose medical information about you to a caregiver or family member who is involved in you medical care, or to disaster relief authorities so that your family can be notified of your location and condition.
In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing medical information about you. If you chose to authorize use or disclosure, you can later revoke that authorization by notifying us in writing of your decision.
In most cases, you have the right to look at or get a copy of medical information that we use to make decisions about your care, when you submit a written request. If you request copies, we may charge a fee for the cost of copying, mailing or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for a review of that decision.
If you believe that information in your record is incorrect or if Important information is missing, you have the right to request that we correct the records, by submitting a request in writing that provides your reason for requesting the amendment. We could deny your request to amend a record if the information was not created by us; if it is not part of the medical information maintained by us; or if we determine that record is accurate. You may appeal, in writing, a decision by us not to amend a record.
You have the right to a list of those instances where we have disclosed medical information about you, other than for treatment, payment, health care operations or where you specifically authorized a disclosure, when you submit a written request. The request must state the time period desired for the accounting, which must be less that a 6-year period of starting after April 14, 2003. You will receive the list on paper. The first disclosure list requested in a 12-month period is free other requests will be charged according to our cost of producing the list. We will inform you of the cost before you incur any costs.
You have the right to request that medical information about you be communicated to in a confidential manner, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to use to communicate with you. We will accommodate reasonable requests.
You have the right to request a paper copy of this notice at any time.
You may request, in writing, that we not use or disclose medical information about you for treatment, payment or healthcare operations or to persons involved in your care except when specifically authorized by you, when required by law, or in an emergency, We will consider your request but we are not legally required to accept it. We will inform you of our decision on your request. All written requests or appeals should be submitted to our Privacy Officer listed at the bottom of this notice.
If you are concerned that your privacy rights may have been violated, or you disagree with a decision we made about access to your records, you may contact our Privacy Officer at (814)944-7383.
Finally, you may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights. Our Privacy Officer can provide you the address.
Under no circumstances will you be penalized or retaliated against for filing a complaint.
Please submit your complaint or question in writing and send to:
Pediatric Healthcare Associates
615 6th Avenue
Altoona, PA 16602