Understanding what is in your record and how your
health information is used helps you to:
• ensure its accuracy
• better understand who, what, when, where,
and why others may access your health information
• make more informed decisions when authorizing
disclosure to others
Your Health Information Rights
Although your health record is the physical property
of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:
• request a restriction on certain uses and
disclosures of your information
• obtain a paper copy of the notice of information
practices upon request
• inspect and obtain a copy of your health
record
• amend your health record
• obtain an accounting of disclosures of your
health information
• request communications of your health information
by alternative means or at alternative
• locations revoke your authorization to use
or disclose health information except to the extent that action has already been taken
Our Responsibilities
This organization is required to:
• maintain the privacy of your health information
• provide you with a 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
• accommodate reasonable requests you may
have to communicate health information by alternative means or at alternative locations.
We will not use or disclose your health information
without your authorization, except as described in this notice.
If you believe your privacy rights have been violated,
you can file a complaint with our Privacy Contact or with the Secretary of Health and Human Services. There will be no retaliation
for filing a complaint. You may contact our Privacy Contact, Andy Scolnick at (215) 396-2450 for further information about
the complaint process.
Examples of Disclosures for Treatment, Payment and
Health Operations
We will use your health information for treatment.
For example: Information obtained by a therapist
or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that
should work best for you. We may provide your physician or a subsequent healthcare provider with copies of various reports
that should assist him or her in treating you.
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,
procedures, and supplies used.
We will use your health information for regular
health operations.
For example: Members of our quality improvement
team may use information in 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:
Notification:
Communication with family:
Research:
Funeral directors:
Organ procurement organizations:
Marketing:
Fund raising:
Food and Drug Administration (FDA):
Workers compensation:
Public health:
Correctional institution:
Law enforcement:
Federal law makes provision for your health information
to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force
member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional
or clinical standards and are potentially endangering one or more patients, workers or the public.
This notice was published and becomes effective
on April 14, 2003.
We may disclose health information for law enforcement
purposes as required by law or in response to a valid subpoena. Should
you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary
for your health and the health and safety of other individuals. 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. 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. We
may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product
defects, or post marketing surveillance information to enable product recalls, repairs, or replacement. We may contact you as part of a fund-raising effort. 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. Consistent
with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the
procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant. We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
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. 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. We may use or disclose information to notify
or assist in notifying a family member, personal representative, or another person responsible for your care, your location,
and general condition. There are some services provided
in our organization through contacts with business associates. Examples include our billing service and a copy service we
use when making copies of your health record. 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.
