Privacy Policy

NOTICE OF PRIVACY PRACTICES

Effective Date of Notice: April 14, 2003.  As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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.

Summary  

We are required by law to maintain the privacy of your Protected Health Information (“PHI”).  PHI is personal information about you, including demographic information that we collect from you, that may be used to identify you and relates to your past, present or future physical or mental health or condition, including treatment and payment for the provision of healthcare.

This Notice explains our legal duties and privacy practice with regard to your PHI. We are required by federal law to provide you with a copy of this Notice and to abide by the terms of this Notice.  Accordingly, we will ask you to sign a statement acknowledging that we have provided you with a copy of the Notice. If you have elected to receive a copy electronically, you still have the right to obtain a paper copy upon request.

We reserve the right to change the terms of this Notice at any time.  The change may be retroactive and cover PHI that we received or created prior to the revision.  If we do change the Notice, a copy of the new Notice will be posted in the waiting room and on our website, if any.  We will provide you with a copy of the revised Notice upon your request.

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I.  PATIENT RIGHTS  

You have six rights as a patient of Cardiology Consultants of Philadelphia, P.C.:

1. The right to consider and sign an authorization for a non-authorized use. 
The law only allows us to use or disclose your PHI in certain circumstances, as explained more fully below.  If we need to make a use or disclosure that does not fall into one of those exceptions–including the disclosure of immunization records to schools or results of work physicals to employers–we will ask you to sign an authorization. 

If we do not have a valid authorization on file specifically authorizing the proposed use or disclosure, then we will not make that use or disclosure.  You may revoke an authorization at any time in writing, but the revocation will not apply to uses or disclosures we have already made in reliance on your original authorization.

2. The right to access your PHI. 
You have a right to access and receive a copy, summary or explanation of your PHI.  If you want to exercise this right, please ask one of our employees for a Request to Access Medical Records form.  You will need to complete this for and submit it to us. 

This right does not extend to psychotherapy notes, information compiled in reasonable anticipation of legal action and confidential information relating to certain lab tests.  We have the right to deny you access, but you will be notified of the reason for denial and be given the right to have the denial reviewed under certain circumstances.

3. The right to request restrictions on certain uses and disclosures.
You may request restrictions of uses or disclosures of your PHI when it is used to carry out your treatment, obtain payment for your treatment or perform healthcare operations of our practice. You must request the restriction before we have used or disclosed the relevant information. We are not required to agree to the restriction, and we have the right to decide not to accept the restriction and not to treat you.

4. The right to receive confidential communications.
You may request that we make confidential communications to you by an alternative means or at an alternative location. The request must be in writing, but we will not ask for an explanation from you. We will accommodate reasonable requests, but we may condition the accommodation on information as to how payment, if any, will be handled and specification of an alternative address or other method of contact.

5. The right to amend PHI. 
You have the right to ask us to amend your PHI.   If you want to exercise this right, please ask one of our employees for a Request for Amendment of Medical Records form.  You will need to complete this form, provide a reason for the request and submit it to us.  We have the right deny your request for amendment, if we determine that your record was not created by us, is not maintained by us, would not be available for access, or is accurate and complete.

Your records will not be changed or deleted as a result of our granting your request, but the amendment will be attached to your record and its existence noted in your record as necessary. (Note: use of this procedure is not necessary for routine changes to your demographic information, such as address, phone number, etc.).

6. The right to receive an accounting. 
You have the right to receive an accounting of our uses and disclosures of your PHI.  If you want to exercise this right, please ask one of our employees for a Request for Accounting form.  You will need to complete this form and submit it to us. 

The accounting does not have to list disclosures made (i) to carry out treatment, payment and healthcare operations; (ii) to you; (iii) pursuant to an authorization; (iv) for national security or intelligence purposes; (v) to correctional institutions or law enforcement personnel or (vi) that occurred prior to April 14, 2003. (Note: compliance with this right is time-consuming, and so we reserve the right to charge you a fee if you request more than one accounting in a twelve-month period.)

II.   USES AND DISCLOSURES  

We intend to limit the disclosure of your PHI to that necessary for Treatment, Payment and Operations: 

We will not permit the following disclosures without your written authorization, and your refusal to provide such authorization will not affect our duty to treat you:

We may make disclosures in certain situations as required by law, even without your written authorization.  These situations include, but are not limited to: 

 

III.   ORGANIZATIONAL POLICIES  

To facilitate the smooth and efficient operation of our practice, we engage in certain practices and policies that you should understand.  You can avoid any of the following practices by discussing your concerns with us and working out an alternative: 

You should also be aware of the following policies regarding our uses and disclosures of your PHI.  You cannot avoid these uses and disclosures, but you should discuss any questions or concerns you might have with us: 

 

IV.   QUESTIONS AND COMPLAINTS  

If you have any questions about this Notice, the matters discussed herein or anything else related to our privacy policy, please feel free to ask for an appointment or call

- Privacy and Security Officer
- (215) 479-4103

You may complain to our Privacy and Security Officer or the United States Secretary of Health and Human Services if you believe your privacy rights have been violated.  To complain to the Secretary, your complaint must be in writing, name us, describe the acts or omissions believed to be in violation of your privacy rights and be filed within 180 days of when you knew or should have known that the act or omission occurred.

You can file a complaint with us by asking for a Complaint Reporting Form.  We will not retaliate against you for filing a complaint.  If you want further information about the complaint process, please talk to our Privacy and Security Officer.