Please review carefully. You may request a copy of our notice at any time. For more information about our privacy practices or additional copies of this notice, please get in touch with us using the information listed at the end of this notice.
We are required by law to maintain the privacy of protected health information, provide individuals with notice of our legal duties and privacy practices regarding protected health information, and notify affected individuals following a breach of unsecured protected health information. We must follow the privacy practices described in this notice while it is in effect. This notice takes effect 10.1.2022 and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by applicable law, and to make new Notice provisions effective for all protected health information we maintain. When we make a significant change in our privacy practices, we will change this notice and post the new notice clearly and prominently at our practice location. We will provide copies of the further information upon request.
We may use and disclose your health information for different purposes, including treatment, payment, and health care operations. We have provided a description and an example for each of these categories. Some information, such as HIV-related information, genetic information, alcohol and/or substance abuse records, and mental health records, may be entitled to special confidentiality protections under applicable state or federal law. We will abide by these special protections as they pertain to relevant cases involving these records.
We may use and disclose your health information for your treatment. For example, we may disclose your health information to a specialist providing treatment to you.
We may use and disclose your health information to obtain reimbursement for the treatment and services you receive from us or another entity involved with your care. Payment activities include billing, collections, claims management, and determinations of eligibility and coverage to obtain payment from you, an insurance company, or another third party. For example, we may send claims to your dental health plan containing certain health information.
We may use and disclose your health information in connection with our healthcare operations. For example, healthcare operations include quality assessment and improvement activities, training programs, and licensing activities.
We may disclose your health information to your family or friends or any other individual identified by you when involved in your care or the payment for your care. Additionally, we may disclose information about you to a patient representative. If a person has the authority by law to make health care decisions for you, we will treat that patient representative the same way we treat you concerning your health information.
We may use or disclose your health information to assist with disaster relief efforts.
We may use or disclose your health information when we are required to do so by law.
If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may disclose health information in response to subpoenas, discovery requests, or legal processes initiated by a party involved in a dispute. We will only disclose the information if efforts have been made, by the requesting party or our office, to inform you of the request or obtain an order protecting the requested information.
We may disclose your PHI to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
We may release your PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to enable them to carry out their duties.
As permitted by applicable law, we may contact you to provide information about our sponsored activities, including fundraising programs. If you do not wish to receive such information from us, you may opt out of receiving the communications.
We may disclose your health information for public health activities, including disclosures to:
We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose health information required for lawful intelligence, counterintelligence, and other national security activities to authorized federal officials. We may disclose to the correctional institutions or law enforcement officials having legal custody of the protected health information of an inmate or patient.
We will disclose your health information to the Secretary of the U.S. Department of Health and Human Services when required to investigate or determine compliance with HIPAA.
We may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
We may disclose your PHI for law enforcement purposes as permitted by HIPAA, as required by law, or in response to a subpoena or court order.
We may disclose your PHI to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, and credentialing, as necessary for licensure and the government to monitor the health care system, government programs, and compliance with civil rights laws.
You have the right to look at or get copies of your health information, with limited exceptions. You must request it in writing. You may obtain a form to request access using the contact information listed at the end of this notice. You may also request access by sending us a letter to the address at the end of this notice. We may provide photocopies if you request information that we maintain on paper. If you request information that we maintain electronically, you have the right to an electronic copy. We will use the form and format you request if readily producible. We will charge you a reasonable cost-based fee for the cost of supplies and labor of copying, and the postage if you want copies mailed. Contact us using the information listed at the end of this notice to explain our fee structure.
If you are denied an access request, you have the right to have the denial reviewed per the requirements of applicable law.
Except for certain disclosures, you have the right to receive an accounting of disclosures of your health information under applicable laws and regulations. To request an accounting of disclosures of your health information, you must submit your request in writing to the Privacy Official. If you request this accounting more than once in 12 months, we may charge you a reasonable, cost-based fee for responding to the additional requests.
You have the right to request additional restrictions on our use or disclosure of your PHI by submitting a written request to the Privacy Official. Your written request must include (1) what information you want to limit, (2) whether you want to limit our use, disclosure, or both, and (3) to whom you want the limits to apply. We are not required to agree to your request except when the disclosure is to a health plan for carrying out payment or health care operations. The information pertains solely to a health care item or service for which you, or a person on your behalf (other than the health plan), has paid our practice in full.
You have the right to request that we communicate with you about your health information by alternative means or at alternative locations. You must make your request in writing. Your request must specify the alternative means or location and provide a satisfactory explanation of how payments will be handled under the alternative means or location you request. We will accommodate all reasonable requests. However, if we cannot contact you using the ways or locations you asked for, we may contact you using our information.
You have the right to request that we amend your health information. Your request must be in writing and explain why we should amend the information. We may deny your request under certain circumstances. If we agree to your request, we will amend your record(s) and notify you of such. If we deny your request for an amendment, we will provide you with a written explanation of why we denied it and explain your rights.
You will receive notifications of breaches of your unsecured protected health information as required by law.
You may receive a paper copy of this notice upon request, even if you have agreed to receive this notice electronically on our Web site or by electronic mail (e-mail).
Don't hesitate to contact us if you want more information about our privacy practices or have questions or concerns.
1191 Eichelberger Street
Hanover, PA 17331
409 Main St
Reisterstown, MD 21136
If you are concerned that we may have violated your privacy rights, or if you disagree with a decision we made about access to your health information, or in response to a request you made to amend or restrict the use or disclosure of your health information or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this notice. You also may submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.
We support your right to the privacy of your health information. We will not retaliate in any way if you file a complaint with the U.S. Department of Health and Human Services or us.