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.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment,
payment or health care 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 information 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.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The
new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you
with any revised Notice of Privacy Practices. You may request a revised version by accessing our website, or calling the office and
requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
1. Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office who
are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information
may also be used and disclosed to pay your health care bills and to support the operation of your physician’s practice.
Following are examples of the types of uses and disclosures of your protected health information that your physician’s office is
permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made
by our office.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any
related services. This includes the coordination or management of your health care with another provider. For example, we would
disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose
protected health information to other physicians who may be treating you. For example, your protected health information may be
provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat
you. In addition, we may disclose your protected health information from time-to-time to another physician or health care provider
(e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with
your health care diagnosis or treatment to your physician.
Payment: Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services
provided by us or by another provider. This may include certain activities that your health insurance plan may undertake before it
approves or pays for the health care services we recommend for you such as: making a determination of eligibility or coverage for
insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For
example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health
plan to obtain approval for the hospital admission.
Health Care Operations: We may use or disclose, as needed, your protected health information in order to support the business
activities of your physician’s practice. These activities include, but are not limited to, quality assessment activities, employee review
activities, training of medical students, licensing, fundraising activities, and conducting or arranging for other business activities.
We will share your protected health information with third party “business associates” that perform various activities (for example,
billing or transcription services) for our practice. Whenever an arrangement between our office and a business associate involves the
use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy
of your protected health information.
We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives
or other health-related benefits and services that may be of interest to you. You may contact our Privacy Officer to request that these
materials not be sent to you.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree or
Object.
We may use or disclose your protected health information in the following situations without your authorization or providing you the
opportunity to agree or object. These situations include:
Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by
law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You
will be notified, if required by law, of any such uses or disclosures.
Public Health: We may disclose your protected health information for public health activities and purposes to a public health
authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of
preventing or controlling disease, injury or disability.
Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been
exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Admin Number - PSHAdmin - 013
Expiration Date 1/1/2025
225 Wilmington West Chester Pike,
Glen Mills, PA 19342
225 Wilmington-West Chester
Pike Chadds-Ford PA 19317-9011