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PRIVACY POLICY
Collection of information through this
Web site:
Any personal information we collect about you from this Web
site, including but not limited to, your name, address, phone number, and e-mail
address is held in the strictest confidence. Your personal information will not be given
or sold to any other parties for marketing or soliciting purposes. Your personal
information may be given to other health care providers only if it is necessary
as part of your treatment and would be done so according to the "Notice of
Privacy Practices" stated below:
NOTICE OF PRIVACY PRACTICES
Hearing & Ear Care
Center Hearing & Ear Care Center
806 W. Main
Street 200 Schneider Dr.. Suite 1
Mount Joy, PA
17552 Lebanon, PA 17046 717.653.6300
717.274.3851
EFFECTIVE: April
14, 2003
THIS NOTICE DESCRIBES HOW
MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
OBTAIN ACCESS TO YOUR MEDICAL INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice describes the practices of Hearing & Ear Care Center in
connection with the use and disclosure of your medical information and
your rights and certain obligations we have regarding the use and
disclosure of your medical information. It applies to the audiologists
within our practice who are involved in your care and/or are authorized to
enter information into your medical records, and all of our employees,
staff and other personnel working in our offices. We are required by law
to maintain the privacy of your medical information and to provide you
with this notice describing our privacy practices. We are required to
abide by the terms of this notice as it is modified from time to time.
WE MAY MAKE CHANGES TO THIS NOTICE IN THE FUTURE, AND ANY OF THE TERMS
OF THIS NOTICE THAT ARE CHANGED WILL APPLY TO ALL OF YOUR MEDICAL
INFORMATION. IF WE CHANGE OUR NOTICE, YOU MAY OBTAIN A COPY OF THE REVISED
NOTICE BY REQUESTING IT IN PERSON AT ANY OF OUR OFFICES OR BY SENDING A
WRITTEN REQUEST FOR A COPY TO OUR PRIVACY OFFICER AT THE ABOVE ADDRESS.
HOW WE MAY USE OR
DISCLOSE YOUR MEDICAL INFORMATION
We are permitted or required
to use your medical information for various purposes. We cannot describe
every possible use or disclosure of your medical information in this
notice. However uses or disclosures that we are permitted or required to
make will generally fall within one of the following categories:
For Treatment: We may use and disclose medical information about
you in order to ensure that you receive proper medical treatment. For
example, we may disclose your health information to another physician or
health care provider involved in your care.
For Payment:
We may use and disclose medical information about you so that we obtain
payment for the treatment and services we provide to you from you, an
insurance company or another third party. For example, we may need to give
your health insurance plan information about your diagnosis and a
description of the care that we provided to you in order to receive
payment for your care.
For Health Care Operations: We may use and disclose medical
information about you for our health care operations. Health care
operations are activities that are necessary to run our offices, maintain
licensure, and to make sure that our patients receive quality care,
services and products. For example, we may use your medical information to
review our treatment of you and the services we provided and to evaluate
the performance of our staff in caring for you.
Appointment Reminders/Order Status: We may contact you or your
personal representative with a reminder postcard or telephone message that
it is time for you to call our office and schedule an appointment. We may
also contact you by telephone with regard to the status of your hearing
aid, earmold, repair or assistive device order.
Treatment Alternatives: We may tell you about or recommend possible
treatment options or alternatives that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care: We may
discuss your medical care with family members or close personal friends
who are involved in your medical care or payment for that care. You have
the right to restrict or refuse any of these uses or disclosures.
As Required By Law: We will disclose medical information about you
when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety: We may use and
disclose medical information about you when necessary to prevent a serious
threat to your health and safety or the health and safety of the public or
another person. Any disclosure, however, would only be to someone able to
help prevent the threatened harm.
Workers’ Compensation: We may release medical information about you
for workers’ compensation or similar programs that provide benefits for
work related injuries or illness as required or permitted by law if you
are injured at work.
Health Oversight Activities: We may disclose your medical
information to a health oversight agency such as licensing boards for
activities authorized by law.
Lawsuits and
Disputes: We may disclose
medical information about you in response to a court or administrative
order, a subpoena, discovery request or other lawful process, but only if
efforts have been made to tell you about the request or to obtain an order
protecting the information requested.
Law Enforcement: Under certain circumstances, we may release
medical information about you if asked to do so by a law enforcement
official.
Government Purposes: We may release your medical information under
limited circumstances if you are a member of the armed forces or foreign
military personnel, or for intelligence, counter intelligence and other
national security activities authorized by law.
Incidental Uses and Disclosures: We may use or disclose your
medical information if it is a by-product of any of the uses or
disclosures described above and it could not be reasonably prevented.
Limited Data Sets: We may use or disclose certain information that
does not directly identify you for research, public health or health care
operations if the recipient of that information agrees to protect the
information.
DISCLOSURES WITH
YOUR AUTHORIZATION
We must obtain your
authorization to use or disclose health information in those situations
not otherwise described in this Notice. If you do authorize us to use or
disclose your medical information, you have the right to revoke that
authorization at anytime.
YOUR RIGHTS IN
CONNECTION WITH YOUR MEDICAL INFORMATION
You have the following
rights in connection with the medical information we maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy
your medical information that is in our possession. You may not, however,
have access to information that is put together for use in a civil,
criminal or administrative proceeding.
To inspect or copy your medical information, you must submit your request
in writing to our corporate office. If you request a copy of the
information, we may charge a fee for the costs of copying, mailing or
other supplies associated with your request.
We may deny your request to inspect or copy your health information in
certain very limited circumstances. If you are denied access to your
medical information, you may be able to request that the denial be
reviewed.
Right to Request Amendment: If you feel that your medical
information is incorrect or incomplete, you may ask us to amend that
information. You have the right to request an amendment for as long as the
information is kept by or for our office. To request an amendment, your
request must be made in writing and submitted to our corporate office. You
must explain why you believe that the medical information is incorrect or
incomplete. If we deny your request, you have a right to give us a short
statement to be placed with you medical information or to have us include
your request for amendment with your medical information.
Right to an Accounting of Disclosures: You have the right to
request, and we must provide you with a list of certain disclosures of
your medical information. We are not required to include on that,
disclosures to carry out your treatment, payment for your care, and other
health care operations and certain other disclosures. To request this list
or accounting of disclosures, you must submit your request in writing to
our office.
Your request must state a time period covered by your request. That time
period may not be longer than six years and may not include dates before
April 14, 2003. Your request should indicate in what form you want the
list (for example on paper or electronically). The first list you request
within a 12-month period will be free. For additional lists, we may charge
you for the costs of providing the list. We will notify you of the cost
involved and you may choose to withdraw or modify your request at that
time before any costs are incurred.
Right to Request Additional Privacy Protections: You have the right
to request additional restrictions from those detailed in this notice.
Your request must be submitted in writing to our corporate office. We are
not required, however, to agree to your request.
Right to Request Confidential Communication: You have the right to
request that we communicate with you about medical matters in a certain
way or at a certain location. For example, you can ask that we only
contact you at work or by mail. Your request must specify how or where you
wish to be contacted. To request confidential communications, you must
make your request in writing to our corporate office. We will not ask you
the reason for your request and we will accommodate all reasonable
requests.
Right to a Paper Copy of this Notice: You may ask us to give you a
copy of this notice at any time by asking for it in person or in writing.
Even if you have agreed to receive this notice electronically, you are
still entitled to a paper copy of this notice.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a
complaint with us or with the Secretary of the United States Department of
Health and Human Services. To file a complaint with us, contact our office
in writing. You will not be penalized for filing a complaint.
If you have any questions about this notice, please contact our office
at the address listed above.
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