HIPAA NOTICE OF PRIVACY
PRACTICES
This Notice is to inform you about how your Protected
Health Information (PHI) may be used and disclosed by Prospectus Berco and
how you can obtain access to this information.
Please read this Notice carefully. Your privacy rights
are important to us.
Effective Date: 04/14/2003
Legal Requirements
Prospectus Berco is required by federal and
state law to maintain the confidentiality of your private health
information. Under the Health Insurance Portability and Accountability Act
of 1996 (HIPAA), we are also required to provide this Notice of our privacy
practices, our legal responsibilities, and your rights regarding your
private health information. Prospectus Berco is required to follow the
practices listed in this Notice.
This Notice may change at any time,
consistent with prevailing federal and state laws. New notices will be
posted, when changed, and will be made available upon request. If you have
any questions about the provisions contained within this Notice, please call
(610) 372-4637 to speak with the HIPAA Privacy Official.
How do we use and disclose your health
information?
Prospectus Berco uses and discloses your
Protected Health Information (PHI) for treatment, payment, and health care
operations in compliance with HIPAA. Specific examples of permitted uses
and/or disclosures of your PHI include the following:
Treatment
Prospectus Berco may use or disclose your
Protected Health Information (PHI) to a behavioral or physical health care
provider who will be providing treatment to you. We may also use or
disclose PHI to members of your interdisciplinary team for the development
and evaluation of treatment plans. PHI may be disclosed to support staff
and volunteers for the purposes of implementing your treatment plan.
Payment
Prospectus Berco may use or disclose your
Protected Health Information (PHI) to obtain payment for services provided
by us.
Health Care Operations
Prospectus Berco may use or disclose your
Protected Health Information ( PHI) during the course of our internal
operations for purposes including but not limited to licensing, training,
and risk management.
Emergency Notification
Prospectus Berco may use or disclose your
Protected Health Information (PHI) in the event of a medical emergency to
obtain treatment consistent with the medical emergency and to notify a
family member or other person responsible for your care in the event of a
medical emergency. Such use or disclosure will be limited to the minimum
necessary to obtain specific treatment or notification, or as authorized by
you.
Health, Safety, Welfare
Employees of Prospectus Berco are “mandated
reporters.” As such, we are required by law to report suspected abuse,
neglect, domestic violence, or other incidents defined by the PA Department
of Public Welfare which are potentially harmful to your health, safety, and
welfare. We report suspected abuse, neglect, domestic violence, or
incidents potentially harmful to your health, safety, and welfare to the
appropriate authorities.
What are your rights?
Access Rights
With limited exception, you have the right to
view your Protected Health Information (PHI). We reserve the right to
charge a reasonable fee to cover our costs related to providing you access
to your PHI. Requests to view your PHI or to receive a summary or
explanation of your PHI may be made to a management employee.
Required by Law
Prospectus Berco may use or disclose your
Protected Health Information (PHI) when required to do so by law. Specific
examples include but are not limited to: response to a subpoena or court
order and matters of national security.
Authorization for Release of Information
Except as required by law, we will not
release your Protected Health Information (PHI) to a third party without a
duly executed Authorization, in accordance with Prospectus Berco’s
Confidentiality Policy. You may rescind such Authorization at any time for
any reason.
Disclosure Rights
You have the right to be informed of those
instances in which your Protected Health Information (PHI) was used or
disclosed without your consent or authorization for purposes other than
those outlined in this Notice. In such instances, and at your request,
Prospectus Berco will notify you, in writing, of such use or disclosure and
will further outline the steps taken to mitigate and resolve such use or
disclosure.
Amendment Rights
You have the right to request amendment to
your Protected Health Information (PHI). Requests must be made in writing
and contain the specific information for which amendment is requested and
the reason for the requested amendment. Requests should be made to the
Privacy Official. PHI that was not created by Prospectus Berco or is
accurate and complete as determined by the Privacy Official will not be
amended.
Marketing
Prospectus Berco will not use your Protected
Health Information (PHI) for marketing or public relations without your
authorization.
Intimidation and Retaliation
Prospectus Berco will not refuse to provide
treatment, refuse to arrange for treatment, nor will we intimidate or
retaliate against any individuals exercising their rights under HIPAA or as
outlined in this Notice.
Questions and Complaints
If you have any questions about this Notice
or about our Privacy Practices, please contact us by calling (610) 372-4637
and requesting to speak to the HIPAA Privacy Official, or by writing to us
at the address at the top of this Notice, Attention: HIPAA Privacy
Official. Alternatively, you may click on the following link to send an
electronic mail (e-mail) message:
HIPAA Privacy Official.
A formal written complaint may be registered
using the same contact information as above if you have any concerns about
your privacy rights, or feel that we have violated them, or you disagree
with a decision regarding access to your Protected Health Information (PHI).
You also may submit a written complaint to the U.S. Department of Health
and Human Services. We will provide you the address to file your complaint
upon request. In compliance with the Intimidation and Retaliation
provisions of this Notice, Prospectus Berco will take no deleterious actions
against any person exercising their rights by contacting the U.S. Department
of Health and Human Services.
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