At Pediatric Associates of Conn., PC we are committed to treating and using protected health information about you responsibly. This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This Notice is effective 3/25/2021, and applies to all protected health information as defined by federal regulations, and has been amended effective 3/25/2021.
Understanding Your Health Record/Information
Each time you visit Pediatric Associates of Conn., PC a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often is referred to as your health or medical record, serves as a:
- Basis for planning your care and treatment
- Means of communication among the many health professionals who contribute to your care
- Legal documentation describing the care you received
- Means by which you or a third party payer can verify that services billed were actually provided
- A tool in educating health professionals
- A source of data for medical research
- A source of information for public health officials charged with improving the health of this state and the nation
- A source of data for our planning and marketing
- A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve
Understanding what is in your record and how your health information is used helps you to endure accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.
Your Health Information Rights:
Although your health record is the physical property of Pediatric Associates of Conn., PC, the information belongs to you. You have the right to:
- Obtain a paper copy of this notice of information practices upon request
- Inspect (by appointment only) and request a copy of your health record as provided for in 45 CFR 164.524
- Amend your health record as provided in 45CFR 164.528
- Obtain an accounting of disclosures of your health information
- Request communications of your health information
- Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.552 especially with regards to any psychotherapy notes
- Revoke your authorization to use or disclose health information except to the extent that action has already been taken
- Opt out fund raising communication
- Pay for medical service in full and request in writing that you insurance company NOT be notified of your visit. Request must be very specific with regards to what information should NOT be released and which date of serviced is bring referenced.
Pediatric Associates of Conn., PC is required to:
- Maintain the privacy of your health information
- Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
- Abide by the terms of this notice
- Notify you if we are unable to agree to a requested restriction
- Accommodate reasonable requests you may have to communicate health information
- Notify you in writing of any breach in protected information
We reserve the right to change our practices and to make provision effective for all protected health information we maintain.
We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.
The complete HIPAA
For More Information or to Report a Problem:
If you have questions and would like additional information, you may contact the President of the practice at 203-755-2999.
If you believe your privacy rights have been violated, you can file a complaint with the practice’s President, or with the Office of Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
Examples of Disclosures for Treatment, Payment & Health Operations:
We will use your health information for treatment.
For example: Information obtained by a nurse, physician or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.
We will use your health information for payment.
For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health operations.
For example: Members of the medical staff may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.
There are some services in our organization through contacts with business associates. Examples include physician services in the emergency department, radiology, and certain laboratory tests. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third payer for services rendered. To protect your health information, however we require the business associate to appropriately safeguard your information.
We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
We may contact you to provide appointment reminders or information about treatment alternatives or health related services, which may be of interest to you.
Food and Drug Administration
We may disclose FDA health information relative to adverse events with respect to food, supplements, product and product defects.
As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associates believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.