We take privacy very seriously.
Advanced Dermatology Associates, LTD
Patient Privacy Notice
Under the HIPAA (Health Insurance Portability and Accountability Act) guidelines, 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. Should you have any questions, please ask for the Compliance Officer/Manager.
Under the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), this notice outlines the policies and procedures of Advanced Dermatology Associates, LTD., regarding the use and disclosure of your Protected Health Information (PHI) and your Electronic Protected Health Information (EPHI). Your PHI/EPHI includes all demographic, insurance and medical information. Advanced Dermatology Associates, LTD is required by law to safeguard your PHI/EPHI and be bound by the terms of this notice unless amended in accordance with the law. Unless specifically allowed by or required under federal law or regulation, the sale of PHI/EPHI is prohibited. In addition, at your sole discretion, you may opt out of any fundraising activities within the practice.
Your PHI/EPHI will be utilized for the purpose of treatment, payment from insurance companies, and general health care operations. Advanced Dermatology Associates, LTD must on occasion release medical information to an insurance company to process the claim. Your signature on the registration form allows Advanced Dermatology Associates, LTD., to disclose this information. If you choose to fully pay for a service out-of-pocket, you can restrict Advanced Dermatology Associates, LTD from disclosure of the service to your health plan. In order to request the release of your PHI/EPHI for other purposes, record release forms must first be signed and dated by you, and then witnessed. In the event that you have a history of substance abuse, mental health problems, sexual abuse, or testing for HIV, whether positive or negative, a separate record release for disclosure of this sensitive PHI/EPHI must be signed, otherwise the information will not be disclosed, as set forth in 45 P.S. 7601 et seq. Genetic information is protected under HIPAA regulations. Pennsylvania law prohibits all healthcare providers from disclosing this information unless reasonable disclosure is medically necessary. As a courtesy to its patients, Advanced Dermatology Associates, LTD uses an automated confirmation system to call patients with a reminder two days prior to an office visit. If you do not wish to receive these calls, office personnel of Advanced Dermatology Associates, LTD will note your request in your electronic chart information. Advanced Dermatology Associates, LTD also sends out recall letters when appointments are to be made in three, six, and twelve-month intervals. If you do not wish to receive these mailings, you have the right to refuse this service. Advanced Dermatology Associates, LTD also notifies patients with pathology results via telephone or by mail. You have the right to place restrictions, by written or verbal requests, on how Advanced Dermatology Associates, LTD communicates regarding these procedures.
You have the right to inspect, amend, and have a copy of your PHI/EPHI. If for any reason it becomes necessary for you to come to Advanced Dermatology Associates, LTD to inspect your records, a private room will be provided to review your chart in paper/electronic format along with an employee of Advanced Dermatology Associates, LTD. The employee will act as a witness and answer any questions. Advanced Dermatology Associates, LTD reserves the right to 30 days’ advance notice of inspection. Advanced Dermatology Associates, LTD has available, at no cost to you, an online secure patient portal for you to view certain portions of your medical records. To do this, you must activate a password-protected patient portal account.
If you have a complaint regarding the safeguarding of your PHI/EPHI by Advanced Dermatology Associates, LTD you may see the receptionist to schedule an appointment with the Compliance Officer/Manager or a Compliance Committee Member. You may contact the Department of Health and Human Services (DHHS) in Philadelphia, PA (215-861-4633), if you have further questions or concerns. Should you wish to remain anonymous, you may send a letter addressed to the Compliance Officer/Manager. There will be no retaliation on any complaints from patients. HIPAA’s HITECH Privacy Act requires all practices to implement the "minimum necessary standard". This simply means that all EPHI and PHI is kept private and secure at all times. Employees of the practice are to use the minimal amount necessary to perform their job tasks. This Act strengthens the privacy and security of health information and is an integral part of the efforts of Advanced Dermatology Associates, LTD to broaden protection of its patients' records. All business associates of Advanced Dermatology Associates, LTD are bound by the Act as well, and are instructed to keep any PHI/EPHI private and secure when coming into contact with it as they perform services.
Breach Disclosures: HIPAA’s Mega-Rule effective March 26, 2013, addresses the PHI/EPHI breach notification policy. If Advanced Dermatology Associates, LTD., has a breach of confidentiality by which PHI/EPHI is compromised, it will follow the steps set forth by DHHS (Department of Health and Human Services) to resolve the matter:
If a patient has demographic and medical information compromised, the patient will be notified by the practice’s Compliance Committee if the practice deems a potential information release threat to that patient. The practice will, as required by regulations, self-report information breaches to DHHS yearly. Advanced Dermatology Associates, LTD., will follow the four step rule in notifying patients: 1. Determine the nature and extent of the disclosed information. For example if there was no breach of social security numbers, credit card or bank account information, such a breach would be defined as a low risk. 2. Investigate who the information was given to and if that person has the ability to access other pertinent information of the compromised patient records. 3. Investigate if the information was acquired or viewed. This could be the case, for example, if a laptop containing PHI/EPHI was stolen. 4. Do a risk analysis on the extent to which risk to the information has already been mitigated and how to mitigate further, if applicable. This four step process will document that the practice contacted the recipient of the PHI/EPHI and received assurance that the information will not be disclosed. As required by regulations, if there is a breach of PHI/EPHI of 500 patients’ records or greater, the practice must publish an announcement in a local newspaper.
You have the right to request a copy of this Privacy Notice, and the receptionist will provide a copy upon your request. Advanced Dermatology Associates, LTD., reserves the right to revise the Privacy Notice at any time. If revisions are made to the Privacy Notice, a copy or amendment of the Privacy Notice will be presented to you, upon your request, at your next visit.
The Compliance Officer/Manager
Advanced Dermatology Associates, LTD
Discrimination is Against the Law
Advanced Dermatology Associates, LTD complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Advanced Dermatology Associates, LTD does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Advanced Dermatology Associates, LTD:
Provides free aid and services to people with disabilities to communicate effectively with us, such as:
Qualified sign language interpreters
Written information in other formats (large print, audio, accessible electronic formats, other formats)
Provides free language services to people whose primary language is not English, such as: Qualified interpreters or information written in other languages.
If you need these services, contact an employee of Advanced Dermatology Associates, LTD
If you believe that Advanced Dermatology Associates, LTD has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: The local Office of Civil Rights or the local Department of Health and Human Services. You can file a grievance with the federal office at: U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 2020, phone: 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
The Compliance Officer/Manager
Advanced Dermatology Associates, LTD
October 1, 2016
Tagline Posting of 15 common languages in Pennsylvania for Non-Discrimination Rule for Section 1557
Language Line: 1-800-821-3420 (TTY: 610-685-4525)
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